CMS Revised & Deleted CPT Codes For 2010

CMS has announced the CPT changes (Additions / Revised and Deletions) for the year 2010 that has been posted in

http://www.cms.hhs.gov/OutpatientCodeEdit/Downloads/SumofDataChngsSpec-CMSReport.pdf

2010 Current Procedural Terminology would contain 298 newly added CPT codes with 178 revised codes and 7 newly added Modifiers. 130 CPT codes have been deleted for the year 2010. A brief update on the changes with regard to major CPT codes are given below

1. Evaluation and Management (E/M)
Effective Jan 1, 2010 both Office and Hospital Inpatient consultation codes, CPT codes 99241 to 99245 and 99251 to 99255 respectively are invalid for Medicare and there are no separate replacement codes for these services rendered. Physicians should report CPT 99201 – 99205 for his consultation services rendered to a New patient and CPT 99211 – 99215 for an Established patient in the Office.

Similarly there are no replacement codes for Inpatient Consultation services rendered in Hospitals. Providers should bill CPT 99221 – 99223 as these codes are not to be considered as ‘Admit codes’. These codes are to be used by all physicians upon their first encounter with the patient. In order to differentiate from the admitting physician and other physicians providing care to the patient, the admitting provider will be required to add Modifier AI to his/her service signifying that he/she is the admitting physician
Please refer the link for more information: http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6740.pdf
2. Anesthesiology

A new line with “ANSCF” / “ANES” for Anesthesia Conversion Factor has been added to the Fee Schedule and the Fee amount is common for the CPT codes 00100 – 09999

CPT 01632 [Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; radical resection] has been deleted and no replacement code applicable for the same.

3. Surgery

CPT 14300 [Adjacent tissue transfer or rearrangement, more than 30 sq cm, unusual or complicated, any area] has been deleted and replaced with CPT 14301 that defines Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cm.

CPT 19295 has been revised with new description ‘Image guided placement, metallic localization clip, percutaneous, during breast biopsy/aspiration (List separately in addition to code for primary procedure)’.

42 New codes are added for Musculoskeletal System (CPT 20000- CPT 29999) that describes the procedure more accurately for Excision / resection of Tumors.

CPT 31626 that describes Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of fiducial markers, single or multiple and

CPT 31627 that describes Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with computer-assisted, image-guided navigation (List separately in addition to code for primary procedure[s]) are newly added for the year 2010

Urodynamics section includes 3 news codes (CPT 51727, CPT 51728, and CPT 51729), 2 revised codes (CPT 51726, and CPT 51797) and 2 deletions (CPT 51772 and CPT 51795)

Pain Management Code updates: Effective January 1, 2010, procedure codes used for reporting Facet joint injections CPT 64470 through 64476 have been deleted and replaced with 64490 – 64495, defined as follows:

1. CPT 64490 – Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; single level

2. CPT 64491 – Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; second level (List separately in addition to code for primary procedure)

3. CPT 64492 – Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; third and any additional level(s) (List separately in addition to code for primary procedure)

4. CPT 64493 – Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; single level

5. CPT 64494 – Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; second level (List separately in addition to code for primary procedure)

6. CPT 64495 – Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; third and any additional level(s) (List separately in addition to code for primary procedure)

No separate payments are allowed for Fluoroscopy, CPT 77003 since the procedure is included in the CPT 64490 – 64495 itself. Providers can continue to bill and get reimbursed for Fluoroscopy, CPT 77003 along with CPT codes 64622 – 64627 since there are no changes in these series.

4. Radiology

Major changes have been made in the Nuclear Medicine (CPT codes 78000-79999). CPT codes that were used to report Myocardial perfusion Imaging (MPI – CPT codes 78460 – 78465), with Wall motion (WI – CPT 78478) and Ejection Fractions (EF – CPT 78480) has been deleted and replaced with CPT codes 78451 – 78454 with description as follows

78451 Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic)

78452 Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or redistribution and/or rest reinjection

78453 Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic)

78454 Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or redistribution and/or rest reinjection

5. Pathology and Laboratory

The final rule on Clinical Laboratory CPT Codes can be referred at
http://www.cms.hhs.gov/ClinicalLabFeeSched/Downloads/Calendar_Year_2010_rationale.pdf

6. Medicine

CPT code 90379 has been deleted and replaced with the existing CPT 90378 with new description Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each

CPT 90663 has been revised that defines Influenza virus vaccine, pandemic formulation, H1N1

References:
http://www.cms.hhs.gov/transmittals/downloads/R1872CP.pdf
http://www.cms.hhs.gov/transmittals/downloads/R1882CP.pdf
http://www.cignagovernmentservices.com/partb/pubs/news/2009/1109/cope10956.pdf

Please click the below link to view 2010 Part B Medicare Physician Fee Schedule for all States
http://codingahead.blogspot.com/2009/11/2010-medicare-fee-schedule.html