Oncology & Hematology Coding Alert
Transitional Care Management and Breast Biopsy May See Code Changes in the New Year
Get a sneak peek at what’s in store for 2014.
You may not have given CPT® 2014 updates much thought yet, but the CPT® Editorial Panel has been working for months on lining up next year’s code revisions. Two updates of interest center around transitional care management and breast biopsy.
Caution: The potential revisions below are listed as “accepted” in the October 2012 and January-February 2013 CPT® Editorial Panel meeting summaries. The actual codes, descriptors, and guidelines won’t be finalized until closer to the time of CPT® 2014’s official publication and are subject to change.
TCM Guidelines Will Match CMS
CPT® 2014 promises to work some of the kinks out of new-in-2013 transitional care management (TCM) codes 99495 and 99496.
The Editorial Panel accepted guideline revisions that will indicate TCM services can apply to new patients. The 2013 CPT® guidelines limit the codes to established patients, but payers such as Medicare already allow the use of the codes for new patients, too. You’ll also get clarifications about reporting discharge services and other E/M services in addition to TCM.
Prepare for Big Changes to Breast Biopsy
You can expect to see CPT® 2014 add 14 codes that will bundle the following:
The new codes will be in the 19XXX range, according to the October summary.
To make room for these new codes, the plan is to delete the following seven codes:
Make the Most of Online CPT® 2014 News
You may access all available Panel Action Summaries from www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/cpt/cpt-summary-panel-actions.page.
The files related to the items above are “2013 Jan-Feb, CPT® Editorial Summary of Panel Actions” and “2012-Oct, CPT® Editorial Summary of Panel Actions.”
There may be more changes to come, too. Actions from the May meeting will be posted this summer.
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