Ob-Gyn Coding Alert

New Category III codes rely on Gailrisk score CPT 2004 moves to update its vaccine and toxoids section to more readily reflect today's administration methods and to include a new code for pain pump refilling. Take 99025 Off Your Charge Slip
 
CPT 2004 deletes 99025 (Initial [new patient] visit when starred [*] surgical procedure constitutes major service at that visit). This is CPT's first step to eliminate all "starred" procedures over the next few years. In addition, a new instruction for 99080 (Special reports such as insurance forms, more than the information conveyed in the usual medical communications or standard reporting form) indicates that you should not report this code with the work- related or medical disability evaluation codes 99455 and 99456 because CPT includes the completion of the workers' compensation forms in the service these codes describe.
 
But remember that this is CPT's general version of how the workers' compensation system works, says Terry A. Fletcher, BS, CPC, CCS-P, CCS, CMSCS, a healthcare coding consultant based in Laguna Beach, Calif., and American Academy of Professional Coders (AAPC) National Advisory Board member. "You still need to maintain your state-specific guidelines for this payer. If your state allows you to bill/code differently, then make sure you follow your state rules."
 
CPT revises two other codes in the Miscellaneous Services section:

99024 - Postoperative follow-up visit, normally included in the surgical package, to indicate that an evaluation and management service was performed during a postoperative period for a reason(s) related  to the original procedure
 
99050 - Services requested after posted office hours in addition to basic service.
 
Update Your Vaccine Coding You won't be using 90659 in 2004 because CPT deletes it to reflect the fact that the influenza whole-virus vaccine is no longer manufactured and used. You should be using either 90657 or 90658 for the split-virus influenza vaccine. In addition, there are some new vaccine codes and a revision to established codes (90703-90708, 90718, 90727 and 90733) to delete references to "jet injection" as a mode of delivery.
 
The Vaccines and Toxoids section also includes several new codes for 2004, including:

90698 - Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenza Type B, and   poliovirus vaccine, inactivated (DTaP - Hib - IPV), for  intramuscular use

90715 - Diphtheria, tetanus toxoids, and acellular pertussis vaccine (DTaP), 6 years and younger, for intramuscular use
 
90734 - Tetravalent conjugated meningococcal vaccine (any group[s]), for subcutaneous use Pain Pump Coding Changes for 2004 CPT 2004 adds 95991 (Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal [intrathecal, epidural] or brain [intraventricular]; administered by physician) so that ob-gyns can report refilling and maintaining implantable pumps or reservoirs for drug delivery. The typical patient will be one with severe cancer-related pain, and gynecologic oncologists probably will be using this code most, [...]