Urology Coding Alert

Category III codes will accommodate new technologies.

Each new year brings new codes, and 2024 will be no exception. The good news is you have a bit of a heads up about some new Category III CPT^® codes that will join your code options next year. Read on to get the scoop.

Differentiate Between Reporting Remote Services

According to the February 2023 CPT^® Editorial Summary of Panel Actions, the AMA approved several new Category III codes that you’ll be able to soon use in your urology practice. The AMA will release the specific language of the approved new codes in July 2023 and they will be effective January 1, 2024.

For now, the AMA Summary of Panel Actions lists two codes, X135T and X136T, “to report remote patient multi-day comprehensive uroflowmetry.”

Remember: Per the Summary of Panel Actions, “… codes that contain an ‘X’ … are placeholder codes that are intended, through the first three characters, to give readers an idea of the proposed placement in the code set of the potential code changes. These codes are not used for claims reporting and will be removed and not retained when the final CPT Datafiles are distributed around early to mid-September of each year.”

“These codes, X135G and X136T, will allow remote monitoring of uroflowmetry performed at a patient’s home using a disposable personal uroflowmeter that wirelessly connects to a mobile app and measures a patient’s voiding activities so patient and caregiver do not have to handle urine or listen to a patient urinate to estimate flow rate,” explains Stephanie Stinchcomb Storck, CPC, CPMA, CCS-P, ACS-UR, longtime urology coder and consultant in Glen Burnie, Maryland. “The data is sent back to the physician’s office in a comprehensive clinical report to show the flow study results. This technology would be considered augmentative AI technology.”

Pointer: These codes are different from existing CPT^® codes 99453 (Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial; set-up and patient education on use of equipment) and 99454 (… device(s) supply with daily recording(s) or programmed alert(s) transmission, each 30 days), Storck says. Monitoring of uroflowmetry is also not considered therapeutic monitoring as described in 98980 (Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least one interactive communication with the patient or caregiver during the calendar month; first 20 minutes) or 98981 (…each additional 20 minutes (List separately in addition to code for primary procedure)).

“A flow study is not considered a physiologic parameter or a therapeutic treatment and new codes were requested,” Storck explains. “This technology can be used for diagnoses such as benign prostatic hyperplasia [BPH], incontinence, or symptoms of both.”

Watch for New Bladder Dysfunction Treatment Codes

The AMA CPT^® Editorial Panel also approved four new codes you’ll be able to use when your urologist performs tibial neurostimulator services to treat patients with bladder dysfunction.

According to the Summary of Panel Actions, CPT^® 2024 will include the following new tibial neurostimulator services (keeping in mind X is just a placeholder):

• X129T
• X130T
• X131T
• X132T

The Summary of Panel Actions also notes that you should expect revisions to the Extracranial Nerves, Peripheral Nerves, and Autonomic Nervous System/Neurostimulators (Peripheral Nerve) guidelines in January 2024.

Don’t miss: Back in 2022, at the AMA Editorial Panel meeting, the AMA approved 2024 revisions to the following spinal neurostimulator services codes:

• 63685 (Insertion or replacement of spinal neurostim­ulator pulse generator or receiver, direct or inductive coupling)
• 63688 (Revision or removal of implanted spinal neurostimulator pulse generator or receiver)
• 64590 (Insertion or replacement of peripheral or gastric neurostimulator pulse generator or receiver, direct or inductive coupling)
• 64595 (Revision or removal of peripheral or gastric neurostimulator pulse generator or receiver)
• 0587T (Percutaneous implantation or replacement of integrated single device neurostimulation system including electrode array and receiver or pulse generator, including analysis, programming, and imaging guidance when performed, posterior tibial nerve)
• 0588T (Revision or removal of integrated single device neurostimulation system including electrode array and receiver or pulse generator, including analysis, programming, and imaging guidance when performed, posterior tibial nerve)
• 0589T (Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (Hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detection algorithms, closed-loop parameters, and passive parameters, when performed by physician or other qualified health care professional, posterior tibial nerve, 1-3 parameters)
• 0590T (… 4 or more parameters)

You’ll also have the following new codes in this section in 2024 (code descriptors to come with the full, official 2024 CPT^® code set release):

• 64XX2
• 64XX3
• 64XX4
• 0X43T
• 0X44T
• X004T
• 0X46T
• X005T
• 0X48T

The changes in this section of the CPT^® code book will also include “revision and addition of the Spine and Spinal Cord/ Neurostimulators (Spinal) and the Extracranial Nerve, Peripheral Nerves, and Autonomic Nervous System Neurostimulators (Peripheral Nerve) guidelines” according to the Summary of Panel Actions.

Coming soon: Stay tuned to Urology Coding Alert to learn the actual, reportable codes later this year when the AMA releases the full, official CPT^® code set details.