Pulmonology Coding Alert

Water seal now included in tube thoracostomy Before you report a thoracentesis procedure in 2008, be sure to check out a copy of the latest CPT manual. Why? The old code set for the procedure is gone, and reporting the old codes rather than the new ones will lead to claim denial. The AMA has released its list of codes that are slated to appear in CPT 2008, and it includes an overhaul of the thoracentesis code section, as well as two codes for smoking cessation counseling. The possibility of last-minute edits to the code book is always possible, but you can probably look forward to implementing these CPT changes for Jan. 1. (Look to future editions of Pulmonology Coding Alert for possible changes to the current CPT 2008 code list.) Consider Specific Codes for Smoking Cessation As Alan L. Plummer, MD, at Emory University School of Medicine in Atlanta told Pulmonology Coding Alert in vol. 8 issue no. 10, two smoking cessation codes that were previously only for Medicare patients will become CPT standards. The AMA converted both G0375 (Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes) and G0376 (... intensive, greater than 10 minutes) to CPT codes, which will be available Jan. 1. Time's on your side: These new codes are time-based, meaning you will not have to determine the level of service based on the complexity of the counseling. The new codes are: • 99406 -- Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes • 99407 --... intensive, greater than 10 minutes. (Note: We'll be tracking 99406-99407 claims in early 2008 to see how they work in practice; look for more information on payer response to these codes as it becomes available.) CPT Moves Thoracentesis Code Set Coders will want to pay attention to changes to the following thoracentesis, pleurodesis and chest tube insertion codes because they are used frequently in pulmonology practices, Plummer says. Check out this breakdown of the new codes. Deleted: 32000 -- Thoracentesis, puncture of pleural cavity for aspiration, initial or subsequent Added: 32421 -- Thoracentesis, puncture of pleural cavity for aspiration, initial or subsequent Impact: The 32421 code is identical to the 32000 code. Just be sure to report 32421 instead of 32000 starting in January. Deleted: 32002 -- Thoracentesis with insertion of tube with or without water seal (e.g., for pneumothorax) (separate procedure) Added: 32422 -- Thoracentesis with insertion of tube, includes water seal (e.g., for pneumothorax), when performed (separate procedure) Impact: The 32422 code is nearly identical to the 32002 code and includes a water seal, if used. Just be sure to report 32422 [...]