2009 CPT & HCPCS Level II Updates & Billing Impacts

2009 CPT & HCPCS Level II Updates & Billing Impacts
Presenters: Susan Collins, MHSA, CPC, CCA, CPMA Lorrie Borchert, CPC, CPAM February 2009

Coding and Billing are Connected
Note: Coding and Billing are Connected Yes, it is the coders job to properly code diagnoses and procedures, but billers also work with codes. Scenario: A coder arrives at a code that has been changed/deleted etc. (and this does happen); the coder has not kept up with the new coding changes, and this code gets entered on a bill. The biller also doesn’t have the knowledge of the code change, so lets it go through - reimbursement will be affected. Just as a coder should be aware of all ICD-9-CM and CPT/HCPCS II changes each year, so should a biller. Part of a billers job is to assure a “clean claim” has been prepared. If a biller has been informed that modifier -21 has been deleted this year (2009) and they see this modifier was used on a code that is to be billed out, they automatically know it will be denied and can get it corrected ahead of time.

Objectives Receive an overview of new, updated and deleted CPT® & HCPCS (Healthcare Common Procedure Coding System) Level II codes Be able to share this information with other staff (ie. coders & billers)

2009 New CPT Codes CMS implements new Category I and III CPT codes and new Level II HCPCS annually. Codes are released to the public in the summer and through the fall taking effect on 1 January. CMS uses Level I and Level II HCPCS codes and descriptors to identify and group the services within each APC (Ambulatory Payment Classifications) What is CPT? (Level I Coding) $$ • Current Procedural Terminology • A code showing the LOS (level of service) you provided for a patient. Level I contains the American Medical Association (AMA) Physicians’ Current Procedural Terminology (CPT). CPT includes nearly 8,000 five-digit codes, each assigned to a short and long description of a service or procedure. It is a system of documenting services performed by physicians and other healthcare professionals. Professionals use the CPT to bill public or private health insurance programs and to track charges for services internally. Level I does not include codes needed to bill for medical items or services that are billed by suppliers other than physicians, physical therapists, nurse practitioners, or other professionals. What are HCPCS Codes? (Level II Codes) $$ • Coding System. HCPCS (pronounced “hick-picks”) is the acronym for the Healthcare Common Procedure Coding System • A code used to describe supplies, injectable items and DMD (durable medical equipment). Level II consists of the HCPCS is a standardized coding system used to identify products, supplies, and services not included in the CPT codes. These codes begin with a single letter, followed by 4 numeric digits. For each Level II code, there is a descriptive terminology that identifies a category of like items. Currently, there are over 4,000 separate categories of like items or services that encompass millions of products from different manufactures. To avoid any appearance of endorsement of a particular product, brand or trade names are not represented by a code. The exception is codes that describe drugs and certain solutions. Current Procedural Terminology (CPT) Category III codes, developed by the American Medical Association (AMA) to allow for data collection concerning the use of "emerging technology, services, and procedures.” The creation of a CPT Category III code by the AMA "neither implies nor endorses clinical efficacy, safety or the applicability to clinical practice."

AMA The American Medical Association (AMA) copyrights Current Procedural Terminology (CPT). All rights reserved. No fee schedules, basic units, relative values or related listings are included in CPT. AMA does not directly or indirectly practice medicine or dispense medical services. AMA assumes no liability for data contained or not contained herein.

Overview of 2009 CPT Changes
152 New Codes 99 Deletions 174 Descriptor Changes 329 Grammatical Changes 2 Reinstated/Recycled 756 changes

Category I Breakdown of 2009 Changes
Section New Codes Deletions Descriptor Changes Grammatical Totals EM Codes 17 15 18 50 Anesthesia 2 1 5 Integumentary 31 33 Respiratory Cardiology 7 Musculoskeletal 11 13 Digestive 3 Urinary Genital (M/F) 4 12 Nervous Eye & Ocular 34 58 Radiology 6 78 89 Laboratory 20 39 Medicine 67 37 22 36 162 TOTALS 133 70 123 179 505 Medicine section had the largest number of changes for 2009. Integumentary had the most revisions.

Evaluation &Management Neonatal and Pediatric Critical Care
Additions: 99460 Initial hospital or birthing center care, per day, for E/M of normal newborn infant 99461 Initial care, per day, for E/M of normal newborn infant seen in other than hospital or birthing center 99462 Subsequent hospital care, per day, for E/M of normal newborn 99463 Initial hospital or birthing center care, per day, for E/M of normal newborn infant admitted and discharged on the same day. The neonatal and Pediatric critical care services sections have undergone comprehensive revisions to reflect the typical and current neonatal care services and practices of today. The revisions provide further clarification of the intent of the newly revised Newborn Care Services subsection. The newborn care services section is now divided into two sections: 1. newborn care services, which includes codes and 2. a new subsection that was added to include Delivery/Birthing Room Attendance and Neonatal Resuscitation Services and codes and The newborn care services have been deleted and replaced with

Additions cont: 99464 Attendance at delivery (when requested by the delivering physician) and initial stabilization of newborn 99465 Delivery/birthing room resuscitation, provision of positive pressure ventilation and/or chest compressions in the presence of acute inadequate ventilation and/or cardiac output 99466 Critical care services delivered by a physician, face-to-face, during an inter-facility transport of critically ill or critically injured pediatric patient, 24 months of age or less; first minutes of hands-on care during transport These codes should only be used when there is direct face-to-face contact by the physician with the patient during the transport, it is not appropriate to report if transport is less than 30 minutes. 99464 and are renumbered codes and found in a new subsection titled Delivery/Birthing Room Attendance and Resuscitation Services. This new place in the hierarchy is also intended to provide further clarity for understanding and reporting these codes.

Additions cont: each additional 30 minutes (List separately in addition to code for primary service) 99468 Initial inpatient neonatal critical care, per day, for the E/M of a critically ill neonate, 28 days of age or less 99469 Subsequent inpatient neonatal critical care, per day, for the E/M of a critically ill neonate, 28 days of age or less 99471 Initial inpatient pediatric critical care, per day, for the E/M of a critically ill infant or young child, 29 days through 24 months of age Codes and have been editorially renumbered and remain time-based codes, and are intended to identify the physical attendance and direct face-to-face care by a physician during the interfacility transport of a critically ill or critically injured patient. These codes are intended to be reported only once on a given date. Face-to-face care begins when the physician assumes primary responsibility for the patient at the referring hospital/facility and ends when the receiving hospital/facility accepts responsibility for the patients’ care. Only the time the physician spends in direct face-to-face contact with the patient during the transport should be reported. It is not appropriate to report codes and for critical care transport services requiring less than 30 minutes.

Additions cont: 99472 Subsequent inpatient neonatal critical care, per day, for the E/M of a critically ill infant or young child, 29 days through 24 months of age 99475 Initial inpatient pediatric critical care, per day, for the E/M of a critically ill infant or young child, 2-5 years of age 99476 Subsequent inpatient neonatal critical care, per day, for the E/M of a critically ill infant or young child, 2-5 years of age 99471 and 99472: These codes are intended to identify the initial and subsequent pediatric critical care services codes and describe the initial day and each subsequent hospital day Evaluation and Management service provided to a critically ill infant, 28 days of age (postnatal) to 2 years of age. The care for these patients is typically managed in pediatric intensive care units by pediatric critical care specialists, neonatologists, and pediatric surgeons. Codes and and related. Cross references have been established to report the initial and subsequent inpatient pediatric critical care services that describe the initial day and each subsequent hospital day evaluation and management provided to a critically ill infant or young child, 25 months through 71 months of age.

Additions cont: 99478 Subsequent intensive care, per day, for the E/M of the recovering very low birth weight infant (present body weight <1500 grams) 99479 Subsequent intensive care, per day, for the E/M of the recovering very low birth weight infant (present body weight of grams) 99480 Subsequent intensive care, per day, for the E/M of the recovering very low birth weight infant (present body weight of grams) Code #’s are what have changed. (Descriptors and guidelines have remained unchanged) Codes 99478, 99479, and are intended to identify the subsequent intensive care services for the evaluation and management of the recovering low birth weight infants ranging from present body weight less than 1500 grams to 5000 grams. The introductory guidelines were further revised to instruct that the subsequent hospital care codes should be reported when subsequent care of the sick neonate who is less than 28 days of age but weighs more than 5000 grams and does not require intensive care or critical care services.

Evaluation &Management Deletions
99289 (crosswalk 99466) 99290 ( “ ) 99293 ( “ ) 99294 ( “ ) 99295 ( “ ) 99296 ( “ ) 99298 ( “ ) 99299 ( “ ) 99300 (crosswalk 99480) 99431 ( “ ) 99432 ( “ ) 99433 ( “ ) 99435 ( “ ) 99436 ( “ ) 99440 ( “ ) 99289 and the other codes in red have been deleted, but “refer to” the other number beside it in parentheses.

Evaluation &Management Descriptor Changes
The examples are removed from (+99354, , , ) The term “appropriate immunization(s)” was removed from the list of orders for the following codes: 99381, 99382, 99383, 99384, 99385, 99386, 99387, 99391, 99392, 99393, 99394, 99395, 99396, and 99397

Musculoskeletal System
Additions 20696 Application of multiplane (pins or wires in more than one plane), unilateral, external fixation w/stereotactic computer-assisted adjustment (eg, spatial frame), including imaging; initial and subsequent alignment[s], assessment[s], and computation[s], of adjustment schedule[s] 20697 Application of multiplane (pins or wires in more than one plane), unilateral, external fixation with stereotactic computer-assisted adjustment (eg, spatial frame), including imaging; exchange (ie, removal and replacement) of strut, each

Additions 22856 Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection), single interspace, cervical 22861 Revision including replacement of total disc arthroplasty (artificial disc) anterior approach, single interspace; cervical 22684 Removal of total disc, arthroplasty (artificial disc), anterior approach, single interspace; cervical

Additions cont: Decompression fasciotomy(ies), pelvic (buttock) compartment(s) (eg, gluteus medius-minimus, gluteus maximus, iliopsoas, and/or tensor fascia lata muscle), unilateral 27057 Decompression fasciotomy(ies), pelvic (buttock) compartment(s) (eg, gluteus medius-minimus, gluteus maximus, iliopsoas, and/or tensor fascia lata muscle) with debridement of nonviable muscle, unilateral These codes have been addes to report decompressive buttock fasciotomies. Debridement procedures to are included in are not reported separately. These codes are considered unilateral and require modifier 50 when performed bilaterally.

Musculoskeletal System Deletions
20986 (crosswalk 0054T, 0055T) 20987 (crosswalk 0054T, 0055T) 20986 and were deleted in 09 and replaced with 0054T and 0055T

Musculoskeletal System Descriptor Changes
12056 12057 +15003 +15005 +15021 +15221 +15241 +15261 +15341 For codes 15003, 15005, 15021, 15221, 15241, and 15341, the term “or part thereof” has been added. 19296 +19297 For codes and the term “balloon catheter” was changed to “expandable catheter (single or multichannel) Term(s) Change: 1. “or part thereof” has been added to 15003, 15005, 15021, 15221, 15241, 15261, and 15341

Musculoskeletal System Descriptor Changes cont.
+20985 22857 22862 22865 Codes 22857, 22862, & had changes due to addition of new codes, but without changes to the actual code descriptions 23585 27215 27216 27217 27218 Codes changed to include terminology concerning fracture patterns of the pelvic bone 27396 27397 Codes & had addition of the term “or transfer (with muscle redirection or rerouting)” and change from “hamstring tendon to patella” to “thigh (eg, extensor or flexor)”

Cardiovascular System
Additions: Bypass Graft Vein: 35535 Bypass graft, with vein; hepatorenal 35570 Bypass graft, with vein; tibial-tibial, peroneal-tibial, or tibial/peroneal trunk-tibial Bypass Graft Other Than Vein: 35632 Bypass graft, with other than vein; ilio-celiac 35633 Bypass graft, with other than vein; ilio-mesenteric 35634 Bypass graft, with other than vein; iliorenal 35535 and were previously reported with an unlisted code. A typical indication for performing this by-pass to the right renal artery is for patients with chronic arterial occlusive disease with significant cardiac disease in whom manipulation of aorta might prove inappropriate or have excessive risk. Codes are more specific anatomical bypass graft codes using the iliac vein as the inflow vessel. The CPT book has an extensive amount of parenthetical notes to help with your code selection.

Cardiovascular System
Additions: Bypass Graft Vein: 35535 Bypass graft, with vein; hepatorenal 35570 Bypass graft, with vein; tibial-tibial, peroneal-tibial, or tibial/peroneal trunk-tibial Bypass Graft Other Than Vein: 35632 Bypass graft, with other than vein; ilio-celiac 35633 Bypass graft, with other than vein; ilio-mesenteric 35634 Bypass graft, with other than vein; iliorenal Descriptor Change: +34806 This code was changed to an add-on code 35535 and were previously reported with an unlisted code. A typical indication for performing this by-pass to the right renal artery is for patients with chronic arterial occlusive disease with significant cardiac disease in whom manipulation of aorta might prove inappropriate or have excessive risk. Codes are more specific anatomical bypass graft codes using the iliac vein as the inflow vessel. The CPT book has an extensive amount of parenthetical notes to help with your code selection. **Only one code with a descriptor change, 34806

Digestive System Additions:
41512 Tongue base suspension, permanent suture technique 41530 Submucosal ablation of the tongue base, radiofrequency, one or more sites, per session Endoscopic cannulation of papilla with direct visualization of common bile duct(s) and/or pancreatic duct(s) (List separately in addition to code(s) for primary procedure) 43279 Laparoscopy, surgical, esophagomyotomy (Heller type), w/fundoplasty, when performed 46930 Destruction of internal hemorrhoid(s) by thermal energy (eg, infrared coagulation, cautery, radiofrequency) 41512 is a technique for the treatment of snoring and obstructive sleep apnea. 41512 is different than which describes a non-suture technique with K-wire. 41530 was previously reported with a Category III code. 43273 is an add-on code which differentiates the new procedure code from for ERCP which provides fluoroimages of the papilla and common bile ducts and is performed in the interventional radiology suite. 43273 should not be reported in addition to a therapeutic ERCP. 43279 is typically performed for treatment of achalasia, a condition in which food remains stuck in the esophagus at the terminal end near the cardioesphogeal junction due to improper esophageal motility. It is frequently caused by an autonomic nerve response in the esophagus. This code was added to specify a laparoscopy approach. 43279 was also established to identify a laparoscopic approach 46930 was created to identify multiple techniques for destruction of hemorrhoids, and replaces which are redundant.

Digestive System Additions cont:
49652 Laparoscopy. Surgical, repair, ventral, umbilical, spigelian or epigastric hernia (includes mesh insertion, when performed); reducible 49653 Laparoscopy, Surgical, repair, ventral, umbilical, spigelian or epigastric hernia (includes mesh insertion, when performed); incarcerated or strangulated 49654 Laparoscopy, surgical, repair, incisional hernia (includes mesh insertion, when performed): reducible 49655 Laparoscopy, surgical, repair, incisional hernia (includes mesh insertion, when performed); incarcerated or strangulated were added to describe laparoscopic repairs for hernias. Parenthetical notes have been added following codes and to restrict use of these codes with open procedures for mesh insertion and lysis of adhesions. Instead, the laparoscopic provision of the previously noted laparoscopic services includes mesh insertion and adhesiolysis when performed. Note: All these codes include mesh insertion when it is performed. These codes cannot be reported in conjunction with codes (Laparoscopy, surgical, enterolysis (freeing of intestinal adhesion) (this is a separate procedure)) and (implantation of mesh or other prosthesis for open incisional or ventral hernia repair or mesh for closure of debridement for necrotizing soft tissue infection)

Digestive System Additions cont:
49656 Laparoscopy, surgical, repair, recurrent incisional hernia (includes mesh insertion, when performed); reducible 49657 Laparoscopy, surgical, repair, recurrent incisional hernia (includes mesh insertion, when performed); incarcerated or strangulated were added to describe laparoscopic repairs for hernias. Parenthetical notes have been added following codes and to restrict use of these codes with open procedures for mesh insertion and lysis of adhesions. Instead, the laparoscopic provision of the previously noted laparoscopic services includes mesh insertion and adhesiolysis when performed. Note: All these codes include mesh insertion when it is performed. These codes cannot be reported in conjunction with codes (Laparoscopy, surgical, enterolysis (freeing of intestinal adhesion) (this is a separate procedure)) and (implantation of mesh or other prosthesis for open incisional or ventral hernia repair or mesh for closure of debridement for necrotizing soft tissue infection)

Digestive System Deletions
46934 (see 46083, 46930, 46999, , 46320, , 46221, 46945, 46946, 46947) 46935 (see 46083, 46930, 46999, , 46320, , 46221, 46945, 46946, 46947) 46936 (see 46083, 46930, 46999, , 46320, , 46221, 46945, 46946, 46947)

Digestive System Descriptor Changes
43460 +49568 Code had a spelling correction and Code had the term “open” added

Urinary System Addition:
55706 Biopsies, prostate, needle, transperineal, stereotactic template guided saturation sampling, including imaging guidance This code was previously reported with a Category III code This code cannot be assigned in conjunction with code (Biopsy, prostate; needle or punch, single or multiple, any approach). 55703 was established to report transperineal biopsies of the prostate using stereotactic template guidance. This service was previously reported with code 0137T, which has been deleted.

Urinary System Deletions
52606 (crosswalk 52214) 52612 (crosswalk 52601, 52630) 52614 (crosswalk 52601, 52630) 52620 (crosswalk 52601, 52630) 53853 (crosswalk 55899) 52606 was deleted and can be cross-walked to 52214 52612 and were deleted and can be cross-walked to 52601

Urinary System Descriptor Changes
52630 Was changed to transurethral approach, had the term “longer than one year postoperative” removed, and a list of included additional procedures added 57400 57410 57415 had the term “other than local” added to distinguish the included anesthesia

Nervous System Additions: Stereotactic Radiosurgery (Cranial):
61796 Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 simple cranial lesion Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional cranial lesion, simple (List separately in addition to code for primary procedure) 61798 Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 complex lesion Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional cranial lesion, complex (List separately in addition to code for primary procedure) Application of stereotactic headframe for stereotactic radiosurgery (List separately in addition to code for primary procedure For 2009, significant changes have been made to the CPT coding system for reporting stereotactic radiosurgery (SRS). When code was added to the CPT codebook, the technology and technique of SRS was first emerging. Since that time, broader indications have been developed for SRS. Due to these changes in the technology, code no longer adequately describes the physician work involved in the procedures. To accurately reflect the current practice of SRS, code has been deleted and seven new codes have been established. These new codes are listed under new subheadings, with guidelines to provide education for reporting these codes. These seven NEW codes replace one – which has been deleted. These codes add more specificity in reporting stereotactic radio surgery. NOTE: These codes are not to use to report stereotactic body radiation therapy for lesions that are neither cranial nor spinal. Refer to the guides in subsection Stereotactic Radiosurgery for definitions of simple and complex cranial lesion reporting. Code CANNOT be reported in conjunction with code and visa versa. Codes & should be used with either code or Code may be used in conjunction with

Nervous System Additions cont: Stereotactic Radiosurgery (Spinal)
63620 Stereotactic Radiosurgery (particle beam, gamma ray, or linear accelerator); 1 spinal lesion Stereotactic Radiosurgery (particle beam, gamma ray, or linear accelerator); each additional lesion (List separately in addition to code for primary procedure) 63620 describes SRS performed on one spinal lesion. A parenthetical note was added following code instructing users not to report code more than once per course of treatment. Code is an add-on code that describes SRS performed on each additional spinal lesion and is reported in addition to code as appropriate. A parenthetical note was added following code instructing users that this code may not be reported more than once per lesion and no more than two times per each course of treatment, regardless of the number of lesions treated.

Nervous System Additions cont: Spine and Spinal Cord:
62267 Percutaneous aspiration within the nucleus pulposus, intervertebral disc, or paravertebral tissue for diagnostic purposes Extra Cranial Nerves, Peripheral Nerves, and Autonomic Nervous System: 64455 Injection(s), anesthetic agent and/or steroid, plantar common digital nerve(s) (eg, Morton’s neuroma) 64632 Destruction by neurolytic agent; plantar common digital nerve Code is provided to evaluate cervical thoracic or lumbar infectious discitis; to evaluate spinal and or paravertebral fluid accumulation; or to harvest cells for diagnostic or therapeutic purposes. Codes and these services are provided for Morton’s neuroma and are reported only for injections and nerve destruction to the lower extreme, Code is reported one time only regardless of the number of injections provided during the session. Code cannot be assigned in conjunction with codes (Fine needle aspiration; with imaging guidance), (Biopsy, bone, trocar or needle; deep (eg, vertebral body, femur), (Decompression procedure, percutaneous, or nucleus pulposus of intervertebral disc, any method, single or multiple leels, lumbar (eg, manual or automated percutaneous discectomy, percutaneous laser discectomy), (injection procedure for discography, each level; lumbar) or (injection procedure for discography, each level; cervical or thoracic). Code can only be used in conjunction with code 63620 Code cannot be assigned in conjunction with code and visa versa.

Nervous Systems Deletions
61793 (crosswalk to , ) Just one deletion – code 61793

Nervous System Descriptor Changes
62287 For code 62287, the term “aspiration” was removed 63020 63030 +63035 For code , the term “including open and endoscopically-assisted approaches” added 64416 64446 64448 64449 For the code 64449, the terminology referring to the daily management removed

REMEMBER: Coding and Billing are Connected

Eye and Ocular Adnexa Additions: Anterior segment
65756 Keratoplasty (corneal transplant); endothelial Backbench preparation of corneal endothelial allograft prior to transplantation (List separately in addition to code for primary procedure) 65756 is offered to some patients as a substitute for full thickness corneal transplant. 65757 is for prep of the graft at the time of implant versus obtaining the graft from an eye bank.

Eye and Ocular Adnexa Descriptor Changes
65710 The term “anterior” was added 65730 The term “pseudophakia” was added 65710 was revised for clarification to to include the term “anterior,” as the procedure it represents is performed for scarring of the anterior cornea and includes replacement of the anterior layers of the cornea only, with limited intraocular incisions or manipulations required, whereas endothelial keratoplasty involves replacement of the endothelium that has become dysfunctional through aging or disease.

Radiology Clinical Brachytherapy Additions:
77785 Remote afterloading high dose rate radionuclide brachytherapy; 1 channel 77786 Remote afterloading high dose rate radionuclide brachytherapy; 2-12 channels 77787 Remote afterloading high dose rate radionuclide brachytherapy; over 12 channels Nuclear Medicine (Diagnostic) 78808 Injection procedure for radiopharmaceutical localization by non-imaging probe study, intravenous (eg. Parathyroid adenoma) have been deleted due to an inadequate descriptor for HDR (high dose rate). These codes are replaced with and have more specificity. With these codes, the physician’s work is measured by the number of catheter or channels utilized. 78808 reflects the resources required to provide radioactive drugs by intravenous route prior to gamma probe localization.

Radiology Deletions 77781 (crosswalk to for more specificity ) 77782 (crosswalk to for more specificity ) 77783 (crosswalk to for more specificity ) 77784 (crosswalk to for more specificity ) 78890 (no reference code given) 78891 (no reference code given) have been deleted due to an inadequate descriptor for HDR (high dose rate). These codes are replaced with and have more specificity. A crosswalk means “refer to”; because these have been deleted, go to code XXXXX for more specificity.

Radiology Descriptor Changes
74270 The term “contrast” was added to this code

Pathology & Laboratory
Additions: Chemistry 83876 Myeloperoxidase (MPO) 83951 Onocoprotein; des-gamma-carboxy-prothrombin (DCP) Hematology and Coagulation 85397 Coagulation & fibrinolysis, functional activity, not otherwise specified (eg, ADAMTS-13), each analyte These codes reflect new technology and are hard coded using the charge master. MPO is a biomarker that can identify troponin-negative patients at risk for myocardial infarction. Code was established to report quantitative determination of myeloperoxidase assay (analyte specific) as an indicator for risk and prognosis of patients with cardiovascular disease. MPO can be used as an early predictor of cardiac risk in patients who present within as little as 4 hours of the onset of chest pain.

Pathology & Laboratory
Additions cont: Microbiology 87905 Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid) N Vivo (eg, Transcutaneous) Laboratory Procedures 88720 Bilirubin, total, transcutaneous 88740 Hemoglobin, quantitative, transcutaneous; per day; carboxyhemoglobin 88741 Hemoglobin, quantitative, transcutaneous, per day; methamoglobin

Pathology & Laboratory Deletion
88400 (crosswalk to 88720) Only one code deleted from this section.

Pathology & Laboratory Descriptor Changes
80048 80053 80069 82040 82375 82376 83890 83891 83892 83893 83894 83897 83907 83909 83925 84132 84155 84295 87810 Since coders are rarely responsible for assigning these codes, see Appendix B for specifics to these changes.

Medicine Additions: Vaccines/Toxoids
90650 Human Papilloma virus (HPV) vaccine, types 16, 18, bivalent, 3 dose schedule, for intramuscular use 90681 Rotavirus vaccine, human, attenuated, 2 dose schedule, live, for oral use 90696 Diphtheria, tetanus toxoids, acellular pertussis vaccine and poliovirus vaccine, inactivated (DTap-IPV), when administered to children 4 through 6 years of age, for intramuscular use 90738 Japanese encephalitis virus vaccine, inactivated, for intramuscular use 90650 targets the oncogenic types of cervical cancer, type 16 and 18. the existing HPV vaccine code as seen on TV, targets types 16 and 18 and non oncogenic types 6 and 11, but does not contain th adjuvant formulation that is in code 90681 delivers the Rotavirus vaccine in two doses versus three. Rotavirus is the leading recognized cause of diarrhea-related illness, hospitalization, and in some parts of the world death among infants and young children. 90738-this vaccine primarily used by the military and is only offered to the civilian population if there will be travel into endemic areas in Asia. Japanese encephalitis is the leading cause of viral encephalitis in Asia. 90696 is a combination vaccine administered in a single injection and is intended to be administered as a booster dose to healthy children ages 4 to 6 who have completed the recommended immunization schedule for DTaP and polio virus during infancy. NOTE: The FDA has not yet approved the vaccine for and 90738

Medicine Additions: End-Stage Renal Disease Services
90951 End-stage renal disease (ESRD) related services monthly, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face physician visits per month 90952 with 2 to 5 face-to-face visits physician visits per month 90953 with 1 face-to-face physician visit per month These codes were established to report ESRD-related services for patients younger than 2 years of age.

Medicine Additions cont: End-Stage Renal Disease Services cont.
90954 End-stage renal disease (ESRD) related services monthly, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face physician visits per month 90955 with 2-3 face-to-face visits physician visits per month 90956 with 1 face-to-face physician visit per month These new codes are revisions and additions of the previous ESRD Services codes. The differences are in the “face-to-face” and number of monthly visit descriptors. 90951 through are reported once per month for one or more visits during the month for age specific services for ESRD services performed in the outpatient setting.

90957 End-stage renal disease (ESRD) related services monthly, for patients years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face physician visits per month 90958 with 2-3 face-to-face visits physician visits per month 90959 with 1 face-to-face physician visit per month 90951 through are reported once per month for one or more visits during the month for age specific services for ESRD services performed in the outpatient setting.

90960 End-stage renal disease (ESRD) related services monthly, for patients 20 years of age or older; with 4 or more face-to-face physician visits per month 90961 with 2-3 face-to-face visits physician visits per month 90962 with 1 face-to-face physician visits per month 90963 End-stage renal disease (ESRD) related services for home dialysis per full month, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents 90951 through are reported once per month for one or more visits during the month for age specific services for ESRD services performed in the outpatient setting. were established to report ESRD-related services for patients 20 years of age or older. These codes do not include the services that are included for younger patients (ie, monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of patients). 90963 through are reported once per month for one or more visits during the month of service to distinguish age specific services for ESRD services for home dialysis patients.

90964 End-stage renal disease (ESRD) related services for home dialysis per full month, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents 90965 End-stage renal disease (ESRD) related services for home dialysis per full month, for patient years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents 90966 End-stage renal disease (ESRD) related services for home dialysis per full month, for patients 20 years of age or older Code through are reported once per month for one or more visits during the month of service to distinguish age specific services for ESRD services for home dialysis patients.

90967 End-stage renal disease (ESRD) related services for dialysis less than a full month of service, per day; for patients younger than 2 years of age 90968 End-stage renal disease (ESRC) related services for dialysis less than a full month of service per day; for patients 2-11 years of age 90969 End-stage renal disease (ESRC) related services for dialysis less than a full month of service per day; for patients years of age 90970 End-stage renal disease (ESRC) related services for dialysis less than a full month of service per day; for patients 20 years of age or older 90967 – are reported the same as previous codes but are used for less than one month of service. These codes are based on the age of the patient and should be reported for each day of ESRD-related services for dialysis.

Medicine Additions: Cardiography
93228 Wearable mobile cardiovascular telemetry with electrocardiographic recording, concurrent computerized real time data analysis and greater than 24 hours of accessible ECG data storage (retrievable with query) with ECG triggered and patient selected events transmitted to a remote attended surveillance center for up to 30 days; physician review and interpretation with report 93229 Wearable mobile cardiovascular telemetry with electrocardiographic recording, concurrent computerized real time data analysis and greater than 24 hours of accessible ECG data storage (retrievable with query) with ECG triggered and patient selected events transmitted to a remote attended surveillance center for up to 30 days; technical support for connection and patient instructions for use, attended surveillance, analysis and physician prescribed transmission of daily and emergent data reports. 93228 and were established to report wearable rhythm derived cardiovascular telemetry These two codes were added in order to keep with the current cardiac monitoring practices. These codes cannot be reported in conjunction with (telephone transmission of post-symptom electrocardiogram rhythm strip(s), 24-hour attended monitoring, per 30 day period of time, tracing only).

Medicine Additions: Cardiovascular Device Monitoring – Implantable & Wearable Devices 93279 Programming device evaluation with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with physician analysis, review and report; single lead pacemaker system. 93280 dual lead pacemaker system 93281 multiple lead pacemaker system 93282 single lead implantable cardioverter-defibrillator system 93283 dual lead implantable cardioverter-defibrillator system 93284 multiple lead implantable cardioverter-defibrillator system 93285 implantable loop recorder system Before assigning code(s) read definitions.

Medicine Additions cont:
Cardiovascular Device Monitoring – Implantable & Wearable Devices (continued) 93286 Peri-procedural device evaluation and programming of device system parameters before or after a surgery, procedure, or test with physician analysis, review and report; single; dual, or multiple lead pacemaker system 93287 Single, dual, or multiple lead implantable cardioverter-defibrillator system 93288 Interrogation device evaluation (in person) with physician analysis; review and report, includes connection, recording and disconnection per patient encounter; single, dial, or multiple lead pacemaker system

Cardiovascular Device Monitoring – Implantable & Wearable Devices (continued) 93289 Single, dual, or multiple lead implantable cardioverter-defibrillator system, including analysis of heart rhythm derived data elements 93290 Implantable cardiovascular monitor system, including analysis of 1 or more recorded physiologic cardiovascular data elements from all internal and external sensors 93291 Implantable loop recorder system, including heart rhythm derived data analysis 93292 Wearable defibrillator System 93286 through are used to report the retrieval of data from all types of cardiovascular monitoring. 92386 and are pre-procedural evaluation and programming before or after surgery, procedure or test. The retrieved information is evaluated to determine the current programming of the device and to evaluate certain aspects of the device function such as battery voltage, lead impedance, tachycardia detection settings, and rhythm treatment settings.

Cardiovascular Device Monitoring – Implantable & Wearable Devices (continued) 93293 Transtelephonic rhythm strip pacemaker evaluation(s) single, dual, or multiple lead pacemaker system, includes recording with and without magnet application with physician analysis, review and report(s), up to 90 days. 93294 Interrogation device evaluation(s) (remote); up to 90 days; single, dual, or multiple lead pacemaker system with interim physician analysis, review(s) and report(s) 93295 Single, dual, or multiple lead implantable cardioverter-defibrillator system with interim physician analysis, review(s) and report(s) 93296 Single, dual, or multiple lead implantable cardioverter-defibrillator system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results

Cardiovascular Device Monitoring – Implantable & Wearable Devices (continued) 93297 Interrogation device evaluation(s) up to 30 days; implantable cardiovascular monitor system, including analysis of 1 or more recorded physiologic cardiovascular data elements from all internal and external sensors, physician analysis, review(s) and report(s) 93298 Implantable loop recorder system, including analysis of recorded heart rhythm data, physician analysis, review(s) and report(s) 93299 Implantable cardiovascular monitor system or implantable loop recorder system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results These codes are used to transtelephonic rhythm strip pacemaker evaluation. 93296 is a code for reporting non-physician technical services. are similar to except that they reflect 30 days of integration instead of 90 days.

Medicine Additions: Echocardiography
93306 Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, with spectral Doppler Echocardiography, and with color flow Doppler echocardiography 93351 Echocardiography, transthoracic, real-time with image documentation (2D) includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuous eletrocardiographic monitoring, with physician supervision Use of echocardiographic contrast agent during stress echocardiography (List separately in addition to code for primary procedure) 93306, and have been developed to address changes in clinical practice and allow the performance and interpretation of contrast enhanced echocardiography before and during a stress test.

Medicine Neurology and Neuromuscular Procedures
Additions: Neurology and Neuromuscular Procedures 95803 Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording) 95992 Canalith repositioning procedure(s) (eg, Epley maneuver, Semont maneuver), per day 95803 replaces a category III code. Actigraphy provides objective long term data on circadian rhythm and sleep patterns. Actigraphy provides day or weeks of data unlike polysomnography to assess the stability of sleep wake patterns and circadian rhythms and provide a good estimate of sleep time. 95592 Canalith repositioning producers describe a prescribed series of movements of the patients body and head. The maneuver is designed to use the force of gravity to redeposit calcium crystals debris that is in the semi-circular canal system (the debris causes benign paroxysmal positional vertigo (BPPV)) into a neutral part of the end organ where it cannot cause vertigo.

Medicine Additions: Hydration, Therapeutic, Prophylactic, Diagnostic Injections and Infusions, and Chemotherapy and Other highly complex Drug or highly Complex biologic Agent Administration 96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour each additional hour (List separately in addition to code for primary procedure) 96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour Each additional hour (List separately in addition to code for primary procedure) Additional sequential infusion, up to 1 hour (List separately in addition to code for primary procedure) Concurrent infusion (List separately in addition to code for primary procedure) Although the code numbers have changed, the descriptors and general instructions have not changed. The new code numbers allow the hydration and therapeutic/prophylactic/diagnostic injections and infusions to be grouped with the chemotherapy codes.

Hydration, Therapeutic, Prophylactic, Diagnostic Injections and Infusions, and Chemotherapy and Other highly complex Drug or highly Complex biologic Agent Administration (continued) 96369 Subcutaneous infusion for therapy or prophylaxis (specify substance or drug); initial, up to 1 hour, including pump set-up and establishment of subcutaneous infusion site(s) Each additional 1 hour (List separately in addition to code for primary procedure) Additional pump set-up with establishment of new subcutaneous infusion site(s) (List separately in addition to code for primary procedure) 96372 Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous of intramuscular These codes are used to identify resource use for highly complex injection and infusion procedures. These codes are intended to be reported in the facility setting.

Hydration, Therapeutic, Prophylactic, Diagnostic Injections and Infusions, and Chemotherapy and Other highly complex Drug or highly Complex biologic Agent Administration (continued) 96373 Intra-arterial 96374 Intravenous push, single or initial substance/drug Each additional sequential intravenous push of a new substance/drug (List separately in addition to code for primary procedure) Each additional sequential intravenous push of the same substance/drug provided in a facility (List separately in addition to code for primary procedure) 96379 Unlisted therapeutic, prophylactic, or diagnostic intravenous or intra-arterial injection or infusion

Medicine Deletions 90760 (crosswalk 96360) 90761 ( “ 96361)
90761 ( “ ) 90765 ( “ ) 90766 ( “ ) 90767 ( “ ) 90768 ( “ ) 90769 ( “ ) 90770 ( “ ) 90771 ( “ ) 90772 ( “ ) 90773 ( “ ) 90774 (crosswalk 96374) 90775 ( “ ) 90776 ( “ ) 90779 ( “ ) 90918 (see , 90963, 90967) 90919 (see , 90964, 90968) 90920 (see , 90965, 90969) 90921 (see , 90966, 90970)

Medicine Deletions Deletions cont:
90922 (crosswalk , 90963, 90967) 90923 ( “ , 90964, 90968) 90924 ( “ , 90965, 90969) 90925 ( “ , 90966, 90970) 91100 93727 ( “ , 93291, 93298) 93731, ( “ , 93294, 93280) 93733 (crosswalk 93293) 93734 ( “ , 93294, 93279) 93735 ( “ , 93294, 93279) 93736 ( “ ) 93741 ( “ , 93292) 93742 ( “ , 93292) 93743, ( “ , 93295, 93283) 93760, (no reference code given)

Medicine Descriptor Changes
93268 93270 93271 93272 93307 99308 93350 95010 95015 95250 95251 90698 93224 93225 93226 93227 93230 93231 93232 93233 93235 93236 93237

Inpatient Only The inpatient list specifies those services that are only paid when provided in an inpatient setting because of the nature of the procedure. Criteria used to determine if the procedure is “IP Only”: -- The underlying physical condition of the patient -- The need for at least 24 hours of postoperative recovery time or monitoring before the patient can be safely discharged.

Who Makes Inpatient Procedure Changes?
CMS determines that Inpatient Only procedures may need a status change to allow them to be performed in the outpatient setting. The following criteria is used to determine Inpatient Only Status: The procedure is being performed in numerous hospitals on an outpatient basis It has been determined the procedure can be appropriately and safely performed in an ASC A person or entity has proposed a procedure on the Inpatient only list to become an addition to the ASC (Ambulatory Surgical Centers) list

Inpatient Only Procedures
List of Additions: 0062T Percutaneous intradiscal annuloplasty, any method, except electrothermal, unilateral or bilateral including fluoroscopic guidance; single level +0063T One or more additional levels (List separately in addition to 0062T for primary procedure) 22526 Percutaneous intradiscal electrothermal annuloplasty, unilateral or bilateral including fluoroscopic guidance; single level one or more additional levels (List separately in addition to code for primary procedure) 22856 (new code) Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection), single interspace, cervical 22856, and were established to report artificial cervical total disc arthroplasty procedures. These services were previously reported with Cat. III codes 0090T, 0096T, and 0093T, respectively. These Category III codes have been deleted for CPT To accommodate the addition of the Category I codes; the lumbar arthroplasty cods that were added for CPT 2007, 22857, 22862, and 22865, have been revised to indented codes.

List of Additions cont: 22861 (new code) Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, single interspace; cervical 22864 (new code) Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace; cervical 27027 (new code) Decompression fasciotomy(ies), pelvic (buttock) compartment(s) (eg, gluteus medius-minimus, gluteus maximus, iliopsoas, and/or tensor fascia lata muscle), unilateral 27057 (new code) Decompression fasciotomy(ies), pelvic (buttock) compartment(s) (eg, gluteus medius-minimus, gluteus maximus, iliopsoas, and/or tensor fascia lata muscle), with debridement of nonviable muscle, unilateral Codes and have been added to report decompressive buttock fasciotomies. As is noted in the parenthetical notes added following these codes, bilateral performance of these services should be identified by appending modifier 50. Debridement procedures identified by codes are included as part

List of Additions cont: 35535 (new code) Bypass graft, with vein; hepatorenal 35570 (new code) tibial-tibial, peroneal-tibial, or tibial/peroneal trunk-tibial 35632 (new code) Bypass graft, with other than vein; ilio-celiac 35633 (new code) ilio-mesenteric 35634 (new code) iliorenal 41512 (new code) Tongue base suspension, permanent suture technique 43279 (new code) Laparoscopy, surgical, esophagomyotomy (Heller type), with fundoplasty, when performed

List of Deletions: 15170 Acellular dermal replacement, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children each additional 100 sq cm or less, or 1 % of body area of infants and children, or part thereof (List separately in addition to code for primary procedure) 15175 Acellular dermal replacement, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children each additional 100 sq cm or less, or 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure) Remember all codes with a plus are add-on codes and must be used with a preceding code.

List of Deletions cont: 34490 Thrombectomy, direct or with catheter; axillary and subclavian vein, by arm incision 36455 Exchange transfusion, blood; other than newborn 49324 Laparoscopy, surgical; with insertion of intraperitoneal cannula or catheter, permanent 49325 with revision of previously placed intraperitoneal cannula or catheter, with removal of intraluminal obstructive material if performed with omentopexy (omental tacking procedure) (List in separately in addition to code for primary procedure)

List of Deletions cont: Neuroendoscopy, intracranial, for placement or replacement of ventricular catheter and attachment to shunt system or external drainage (List separately in addition to code for primary procedure) 64448 Injection, anesthetic agent; femoral nerve, continuous infusion by catheter (including catheter placement) 64449 lumbar plexus, posterior approach, continuous infusion by catheter (including catheter placement)

Modifier Change - 21 has been deleted
To report prolonged physician services. Coders should review the guidelines in the E/M section when reporting -The most notable change to the modifier group of codes is the deletion of modifier -21 Codes should be used to report prolonged physician services. Coders should review the guidelines in the E/M section regarding re porting these codes. -If you have a bill that has a code with a modifier -21, there will be no reimbursement for this procedure; it will be rejected. Modifier -21 has been deleted. -What are Modifiers? • Used to identify circumstances that alter or enhance the description of a service or supply.

Device Intensive Additions
24361 Arthroplasty, elbow; with distal humeral prosthetic replacement 24363 with distal humerus and proximal ulnar prosthetic replacement (eg, total elbow) 24366 Arthroplasty, radial head; with implant 25441 Arthroplasty with prosthetic replacement; distal radius 25442 distal ulna 27446 Arthroplasty, knee, condyle and plateau; medial OR lateral compartment

Device Intensive Additions
List of Additions cont: 65770 Keratoprosthesis 69714 Implantation, osseointegrated implant, temporal bone, with percutaneous attachment to external speech processor/cochlear stimulator; without mastoidectomy 69715 with mastoidectomy 69717 Replacement (including removal of existing device), osseointegrated implant, temporal bone, with percutaneous attachment to external speech processor/cochlear stimulator; without mastoidectomy 69718 with mastoidectomy

Device Intensive Deletions
33210 Insertion or replacement of temporary transvenous single chamber cardiac electrode or pacemaker catheter (separate procedure) 33211 Insertion or replacement of temporary transvenous dual chamber pacing electrodes (separate procedure) 33216 Insertion of a transvenous electrode; single chamber (one electrode) permanent pacemaker or single chamber pacing cardioverter-defibrillator 33217 dual chamber (two electrodes) permanent pacemaker or dual chamber pacing cardioverter-defibrillator 36566 Insertion of tunneled centrally inserted central venous access device, requiring two catheters via two separate venous access sites; with subcutaneous port(s)

New HCPCS Codes - 2009 A6545 C9898 A9284 C9899 A9580 D0417 C8929 D0418
C9246 E0487 C9247 E0656 C9248 E0657 C9356 E0770 C9358 E1354 C9359 E1356 E1357 G0406 E1358 G0407 E2230 G0408 E2231 G0409 E2295 G0410 G0398 G0411 G0399 G0412 G0400 G0413 G0402 G0414 G0403 G0415 G0404 G0416 G0405 G0417 On the next 9 slides, I’ve listed the New, Changed, Deleted and Reinstated HCPCS Codes for This is for your information only. I will not be reviewing these during this presentation. In the Ingenix HCPCS Level II 2009 book, this list can be found in Appendix 5 on page 76

New HCPCS Codes – 2009 Continued
G0418 G8495 G0419 G8496 G8485 G8497 G8486 G8498 G8487 G8499 G8488 G8500 G8489 G8501 G8490 G8502 G8491 G8503 G8492 G8504 G8493 G8505 G8494 G8506 G8507 G8519 G8508 G8520 G8509 G8521 G8510 G8522 G8511 G8523 G8512 G8524 G8513 G8525 G8514 G8526 G8515 G8527 G8516 G8528 G8517 G8529 G8518 G8530

G8531 G8543 G8532 G8544 G8533 J0641 G8534 J1267 G8535 J1453 G8536 J1459 G8537 J1930 G8538 J1953 G8539 J2785 G8540 J3101 G8541 J3300 G8542 J7186 J7606 L6722 J8705 L8604 J9033 Q4100 J9207 Q4101 J9330 Q4102 K0672 Q4103 L0113 Q4104 L6711 Q4105 L6712 Q4106 L6713 Q4107 L6714 Q4108 L6721 Q4109

Q4110 Q4111 Q4112 Q4114 S2118 S2270 S3628 S3711 S3860 S3861 S3862 S9433 Changed Codes: A6010 A6204 A6011 A6205 A6021 A6206 A6022 A6207 A6023 A6208 A6024 A6209 A6196 A6210 A6197 A6211 A6198 A6212 A6199 A6213 A6203 A6214

HCPCS Changed Codes – 2009 Continued
A6215 A6233 A6219 A6234 A6220 A6235 A6221 A6236 A6222 A6237 A6223 A6238 A6224 A6239 A6228 A6240 A6229 A6241 A6230 A6242 A6231 A6243 A6232 A6244 A6245 A6259 A6246 A6260 A6247 A6261 A6248 A6262 A6251 A6266 A6252 A6407 A6253 A9502 A6254 C8921 A6255 C8922 A6256 C8923 A6257 C8924 A6258 C8925

C8927 D4260 C8928 D4261 D0486 D5211 D1203 D5212 D1204 E0764 D3310 G0129 D3320 G0248 D3330 G0250 D4210 G0275 D4211 G8417 D4240 G8418 D4241 G8419 G8420 G8447 G8427 G8448 G8428 G8457 G8429 G8485 G8430 G8486 G8431 G8487 G8433 J0270 G8437 J0348 G8438 J1572 G8439 J2788 G8440 J2790 G8446 J3301

J7639 J9110 J9000 J9120 J9001 J9150 J9010 J9151 J9015 J9160 J9017 J9165 J9020 J9170 J9040 J9181 J9045 J9185 J9050 J9190 J9098 J9200 J9100 J9201 J9206 J9270 J9208 J9300 J9209 J9310 J9211 J9320 J9213 J9340 J9214 J9350 J9215 J9355 J9216 J9357 J9230 J9360 J9265 J9390 J9266 J9600 J9268 K0669

HCPCS Changed Codes and Deleted Codes – 2009 Continued
K0899 L8681 L3905 L8689 L4360 L8695 Deleted Codes: C9003 J7344 G0300 J9182 G0314 L7612 G0321 S2075 G0332 C9237 J1751 G0308 Deleted Codes cont. G0315 G0323 G0322 G0366 G0344 J3100 J1752 J7347 J7346 L3890 L2860 L7614 L7613 S2077 S2076 C9239 C9238 G0310 G0309 G0317 G0316 G0324

HCPCS Deleted Codes – 2009 Continued
G0367 J7349 J7340 L5994 J7348 L7622 L5993 S9092 L7621 C9723 S2135 G0312 C9240 G0319 G0311 G0326 G0318 G0377 G0325 J7342 G0368 J7602 J7341 J5995 S0141 G0297 G0313 G0320 G0327 G0394 J7343 J7603 L7611 S0143

HCPCS Reinstated Codes – 2009
J7611 Albuterol, inhalation solution, FDA-approved final product, noncompounded, administered through DME, concentrated form, 1 mg. J7612 Levalbuterol, inhalation solution, FDA-approved final product, noncompounded, administered through DME, concentrated form, 0.5 mg. J7613 Albuterol, inhalation solution, FDA-approved final product, noncompounded, administered through DME, unit dose, 1 mg. J7614 Levalbuterol, inhalation solution, FDA-approved final product, noncompounded, administered through DME, unit dose, 0.5 mg.

Summary Please share these updates with other billers and coders at your facility REMEMBER: Coding and Billing are Connected

Questions ?

References (OPPS Final Rule Federal Register) American Medical Association, CPT 2009 1 CPT Changes: An Insider’s View 2009, Ingenix “2009 CPT & OPPS Changes”, presentation by Sandra Draper, 12/18/2008, Precyse Solutions, LLC

2009 CPT & HCPCS Level II Updates & Billing Impacts

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