Orthopedic Coding Alert
Changes Marked by New Add-ons, Revised Arthrodesis Codes
Here’s how 99211 will be slightly different next year, too. The AMA has released its 2022 list of additions, revisions, and deletions for the next CPT® code book. For orthopedic coders, it’s going to mean getting used to a few brand-new codes, revisions to a few more codes, and the elimination of a couple more. Breakdown: There are more than 400 new, revised, and deleted codes for 2022; most of them go into effect on Jan. 1, 2022, meaning you have plenty of time to adjust. (Note: All of the codes discussed in this article go into effect Jan. 1, 2022.) Check out this quick rundown on all the CPT® changes you’ll need to know to optimize your orthopedic coding in 2022. Use New Add-ons for Laminectomies The latest CPT® code list includes the following two new codes: Analysis: These codes will be the last two entries in the CPT® section titled: “Posterior Extradural Laminotomy or Laminectomy for Exploration/ Decompression of Neural Elements or Excision of Herniated Intervertebral Discs.” The code set currently ranges from 63001 (Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (eg, for tumor or retropulsed bone fragments); thoracic, single segment) through 63051 (Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments; with reconstruction of the posterior bony elements (including the application of bridging bone graft and non-segmental fixation devices [eg, wire, suture, mini-plates], when performed)). Also: The +63052 and +63053 codes are add-on codes, meaning you must report them in addition to a “primary” code — and cannot ever report them as standalone. Stay tuned for word on which codes you’ll be allowed report with +63052 and +63053 appended. Orthopedic coders will also want to note the following quartet of radiology codes set to debut in 2022: Analysis: These codes round out the CPT® section titled “Bone/Joint Studies.” The code set currently ranges from 77071 (Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated) through 77086 (Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment). Descriptor Tweaks for Language Mark Most Revisions CPT® 2022 also applies some new verbiage to some established code descriptors. These changes might appear superficial, but the AMA doesn’t make changes to descriptors for no reason. Make sure you pay attention to these revisions — no matter how trivial they seem — as a single different word in a code descriptor could mean a world of difference on a claim form: 2021 descriptor: (Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician or other qualified health care professional. Usually, the presenting problem(s) are minimal.) The difference: CPT® 2022 deletes “Usually, the presenting problem(s) are minimal.” 2021 descriptor: (Arthrodesis, posterior or posterolateral technique, single level; cervical below C2 segment) The difference: CPT® 2022 replaces “level” with “interspace.” 2021 descriptor: (Arthrodesis, posterior or posterolateral technique, single level; thoracic (with lateral transverse technique, when performed)) The difference: CPT® 2022 replaces “level” with “interspace.” 2021 descriptor: (Arthrodesis, posterior or posterolateral technique, single level; lumbar (with lateral transverse technique, when performed)) The difference: CPT® 2022 replaces “level” with “interspace.” 2021 descriptor: (Arthrodesis, posterior or posterolateral technique, single level; each additional vertebral segment (List separately in addition to code for primary procedure)) The difference: CPT® 2022 replaces “vertebral segment” with “interspace.” 22633 (Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace; lumbar) 2021 descriptor: (Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; lumbar) The difference: CPT® 2022 deletes “and segment.” 2021 descriptor: (Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; each additional interspace and segment (List separately in addition to code for primary procedure)) The difference: CPT® 2022 deletes “and segment.” 2021 descriptor: (Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; each additional segment, cervical, thoracic, or lumbar (List separately in addition to code for primary procedure)) The difference: CPT® 2022 adds “vertebral” to describe the segment on second reference. 2021 descriptor: (Laminectomy with cordotomy, with section of both spinothalamic tracts, 1 stage; thoracic) The difference: CPT® 2022 replaces the semicolon before “thoracic” with a comma. Say Goodbye to These Laminectomy Codes Be sure to note these code deletions, which will take effect in January: Analysis: These codes will be deleted from the CPT® code section titled “Lateral Extracavitary Approach for Extradural Exploration/Decompression,” which currently includes codes 63101 (Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (eg, for tumor or retropulsed bone fragments); thoracic, single segment) through +63295 (Osteoplastic reconstruction of dorsal spinal elements, following primary intraspinal procedure (List separately in addition to code for primary procedure)).
Related Articles
Orthopedic Coding Alert
- CPT® 2022:
Changes Marked by New Add-ons, Revised Arthrodesis Codes
Here’s how 99211 will be slightly different next year, too. The AMA has released its [...] - ICD-10 2022:
Get to Know the New Dx Codes
… and remember that the codes are in effect before 2022. Last month, we previewed [...] - E/M Coding:
Catch Up With Still-Evolving Office/Outpatient E/M Rules
Here’s why you should keep a lookout for more tweaks to rules. Autumn is almost [...] - You Be the Coder:
Multiple Hip Socket Fractures
Question: Encounter notes indicate that after the orthopedist performed a level-four office evaluation and management [...] - Reader Questions:
Answer Anesthesia Question Before Coding This Fix
Question: Encounter notes indicate that the provider performed closed treatment of the proximal tibiofibular joint. [...] - Reader Questions:
Observe These Rules When Reporting Z03-Z05
Question: Should we report the observation diagnosis codes (Z03-Z05) as primary diagnoses or secondary? Or [...] - Reader Questions:
Walk Straight Coding Line to ID March Fx Dx
Question: Encounter notes indicate that the provider treated a patient with a “march fracture, 2+3 [...]
