1 / 52

2010 CPT & HCPCS

2010 CPT & HCPCS . What’s new for the New Year Katherine Kannard, CPC, CPC-I, CPMA. Agenda. 2010 CPT changes continued 2010 HCPCS changes New, deleted and revised codes that will affect your coding and reimbursement- CPT Medicine Section, Category II, Category III codes, and HCPCS codes.

feo
Télécharger la présentation

2010 CPT & HCPCS

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. 2010 CPT & HCPCS What’s new for the New Year Katherine Kannard, CPC, CPC-I, CPMA

  2. Agenda • 2010 CPT changes continued • 2010 HCPCS changes New, deleted and revised codes that will affect your coding and reimbursement- CPT Medicine Section, Category II, Category III codes, and HCPCS codes

  3. Medicine Codes For the Immune Globulin Section • 90378 Description change removing the words “immune globulin (RSV IgIM)” and adding the words “monoclonal antibody recombinant” • 90379 was deleted

  4. Medicine Codes For the Vaccine Toxoid Section • 90669 Description change removing the words “polyvalent” and replacing it with the words “7 valent” and also deleting the words “when administered to children 5 years younger than 5 years” • 90670 New code for pneumococcal conjugate vaccine, 13 valent, for intramuscular use

  5. Medicine Codes For the Special Otorhinolaryngologic Services Section • 92540 New code for basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording, positional nystagmus test, minimum of 4 positions, with recording, optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording, and oscillating tracking test, with recording • 92550 New code for tympanometry and reflex threshold measurements • 92569 was deleted • 92570 New code for acoustic immittance testing, includes tympanometry (impedance testing), acoustic reflex threshold testing, and acoustic reflex decay testing

  6. Medicine Codes For the Cardiovascular Section • 93279 Description changed adding the words “in person ” • 93280-93285 Description was marked as change but the only thing that changed was the addition of another reference of the CPT assistant • 93286 Description changed adding the words “in person ” • 93287 Description was marked as change but the only thing that changed was the addition of another reference of the CPT assistant • 93701 Description changed removing the words “thoracic, electrical” and replacing them with “derived-physiologic cardiovascular analysis” • 93750 New code for interrogation of ventricular assist device (VAD), in person, with physician analysis of device parameters (eg, drivelines, alarms, power surges), review of device function (eg, flow and volume status, septum status, recovery), with programming, if performed, and report

  7. Medicine Codes For the Pulmonary Section • 94011 New code for measurement of spirometric forced expiratory flows in an infant or child through 2 years of age • 94012 New code for measurement of spirometric forced expiratory flows, before and after bronchodilator, in an infant or child through 2 years of age • 94013 New code for measurement of lung volumes (ie, functional residual capacity [FRC], forced vital capacity [FVC], and expiratory reserve volume [ERV]) in an infant or child through 2 years of age

  8. Medicine Codes For the Neurologic and Neuromuscular Section • 95806 Description changed to read “sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory” airflow, and respiratory effort (eg, thoracoabdominal movement) • 95905 New code for motor and/or sensory nerve conduction, using preconfigured electrode array(s), amplitude and latency/velocity study, each limb, includes F-wave study when performed, with interpretation and report

  9. Medicine Codes For the Chemotherapy Section • 96570 and 96571 (Add on Codes) Description changed removing the word “esophagus” and replacing it with “gastrointestinal tract” For the Other Services and Procedures Section • 99185 and 99186 were deleted

  10. Category II Codes Category II codes are a set of supplemental tracking codes that are used for performance management (PQRI). These can reduce the need for record requests and chart reviews. They are not mandatory to use and can not be used to substitute for Category I codes. Category II Modifiers are • 1P “Peformance Measure Exclusion Modifier due to Medical Reasons” • 2P Peformance “Measure Exclusion Modifier due to Patient Reasons” • 3P Peformance Measure Exclusion Modifier due to System Reasons”

  11. Category II Codes For the Patient Management Section • 0519F Description changed removing the words “course of treatment” and replacing them with the words “a new treatment regimen” • 0520F Description changed removing the words “normal tissue dose constraints” and replacing them with the words “radiation dose limits to normal tissues” and removing the words “within 5 treatment days from” and replacing them with “prior to” and removing the word “one” and replacing it with “2” • 0521F Description changed adding the word “(COA)2 “ • 0528F New code for recommended follow-up interval for repeat colonoscopy of at least 10 years documented in colonoscopy report (End/Polyp)

  12. Category II Codes For the Patient Management Section-continued • 0529F New code for interval of 3 or more years since patient’s last colonoscopy, documented (End/Polyp) • 0535F New code for dyspnea management plan of care, documented (Pall Cr) • 0540F New code for Glucorticoid Management Plan documented (RA) • 0575F New code for HIV RNA control plan of care, documented (HIV)

  13. Category II Codes For the Patient History Section • 1150F New code for documentation that a patient has a substantial risk of death within 1 year (Pall Cr) • 1151F New code for documentation that a patient does not have a substantial risk of death within one year (Pall Cr) • 1152F New code for documentation of advanced disease diagnosis, goals of care prioritize comfort (Pall Cr) • 1153F New code for documentation of advanced disease diagnosis, goals of care do not prioritize comfort (Pall Cr) • 1157F New code for advance care plan or similar legal document present in the medical record (COA) • 1158F New code for advance care planning discussion documented in the medical record (COA)

  14. Category II Codes For the Patient History Section-continued • 1159F New code for medication list documented in medical record (COA) • 1160F New code for review of all medications by a prescribing practitioner or clinical pharmacist (such as, prescriptions, OTCs, herbal therapies and supplements) documented in the medical record (COA) • 1170F New code for functional status assessed (COA) (RA) • 1180F New code for all specified thromboembolic risk factors assessed (AFIB) • 1220F New code for patient screened for depression (SUD)

  15. Category II Codes For the Physical Exam Section • 2050F New code for wound characteristics including size AND nature of wound base tissue AND amount of drainage prior to debridement documented (CWC) For the Diagnostic/Screening Processes or Results • 3016F New code for patient screened for unhealthy alcohol use using a systematic screening method (PV) • 3018F New code for pre-procedure risk assessment AND depth of insertion AND quality of the bowel prep AND complete description of polyp(s) found, including location of each polyp, size, number and gross morphology AND recommendations for follow-up in final colonoscopy report documented (End/Polyp) • 3250F New code for specimen site other than anatomic location of primary tumor (PATH) • 3302F-3312F were deleted

  16. Category II Codes For the Diagnostic/Screening Processes or Results-continued • 3321F New code for AJCC Cancer Stage 0 or IA Melanoma, documented (ML) • 3322F New code for melanoma greater than AJCC Stage 0 or IA (ML) • 3370F New code for AJCC Breast Cancer Stage 0 documented (ONC) • 3372F New code for AJCC Breast Cancer Stage I: T1mic, T1a or T1b (tumor size ≤ 1 cm) documented (ONC) • 3374F New code for AJCC Breast Cancer Stage I: T1c (tumor size > 1 cm to 2 cm) documented (ONC) • 3376F New code for AJCC Breast Cancer Stage II documented (ONC) • 3378F New code for AJCC Breast Cancer Stage III documented (ONC)

  17. Category II Codes For the Diagnostic/Screening Processes or Results-continued • 3380F New code for AJCC Breast Cancer Stage IV documented (ONC) • 3382F New code for AJCC colon cancer, Stage 0 documented (ONC) • 3384F New code for AJCC colon cancer, Stage I documented (ONC) • 3386F New code for AJCC colon cancer, Stage II documented (ONC) • 3388F New code for AJCC colon cancer, Stage III documented (ONC) • 3390F New code for AJCC colon cancer, Stage IV documented (ONC) • 3450F New code for dyspnea screened, no dyspnea or mild dyspnea (Pall Cr) • 3451F New code for dyspnea screened, moderate or severe dyspnea (Pall Cr) • 3452F New code for dyspnea not screened (Pall Cr)

  18. Category II Codes For the Diagnostic/Screening Processes or Results-continued • 3455F New code for TB screening performed and results interpreted within six months prior to initiation of first-time biologic disease modifying anti-rheumatic drug therapy for RA (RA) • 3470F New code for Rheumatoid arthritis (RA) disease activity, low (RA) • 3471F New code for Rheumatoid arthritis (RA) disease activity, moderate (RA) • 3472F New code for Rheumatoid arthritis (RA) disease activity, high (RA) • 3475F New code for disease prognosis for rheumatoid arthritis assessed, poor prognosis documented (RA) • 3476F New code for disease prognosis for rheumatoid arthritis assessed, good prognosis documented (RA) • 3490F New code for history of AIDS-defining condition (HIV) • 3491F New code for HIV indeterminate (infants of undetermined HIV status born of HIV-infected mothers) (HIV)

  19. Category II Codes For the Diagnostic/Screening Processes or Results-continued • 3492F New code for history of nadir CD4+ cell count <350 cells/mm (HIV) • 3493F New code for no history of nadir CD4+ cell count <350 cells/mm AND no history of AIDS-defining condition (HIV) • 3494F New code for CD4+ cell count <200 cells/mm (HIV) • 3495F New code for CD4+ cell count 200-499 cells/mm (HIV) • 3496F New code for CD4+ cell count ≥500 cells/mm (HIV) • 3497F New code for CD4+ cell percentage <15% (HIV) • 3498F New code for CD4+ cell percentage ≥15% (HIV) • 3500F New code for CD4+ cell count or CD4+ cell percentage documented as performed (HIV) • 3502F New code for HIV RNA viral load below limits of quantification (HIV) • 3503F New code for HIV RNA viral load not below limits of quantification (HIV)

  20. Category II Codes For the Diagnostic/Screening Processes or Results-continued • 3510F New code for documentation that tuberculosis (TB) screening test performed and results interpreted (HIV) • 3511F New code for chlamydia and gonorrhea screenings documented as performed (HIV) • 3512F New code for syphilis screening documented as performed (HIV) • 3513F New code for Hepatitis B screening documented as performed (HIV) • 3514F New code for Hepatitis C screening documented as performed (HIV) • 3515F New code for patient has documented immunity to Hepatitis C (HIV) • 3550F New code for low risk for thromboembolism (AFIB) • 3551F New code for intermediate risk for thromboembolism (AFIB) • 3552F New code for high risk for thromboembolism (AFIB)

  21. Category II Codes For the Diagnostic/Screening Processes or Results-continued • 3555F New code for patient had International Normalized Ratio (INR) measurement performed (AFIB) • 3570F New code for final report for bone scintigraphy study includes correlation with existing relevant imaging studies (eg, x-ray, MRI, CT) corresponding to the same anatomical region in question (NUC_MED) • 3572F New code for patient considered to be potentially at risk for fracture in a weight-bearing site (NUC MED) • 3573F New code for patient not considered to be potentially at risk for fracture in a weight-bearing site (NUC_MED)

  22. Category II Codes For the Therapeutic, Preventive, or Other Inventions Section-continued • 4011F Description changed removing the example • 4148F New code for Hepatitis A vaccine injection administered or previously received (HEP-C) • 4149F New code for Hepatitis B vaccine injection administered or previously received (HEP-C) • 4152F, 4154F, and 4156F were deleted • 4158F Description changed removing “education regarding risk of alcohol consumption performed” and replacing it with “counseled about risks of alcohol use” • 4180F Description changed adding the word “referred” and removing the words “A through Stage IIIC” • 4192F New code for patient not receiving glucocorticoid therapy (RA) • 4193F New code for patient receiving <10 mg daily prednisone (or equivalent), or RA activity is worsening, or glucocorticoid use is for less than 6 months (RA)

  23. Category II Codes For the Therapeutic, Preventive, or Other Inventions Section-continued • 4194F New code for patient receiving ≥10 mg daily prednisone (or equivalent) for longer than 6 months, and improvement or no change in disease activity (RA) • 4195F New code for patient receiving first-time biologic disease modifying anti-rheumatic drug therapy for rheumatoid arthritis (RA) • 4196F New code for patient not receiving first-time biologic disease modifying anti-rheumatic drug therapy for rheumatoid arthritis (RA) • 4200F Description changed adding “as primary therapy” and removing the word “only” and replacing it with “ with or without nodal irradiation” • 4201F Description changed adding the words “with or without nodal irradiation as adjuvant or salvage therapy” and removing the words “ to region(s) other than prostate only” and replacing it with “patient” • 4250F Description changed replacing “30 minutes” with “15 minutes”

  24. Category II Codes For the Therapeutic, Preventive, or Other Inventions Section-continued • 4260F New code for wound surface culture technique used (CWC) • 4261F New code for technique other than surface culture of the wound exudate used (eg, Levine/deep swab technique, semi-quantitative or quantitative swab technique) OR wound surface culture technique not used (CWC) • 4265F New code for use of wet to dry dressings prescribed or recommended (CWC) • 4266F New code for use of wet to dry dressings neither prescribed nor recommended (CWC) • 4267F New code for compression therapy prescribed (CWC) • 4268F New code for patient education regarding the need for long term compression therapy including interval replacement of compression stockings received (CWC) • 4269F New code for appropriate method of offloading (pressure relief) prescribed (CWC)

  25. Category II Codes For the Therapeutic, Preventive, or Other Inventions Section-continued • 4270F New code for patient receiving potent antiretroviral therapy for 6 months or longer (HIV) • 4271F New code for patient receiving potent antiretroviral therapy for less than 6 months or not receiving potent antiretroviral therapy (HIV) • 4274F New code for influenza immunization administered or previously received (HIV) (P-ESRD) • 4275F New code for Hepatitis B vaccine injection administered or previously received (HIV) • 4276F New code for potent antiretroviral therapy prescribed (HIV) • 4279F New code for pneumocystis jiroveci pneumonia prophylaxis prescribed (HIV) • 4280F New code for pneumocystis jiroveci pneumonia prophylaxis prescribed within 3 months of low CD4+ cell count or percentage (HIV)

  26. Category II Codes For the Therapeutic, Preventive, or Other Inventions Section-continued • 4290F New code for patient screened for injection drug use (HIV) • 4293F New code for patient screened for high-risk sexual behavior (HIV) • 4300F New code for patient receiving warfarin therapy for nonvalvular atrial fibrillation or atrial flutter • (AFIB) • 4301F New code for patient not receiving warfarin therapy for nonvalvular atrial fibrillation or atrial flutter (AFIB) • 4305F New code for patient education regarding appropriate foot care AND daily inspection of the feet received (CWC) • 4306F New code for patient counseled regarding psychosocial AND pharmacologic treatment options for opioid addiction (SUD) • 4320F New code for patient counseled regarding psychosocial AND pharmacologic treatment options for alcohol dependence (SUD)

  27. Category II Codes For the Follow-up or Other Outcomes Section 5020F Description change adding the words “and to the patient” 5100F New code for potential risk for fracture communicated to the referring physician within 24 hours of completion of the imaging study (NUC_MED) For the Patient Safety Section 6030F Description change removing the word “followed” and replacing it with “(or acceptable alternative antiseptics, per current guideline)”

  28. Category III Codes Category II codes are a set of temporary codes for emerging services, technology, and/or procedures. Category III codes take precedence over Category I codes. Therefore if you have a service that could be code in either category, use the Category III codes.

  29. Category III Codes • 0062T-0070T were deleted • 0077T, 0084T, 0086T-0087T, 0144T-0151T, and 0170T were deleted • 0194T was deleted • 0197T New code for intra-fraction localization and tracking of target or patient motion during delivery of radiation therapy (eg, 3D positional tracking, gating, 3D surface tracking), each fraction of treatment • 0198T New code for measurement of ocular blood flow by repetitive intraocular pressure sampling, with interpretation and report • 0199T New code for physiologic recording of tremor using accelerometer(s) and/or gyroscope(s) (including frequency and amplitude), including interpretation and report

  30. Category III Codes • 0200T New code for percutaneous sacral augmentation (sacroplasty), unilateral injection(s), including the use of a balloon or mechanical device, when used, 1 or more needles • 0201T New code for percutaneous sacral augmentation (sacroplasty), bilateral injections, including the use of a balloon or mechanical device, when used, 2 or more needles • 0202T New code for posterior vertebral joint(s) arthroplasty (eg, facet joint[s] replacement), including facetectomy, laminectomy, foraminotomy, and vertebral column fixation, injection of bone cement, when performed, including fluoroscopy, single level, lumbar spine • 0203T New code for sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (eg, by airflow or peripheral arterial tone) and sleep time • 0204T New code for sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (eg, by airflow or peripheral arterial tone)

  31. Category III Codes • 0205T New code for intravascular catheter-based coronary vessel or graft spectroscopy (eg, infrared) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation, and report, each vessel (List separately in addition to code for primary procedure) • 0206T New code for algorithmic analysis, remote, of electrocardiographic-derived data with computer probability assessment, including report • 0207T New code for evacuation of meibomian glands, automated, using heat and intermittent pressure, unilateral

  32. New Modifiers • AI- Principal physician of record • J4 DMEPOS competitive bid furnished by hospital • PA-Surgery, wrong body part • PB0-Surgery, wrong patient • PC-Wrong surgery on patient • PI-PET tumor initial therapy strategy • PS-PET tumor subsequent therapy strategy • V5-Vascular catheter • V6-Arteriovenous graft • V7-Arteriovenous fistula • V8-Infection present • V9-No infection present

  33. HCPCS Codes New Codes • A4264 Permanent Implantable Contraceptive Intratubal occlusion device(s) and delivery system • A4336 Urethral insert, any type • A4360 Disposable external urethral device with pad and/or pouch • A4456 Adhesive remover, wipes • A4466 Elastic garment/covering or any similar stretchable material • A9581 Gadoxetate disodium injection 1ml • A9582 Iodine I-123 iobenguane diagnostic per study dose up to 15 millicuries • A9583 Gadofosveset trisodium injection, 1ml • A9604 Samarium Sm 153 lexidronam, therapeutic per treatment dose up to 150 millicuries • C9250 Artiss human plasma fibrin sealant, 2 ml • C9254 Injection, lacosamide 1mg • C9255 Paliperidone palmitate injection, 1mg

  34. HCPCS Codes New Codes-continued • C9256 Dexamethasone intravitreal implant, 0.1mg • C9257 Bevacizumab injection 0.25 mg • C9360 SurgiMend, neonatal bovine origin per 0.5 cm • C9361 NeuroMend nerve wrapper 0.5 cm • C9362 Implant,bone void filler-strip per 0.5cc • C9363 Integra Meshed Bilayer Wound Matrix per sq cm • C9364 Porcine implant, Permacol, per sq cm • E0433 Portable liquid oxygen sys, I month’s supply=1 unit • E1036 Patient transfer system patient weight capacity>300 lbs • G0420 Educational service Chronic Kidney Disease individual 1 hour per session • G0421 Educational service Chronic Kidney Disease group 1 hour per session • G0422 Intensive cardiac rehab w/exercise with/without ECG monitoring • G0423 Intensive cardiac rehab no exercise with/without ECG monitoring

  35. HCPCS Codes New Codes-continued • G0425 Initial Inpatient telehealth consult 30 min • G0426 Initial Inpatient telehealth consult 50 min • G0427 Initial Inpatient telehealth con 70min or more • G0430 Drug screen multi class other than chromatographic method, each procedure • G0431 Drug screen single class, each drug class • G8545 Intend to report HepC measures group • G8546 Intend to report Community Acquired Pneumonia measures group • G8547 Intend to report Ischemic Vascular Disease measures group • G8548 Intend to report Heart Failure measures group • G8549 HepC Measures Group actions performed • G8550 Community Acquired Pneumonia Measures Group actions performed

  36. HCPCS Codes New Codes-continued G8551 Heart Failure Measures Group actions performed G8552 Ischemic Vascular Disease Measures Group actions performed G8553 1 prescription transmitted via electronic Rx system G8556 Referral to physician for otologic evaluation G8557 Patient ineligible for referral to physician for otologic evaluation G8558 No referral to physician for otologic evaluation G8559 Patient referred to physician for otologic evaluation G8560 Patient history of active drainage previous 90 days G8561 Patient ineligible for referral to physician for otologic evaluation with active drainage G8562 Patient no history of active drainage previous 90 days G8563 Patient not referred to physician for otologic evaluation , not specific reason G8564 Patient referred to physician for otologic evaluation , not specific reason G8565 Verification and documentation of rapid progressive hearing loss G8566 Patient ineligible for referral to physician for otologic evaluation for rapid progressive hearing loss

  37. HCPCS Codes New Codes-continued • G8567 No verification and documentation of rapid progressive hearing loss • G8568 Patient not referred to physician for otologic evaluation , not specific reason • G8569 Prolonged intubation required greater than 24 hours • G8570 Prolonged intubation not required greater than 24 hours • G8571 Sternal deep wound infection 30 days postop • G8572 No sternal deep wound infection • G8573 Stroke/CVA following isolated CABG surgery • G8574 No Stroke/CVA following isolated CABG surgery • G8575 Postop renal insufficiency or required dialysis • G8576 No Postop renal insufficiency or required dialysis • G8577 Reoperation required due to bleeding/tamponade, graft occlusion or other cardiac reason • G8578 No Reoperation required due to bleeding/tamponade, graft occlusion or other cardiac reason

  38. HCPCS Codes New Codes-continued • G8579 Antiplatelet medication at discharge • G8580 Antiplatelet medication contraindication/not indicated • G8581 No Antiplatelet medication at discharge • G8582 Beta-blocker medication at discharge • G8583 Beta-blocker medication contraindication/not indicated • G8584 No Beta-blocker medication at discharge • G8585 Antilipid treatment at discharge • G8586 Antilipid treatment at discharge contraindication/not indicated • G8587 No Antilipid treatment at discharge • G8588 Most recent Systolic BP <140 • G8589 Most recent Systolic BP >= 140 • G8590 Most recent Diastolic BP < 90 • G8591 Most recent Diastolic BP >= 90

  39. HCPCS Codes • G8592 No BP measurement • G8593 Lipid results documented and reviewed (must include cholesterol, HDL-C, triglycerides, and calculated LDL-C) • G8594 No lipid profile performed • G8595 Most recent Ldl < 100 • G8596 No LDL performed • G8597 Most recent Ldl >= 100 • G8598 Aspirin or other antithrombotic therapy used • G8599 No Aspirin or other antithrombotic therapy used • G8600 IV tPA initiated w/in 3 hrs • G8601 No IV tPA initiated w/in 3 hrs, documented reason by clinician • G8602 No IV tPA initiated w/in 3 hrs, no reason documented by clinician • G8603 Spoken language composition score higher than at admission • G8604 Spoken language composition score not higher than at admission • G8605 Spoken language composition not scored

  40. HCPCS Codes New Codes-continued • G8606 Attention score higher than at admission • G8607 Attention score not higher than at admission • G8608 No attention score performed • G8609 Memory score higher than at admission • G8610 Memory score not higher than at admission • G8611 No memory score performed • G8612 Motor speech score higher than at admission • G8613 Motor speech score not higher than at admission • G8614 No motor speech score performed • G8615 Reading score higher than at admission • G8616 Reading score not higher than at admission • G8617 No reading score performed • G8618 Spoken language expression score higher than at admission • G8619 Spoken language expression score not higher than at admission

  41. HCPCS Codes New Codes-continued • G8620 No spoken language expression score performed • G8621 Writing score higher than at admission • G8622 Writing score not higher than at admission • G8623 No writing score performed • G8624 Swallowing score higher than at admission • G8625 Swallowing score not higher than at admission • G8626 No swallowing score performed • G8627 Surgical procedure performed w/in 30 days following cataract surgery, major complications • G8628 Surgical procedure not performed w/in 30 days following cataract surgery, major complications • G9141 Influenza A H1N1,administration with counseling • G9142 Influenza A H1N1, vaccine, any route of administration • G9143 Warfarin responsive genetic test, any method, any number of specimens

  42. HCPCS Codes New Codes-continued (Drugs) • J0461 Atropine sulfate injection 0.01mg • J0559 Penicillin G benzathine/procaine injection 2500 units • J0586 AbobotulinumtoxinA injection, 5 units • J0598 C1 esterase inhibitor injection, 10 units • J0718 Certolizumab pegol injection, 1 mg • J0833 Cosyntropin injection NOS, 0.25 mg • J0834 Cosyntropin cortrosyn injection, 0.25 mg • J1680 Human fibrinogen concentrate injection, 100 mg • J2562 Plerixafor injection 1mg • J2793 Rilonacept injection, 1mg • J2796 Romiplostim injection, 10 micrograms • J7185 Xyntha injection per i.u. • J7325 Synvisc or Synvisc-One, 1 mg • J9155 Degarelix injection, 1 mg • J9171 Docetaxel injection, 1 mg • J9328 Temozolomide injection, 1 mg

  43. HCPCS Codes New Codes-continued • K0739 Repair/non routine service DME non-oxygen equipment • K0740 Repair/service oxygen equipment, 15 min • L2861 Torsion mechanism knee/ankle • L3891 Torsion mechanism wrist/elbow • L5973 Ankle-foot system dorsiflexion and/or plantar flexion includes power source • L8031 Breast prosthesis with adhesive • L8032 Reusable nipple prosthesis • L8627 Cochlear Implant Device external speech processor replacement • L8628 Cochlear Implant Device external controller replacement • L8629 Cochlear Implant Device transmit coil and cable • L8692 Non-osseointegrated sound processor, body worn, includes headband

  44. HCPCS Codes New Codes-continued (Temporary) • Q0138 Ferumoxytol, non-esrd injection, 1 mg • Q0139 Ferumoxytol, esrd use, injection, 1 mg • Q0506 Lithium-ion battery for electric/pneumatic Ventricular Assist Device • Q4074 Iloprost non-compounded unit dose up to 20 micrograms • Q4115 Alloskin skin substitute per square centimeter • Q4116 Alloderm skin substitute per square centimeter • Q9968 Non-radioactive non-contrast injection, visualization adjunct 1mg • S0280 Medical home program, initial plan • S0281 Medical home program, maintenance • S3713 KRAS mutation analysis testing • S3865 Comprehensive gene sequence analysis for hypertrophic cardiomyopathy • S3866 Specific gene test for hypertrophic cardiomyopathy • S3870 Autism Spectrum disorder and/or mental retardation test for developmental delay

  45. HCPCS Codes Deleted Codes • A4365 Adhesive remover wipes • A6200 Compos drsg <=16 no border • A6201 Compos drsg >16<=48 no bdr • A6202 Compos drsg >48 no border • A6542 Gc stocking custom made • A6543 Gc stocking lymphedema • A9535 Injection, methylene blue • A9605 Sm 153 lexidronm • C9245 Injection, romiplostim • C9246 Inj, gadoxetate disodium • C9247 Inj, iobenguane, I-123, dx • C9249 Inj, certolizumab pegol • C9251 Inj, C1 esterase inhibitor • C9252 Injection, plerixafor • C9253 Injection, temozolomide

  46. HCPCS Codes Deleted Codes-continued • E1340 Repair for DME, per 15 min • E2223 Valve replacement only each • E2393 Valve, pneumatic tire tube • E2399 Noc interface • G0392 AV fistula or graft arterial • G0393 AV fistula or graft venous • G8503 Doc proph antibx w/in 1 hr • G8504 Doc ord pro antbx w/in 1 hr • G8505 No doc proph antibx w/in 1hr • G8512 Pain sev quant present • G8513 ABI meas & doc • G8514 PT inelig; ABI measure • G8515 No ABI measurement • G8516 Scrn fal rsk >2 fal or w/inj

  47. HCPCS Codes Deleted Codes-continued • G8517 Scrn fall rsk; <2 falls • G8521 Antplt recd 48 hrs & disch • G8522 Pt inelig; antiplt therapy • G8523 Antplt not recd reas no spec • G8527 Doc ord antimic prophy • G8528 Pt inelig; proph antibiot • G8529 No doc ord antimic prophy • G8533 Partic in clin data base reg • J0460 Atropine sulfate injection • J0530 Penicillin g benzathine inj • J0540 Penicillin g benzathine inj • J0550 Penicillin g benzathine inj • J0835 Inj cosyntropin per 0.25 MG

  48. HCPCS Codes Deleted Codes-continued • J1565 RSV-ivig • J7322 Synvisc inj per dose • J9170 Docetaxel injection • L0210 Thoracic rib belt • L1800 Knee orthoses elas w stays • L1815 Elastic with condylar pads • L1825 Ko elastic knee cap • L1901 Prefab ankle orthosis • L2770 Low ext orthosis per bar/jnt • L3651 Prefab shoulder orthosis • L3652 Prefab dbl shoulder orthosis • L3700 Elbow orthoses elas w stays • L3701 Prefab elbow orthosis

  49. HCPCS Codes Deleted Codes-continued • L3909 Prefab wrist orthosis • L3911 Prefab hand finger orthosis • L6639 Heavy duty elbow feature • Q2023 Xyntha, inj • Q2024 Bevacizumab injection • Q4080 Iloprost non-comp unit dose • S0162 Injection efalizumab • S0345 Home ecg monitrng global 24h • S0346 Home ecg monitrng tech 24hr • S0347 Home ecg monitrng prof 24hr • S0605 Digital rectal examination, • S8190 Electronic spirometer

  50. HCPCS Codes Description Changes • C9359 Porous purified collagen matrix bone void filler (Integra Mozaik Osteoconductive scaffold putty, Integra Os Osteoconductive scaffold putty), Per 0.5cc • G0379 Direct admission of patient for hospital observation care • G8456 Current smokeless tobacco user • G8492 Intend to report the Perioperative Care measures group • G8496 All quality actions for the applicable measures in the preventive care measures group have been performed for this patient • G8502 All quality actions for the applicable measures in the back pain measures group have been performed for this patient • L8691 Auditory Ossointegrated Device, External Sound Processor, replacement

More Related