Pulmonology Coding Alert
Refine Your Medicine, Cardiothoracic Surgery Reporting With Key Code Expansions
Give up diagnostic thoracoscopy code 32602 in favor of newbies 32607-32609. Remember to check for deleted codes when preparing to use your CPT® 2012 manual, not just new codes and revised descriptors. Next year's set of procedure codes will include fresh additions for coding some common medicine/pulmonary procedures. Concurrently, you will be missing the resistance to airflow determination code, as well as a few other familiar pulmonary procedures. Gauge Potential Opportunities With Brand New Medicine Codes You and your pulmonologists should pay special attention to the following new codes under the medicine/pulmonary section of CPT® 2012 manual: 94726 -- Plethysmography for determination of lung volumes and, when performed, airway resistance 94727 -- Gas dilution or washout for determination of lung volumes and, when performed, distribution of ventilation and closing volumes 94728 -- Airway resistance by impulse oscillometry +94729 -- Diffusing capacity (e.g., carbon monoxide, membrane) (List separately in addition to code for primary procedure) 94780 -- Car seat/bed testing for airway integrity, neonate, with continual nursing observation and continuous recording of pulse oximetry, heart rate and respiratory rate, with interpretation and report; 60 minutes +94781 -- ...each additional full 30 minutes (List separately in addition to code for primary procedure). Some of these codes were formulated in an effort to try to adapt to current practice and clarify previous confusion when reporting PFTs. One example is plethysmography. Previous options for reporting this service was 93720 (Plethysmography, total body; with interpretation and report) or 94360 (Determination of resistance to airflow, oscillatory or plethysmographic methods). Effective Jan. 1 a new code will now reflect the more accurate testing method. CPT® will also give way to 18 debuting cardiothoracic surgery codes in 2012. These codes include: 32096 -- Thoracotomy, with diagnostic biopsy(ies) of lung infiltrate(s) (e.g., wedge, incisional), unilateral 32097 -- Thoracotomy, with diagnostic biopsy(ies) of lung nodule(s) or mass(es) (e.g., wedge, incisional), unilateral 32098 -- Thoracotomy, with diagnostic biopsy(ies) of pleura 32505 -- Thoracotomy, with therapeutic wedge resection (e.g., mass, nodule), initial +32506 -- ...with therapeutic wedge resection (e.g., mass or nodule), each additional resection, ipsilateral (List separately in addition to code for primary procedure) +32507 -- ...with diagnostic wedge resection followed by anatomic lung resection (List separately in addition to code for primary procedure) 32607 -- Thoracoscopy; with diagnostic biopsy(ies) of lung infiltrate(s) (e.g., wedge, incisional), unilateral 32608 -- ...with diagnostic biopsy(ies) of lung nodule(s) of mass(es) (e.g., wedge, incisional), unilateral 32609 -- ...with biopsy(ies) of pleura 32666 -- ...with therapeutic wedge resection (e.g., mass, nodule), initial unilateral +32667 -- ...with therapeutic wedge resection (e.g., mass or nodule), each additional resection, ipsilateral (List separately in addition to code for primary procedure) +32668 -- ...with diagnostic wedge resection followed by anatomic lung resection (List separately in addition to code for primary procedure) 32669 -- ...with removal of a single lung segment (segmentectomy) 32670 -- ...with removal of two lobes (bilobectomy) 32671 -- ...with removal of lung (pneumonectomy) 32672 -- ...with resection-plication for emphysematous lung (bullous or non-bullous) for lung volume reduction (LVRS), unilateral includes any pleural procedure, when performed 32673 -- ...with resection of thymus, unilateral or bilateral +32674 -- ...with mediastinal and regional lymphadenectomy (List separately in addition to code for primary procedure). "The codes are cardiothoracic surgery codes. It seems that they [CPT®] have expanded each of these series to include more detail, and more accurately capture the amount of effort associated with unilateral vs bilateral services as well as procedures involving multiple (ipsilateral) biopsies," says Carol Pohlig, BSN, RN, CPC, ACS, senior coding and education specialist at the University of Pennsylvania Department of Medicine in Philadelphia. Prepare For Cardiothoracic Surgery Code Changes As a matter of fact, CPT® will delete some of the old endoscopy procedures on the lungs and pleura for 2012. These are: 32602 -- Thoracoscopy, diagnostic (separate procedure); lungs and pleural space, with biopsy 32603 -- Thoracoscopy, diagnostic (separate procedure); pericardial sac, without biopsy 32605 -- Thoracoscopy, diagnostic (separate procedure); mediastinal space, without biopsy 32657 -- Thoracoscopy, surgical; with wedge resection of lung, single or multiple 32660 -- Thoracoscopy, surgical; with total pericardiectomy. Instead of 32602, you will use 32607-32609 to report diagnostic thoracoscopy of lungs and pleural space with biopsy. CPT® 32601 will replace 32603 and 32605 for diagnostic thoracoscopy without biopsy. Meanwhile, surgical thorocoscopy code 32657 will give way to new codes 32666-32668. Extra: 94726-94727 Takes The Place Of FRC Deleted Code You should also be aware of deletions within the medicine/pulmonary section of your CPT® manual. For instance, where you would code 94240 (Functional residual capacity or residual volume: helium method, nitrogen open circuit method, or other method) to measure functional residual capacity (FRC) in 2011, next year you will have to report 94726-94727. Other deleted codes for 2012 will include: 94260 -- Thoracic gas volume 94350 -- Determination of maldistribution of inspired gas: multiple breath nitrogen washout curve including alveolar nitrogen or helium equilibration time 94360 -- Determination of resistance to airflow, oscillatory or plethysmographic methods 94370 -- Determination of airway closing volume, single breath tests 94720 -- Carbon monoxide diffusing capacity (e.g., single breath, steady state) 94725 -- Membrane diffusion capacity.
Pulmonology Coding Alert
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Refine Your Medicine, Cardiothoracic Surgery Reporting With Key Code Expansions
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