Part B Insider (Multispecialty) Coding Alert
New Edition of CPT Overhauls Hydration Code Set
Plus: No new modifiers debut in January, although one will be deleted.
Just as you were getting to know codes 90769-90771 (Subcutaneous infusion for therapy or prophy-laxis...) -- which CPT just debuted last January -- it's time again to forget what you learned and start coding a new way.
CPT 2009, which takes effect on Jan. 1, deletes the entire Thera-peutic, Prophylactic, and Diagnostic Injections and Infusions" section (90765-90779). In its place, you'll find a new section entitled, "Thera-peutic, Prophylactic, and Diagnostic Injections and Infusions (Excludes Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration." The codes in the new section will run from 96365 (Intravenous infusion, for therapy, prophylaxis, or diagnosis [specify substance or drug]; initial, up to 1 hour) through 96379 (Unlisted therapeutic, prophylactic, or diagnostic intra-venous or intra-arterial injection or infusion).
"The new codes seem to mirror the old ones in that the descriptors are practically identical," says Heather Corcoran with CGH Billing. "However, it's clear that CPT added new introductory notes and must have wanted the codes further back in the medicine section than where they used to be -- sandwiched between vaccine codes and psychiatry codes."
CPT Cuts Modifier 21
CPT will delete modifier 21 (Prolonged evaluation and management services) this year."Not many practices that I work with were using modifier 21 in the first place," Corcoran says.
Modifier 21 was an informational code and does not require carriers to give you extra reimbursement. In addition, you could only use modifier 21 with the highest level E/M codes in a grouping, for example, 99205, 99215, 99245, etc.The only way to accurately collect for prolonged services has been by using 99354-99358 (Prolonged physician service in the office or other outpatient setting...).
CPT will change the introductory notes to the 99354-99357 series for 2009, including the new statement, "The use of the time based add-on codes requires that the primary E/M service have a typical or specified time published in the CPT codebook."
Part B Insider (Multispecialty) Coding Alert
- CPT 2009:
CPT Makes HPV Code Official; Radically Changes TURP Coding
Hint: You can use one code with a modifier for stages 1 and 2 of TURP.Forget [...] - CPT 2009:
New Edition of CPT Overhauls Hydration Code Set
Plus: No new modifiers debut in January, although one will be deleted.Get ready for a whole [...] - CPT 2009:
CPT Adds New Canalith Repositioning Code, Allowing You to Ditch Unlisted Code for Epley
Plus: Several new surgical codes debut, but it's which codes are missing from CPT 2009 that's [...] - CPT 2009:
CPT 2009 Updates Cardiovascular Device Monitoring Codes
You'll find 21 new codes to guide your electrophysiology coding choices, as well as an [...] - Correction:
ZPICs to Collect Flat Fee, Not Percentage
In last week's issue of the Insider (Vol. 9, No. 37, page 281), we indicated [...] - Reader Question:
CMS Proposed Changing Payment Guidelines for Non-Credentialed Physicians
Under proposed plan, CMS would no longer allow retroactive billing for newly-credentialed doctors.Question: In your [...] - ICD-9 Coding:
Think 'Likely' Diagnosis Trumps Symptoms? Think Again
Look for these phrases in your physician's documentation.Typically, your first-listed ICD-9 code is your physician's [...] - Physician Notes:
Transition to ICD-10 Could Cost Large Medical Practice Upwards of $2 Million
Plus: MedPAC brings payment information for physicians, therapists, and other providers to the forefront.Transition to the [...]
