Oncology & Hematology Coding Alert

Question: I was looking through the codes for interstitial device placement in the AMA CPT manual index and several entries refer to 49410. I couldn't find it in the tabular list. Is 49410 one of the new resequenced codes located out of numerical order?

Tennessee Subscriber

Answer: No. AMA's errata page indicates you should delete 49410 (which is not a valid CPT code at this time) from the index entry "Placement, Interstitial device, Abdomen." However, it does not suggest a replacement code nor does it address any other 49410 entries in the manual.

Solution: As the descriptor for new code 49411(Placement of interstitial device[s] for radiation therapy guidance [e.g., fiducial markers, dosimeter], percutaneous, intra-abdominal, intra-pelvic [except prostate], and/or retroperitoneum, single or multiple) indicates, 49411 is appropriate for intra-abdominal, intra-pelvic, and retroperitoneal interstitial device placement.

Keeping tabs on manual corrections is essential to proper coding. For AMA publications, go to the AMA Web site, www.ama-assn.org, move your pointer over "Physician Resources," and select "Solutions for Managing Your Practice." In the new page, choose "Coding Billing Insurance," then "CPT," then "About CPT," and finally "Errata." The "Errata" page has links to AMA publication corrections.

Resequenced codes: Your question refers to the new CPT convention of resequenced codes, which involves placing certain codes out of numerical order. The new system uses a # symbol to indicate a code is out of numerical order. The CPT manual includes a note at the location where the code should fall numerically to point you to the actual location of the code and descriptor.

AMA created the convention so that when it adds large groups of new concepts to CPT, there's no need to delete and renumber existing codes. CPT simply lists the new out-of-sequence code(s) with already existing codes for similar procedures. If a code's meaning or intent changes, you still can expect a deleted and renumbered code.

Tip: Check out Appendix N in your CPT manual for a full list of resequenced codes, including tumor excision, voiding exams, and Vitamin D lab codes.