Urology Coding Alert

Question: I just got my 2010 CPT Manual and I'm noticing some codes have a # mark next to them. What does that mark mean?

New York Subscriber

Answer: The pound symbol (#) or hash mark is a new marking in the 2010 CPT manuals that warns you that a code is out of order. This year, rather than moving groups of codes to new sections and completely renumbering existing codes, the AMA opted to add the # designation.

"Resequencing makes a lot of sense to avoid renumbering the codes," explained William T. Thorwarth, Jr., MD, in "CPT 2010 Overview" at the CPT and RBRVS 2010 Annual Symposium's opening session in Chicago.

The AMA also has a new method of relocating an existing out of order code. Rather than deleting the code and creating a new number, the AMA will move the code to its more appropriate location and leave a note for you. "Where you would expect the code to be, we added references referring to the code's new place," Peter A. Hollmann, MD, said in the symposium's final session of the day: "CPT 2010 Resequencing Principles."

For example, CPT moved add-on code +51797 (Voiding pressure studies, intra-abdominal [i.e., rectal, gastric, intraperitoneal] [List separately in addition to code for primary procedure]) under the complex cystometrogram (CMG) codes (51727-51729). CPT didn't change the definition of this code, but due to the bundling changes for all urodynamics typically performed on the same day, it fit better after the urodynamics codes 51727-51729.

So, the AMA placed +51797 after 51729 and added:

• The # sign in front of +51797 to designate the code as out of order and
• A reference where +51797 would have been found numerically.

-- Answers to Reader Questions and You Be the Coder contributed by Michael A. Ferragamo, MD, FACS, clinical assistant professor of urology, University Hospital, State University of New York, Stony Brook.