Notable 1999 CPT Changes for Ob-Gyn Practices
Published on Sun Nov 01, 1998
The 1999 CPT books have hit the streets,and its time to figure out what applies to the ob/gyn coder.
General Layout and Symbols
Thumbing through the new CPT, you wont notice any huge changes from the 1998 book except for a couple of new symbols and new appendices. The layout is generally the same. There is one notable exception. In the Evaluations and Management (E/M) Guidelines and the Surgery Guidelines sections of the 1998 CPT, a complete list of modifiers for that section appears with full descriptions. In the 1999 CPT, the E/M Guidelines include no modifier descriptions, and the Surgical Guidelines only list seven modifiers with abbreviated descriptions under a section entitled Reporting More than One Procedure/Service. Instead, detailed descriptions for all modifiers appear only in Appendix A.
Because it is the codes themselves that capture revenues, you will want to be aware of additions, revisions and deletions in each section. As in the past, new codes are indicated with the large fat dot l before the code number. Codes with substantial revision have a s in front of the code number, and the symbols appear on either side of new and revised notes. All of the new, revised and deleted codes are listed in Appendix B, which includes 676 changes for 1999. The following highlights the changes most noteworthy to ob/gyn coders, along with notes and comments about these changes from ACOGs Department of Coding and Nomenclature.
E/M Services Guidelines
Attempting to clarify the confusion around the reporting of both an E/M service and a procedure on the same day, the CPT has added two new paragraphs in the section under Levels of E/M Services (CPT 1999, page 3). ACOG comments that, Specifically, CPT has clarified that when the patients condition requires a significant, separately identifiable E/M service that is above and beyond the usual pre-service and post-service care associated with a procedure that was performed at that encounter, both the E/M service (with a modifier -25 added) and the procedure may be reported. The new CPT paragraphs state that different diagnoses are not required for each service as the E/M service may be caused or prompted by the symptoms or conditions for which the procedure and/or service was provided. ACOG poses this example: a patient presents with vaginal bleeding, and following an evaluation of the problem, the physician decides to perform an endometrial biopsy at the same encounter.
Tip: This does not change the rules surrounding reporting CPT starred procedures where an E/M service for an established patient would not be reported in addition to the procedure if that procedure constituted the major service at the encounter.
Preventive Medicine Service Guides
Addressing the question of whether an Office/Outpatient Code can be reported [...]
