Orthopedic Coding Alert
Arthroplasty, US Highlight Coding Changes
Here’s what you’ll report instead of +0163T in 2023. The AMA has finalized its list of CPT® codes for the 2023 code book, and there are some additions, deletions, and revisions that orthopedic coders will want to note. In the last issue, we focused solely on the extensive changes to the evaluation and management (E/M) section of CPT® 2023. In this issue, we’ll take you through the rest of the changes in the code book that you’ll want to note. Take a look at what’s awaiting you on Jan. 1, 2023, when CPT® 2023 takes effect. Suture Removal Gets Reworked CPT® 2023 will revise a section of the code book dealing with suture/staple removal. Here’s a look at how this section of the code book will look next year (On “Revised” codes, strikethroughs denote what’s being deleted from 2022 definition; underlines denote what’s being added for 2023 definitions): Deleted: Revised: Added: Impact: CPT® is getting rid of 15850 and instructing coders to use 15851 instead. The revised 15851 code is more detailed, adding “or staples” to the descriptor, as well as making the verbiage clearer with regards to the types of anesthesia. Further, the code descriptor drops the requirements “other than local” and “other surgeon.” The new add-on codes in the suture/staple removal category, +15853 and +15854, appear identical, and they are — nearly. The only difference between the two codes is that +15853 is for removal of sutures or staples; +15854 is for removal of sutures and staples. Also, the instructions for these codes require you to append them to an evaluation and management (E/M) code — not a procedure code. So, let’s say the physician performs a level-three office E/M service for an established patient and then removes sutures and staples without anesthesia. In 2023, you’ll report 99213 (Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using time for code selection, 20-29 minutes of total time is spent on the date of the encounter.) with +15854 appended for the service. Arthroplasty Add-on Changes Your Coding CPT® 2023 will also tweak a couple of arthroplasty codes and an arthrodesis code. Here’s a look at how this section of the manual will look next year (On “Revised” codes, strikethroughs denote what’s being deleted from 2022 definition; underlines denote what’s being added for 2023 definitions): Revised: New: Impact: The revisions to 22857 and 27280 are more about tightening up the language in the descriptors than changing anything substantial. Although no official guidance has been issued yet, it looks like you’ll report +22860 if you need to code for a second interspace beyond the first represented by 22857. US Gets a New Addition, Some Revisions CPT® 2023 will give coders some revised codes in the ultrasound (US) section as well. (On “Revised” codes, strikethroughs denote what’s being deleted from 2022 definition; underlines denote what’s being added for 2023 definitions): New: Revised: T Codes Get 1 Deletion, Many Additions The category III codes (T codes) in CPT® 2023 will include some changes that orthopedic coders will want to note. First, CPT® will delete +0163T (Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression), each additional interspace, lumbar (List separately in addition to code for primary procedure)). Since CPT® added +22860 for 2023, +0163T was redundant. Second, CPT® will add the following category III codes to its 2023 roster: T code reminder: Category III codes are temporary (T) codes used to gauge the effectiveness of emerging technologies, services, and procedures. Payers are likely to vary significantly on how they would like these codes used, so contact each individual payer before reporting 0719T or 0720T.
,; single interspace, lumbar)open, sacroiliac joint, open, includingincludes obtaining bone graft, including instrumentation, when performed).
and pelvis) or separate acquisitions (eg, lung ventilation and perfusion), single day imaging, or single area or acquisitionimaging over 2 or more days)and pelvis) or separate acquisitions (eg, lung ventilation and perfusion), single day imaging, or single area or acquisitionimaging over 2 or more days)
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