Coding Alert
Coding Alert – ​2018 CPT Coding Updates

The 2018 CPT codes, as published by the AMA (American Medical Association), once again contain many significant changes. Providers must understand and comply with these changes to ensure services provided are reported accurately.

We’ve put together some highlights of the notable changes. Please note, this information does not address Quartz coverage of these services


2018 features many deleted codes as well as revisions to code descriptions and terminology.


Modifiers

In accordance with the Affordable Care Act, the AMA has created two new modifiers identify the status of services as habilitative (Modifier 96) and rehabilitative (Modifier 97) services. These modifiers should only be reported with CPT codes that define habilitative and rehabilitative services.


Anesthesia Services

  1. Lower Abdomen
    CPT 00811-00813 were added. 
    The new code set includes a code to specify screening colonoscopy
  2. Percutaneous Neurostimulator Placement – several codes include a revision in the description

Radiology

In an attempt by the AMA to rationalize this Radiology section, many were changes were made, including the deletion of chest x-ray codes (71010-71035)

  1. Chest X-Ray:
    • Four new codes based on the number of views performed
  2. Abdominal X-Ray:
    • Three new codes based on the number of views performed

Surgery Services

  1. Cardiology:
    1. Patient / Caregiver training for INR monitoring was added using CPT 93792.  This code is under the direction of a physician or other QHP face-to-face time
    2. Several new Category III codes were added for Noninvasive Coronary FFR (fractional flow reserve), External Patient Activated Event Monitor and Fetal Magnetocardiography
    3. Cardiovascular Surgery
      • 36465 – Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; single incompetent extremity truncal vein (add on code 36466)
      • 36466 – Used to represent multiple incompetence truncal veins on the same leg​
    4. Hemic and Lymphatic Systems
      •  38220 revised to include multiple aspirations
      • 38221 revised to include multiple biopsies
      • 38222 has been added to report Diagnostic bone marrow; biopsy(ies) and aspiration(s)​

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Summary of Changes

The CPT code set for 2018 contains 10,155 codes of which

  • 170 are new codes in 2018
  • Two new modifiers
  • 60 revised codes, and
  • 82 deleted codes

Please refer to your 2018 CPT code book for a full listing.


Evaluation and Management

  1. Cognitive Assessment and Care Plan Services (99483) –
    Used to report cognitive assessment and care planning in patients with cognitive impairments. This code may only be reported if all 10 distinct elements defined in the code are provided. The absence of any listed elements requires the reporting of an alternate Evaluation and Management code. In addition, restriction is made regarding the total number of times that the service may be reported within 180 calendar days.
  2. Psychiatric Collaborative Care Management (99492) –
    A time based, per month code requiring multiple elements to support billing. This is a primary care provider code; not mental health. Report 99493 for subsequent months and 99494 for each additional 30 minutes.

Medicine Services

  • 97127 has been added to report Cognitive Function Intervention services, replacing 97532
  • Unlike 97532, 97127 is not a time-based code and can only be reported once per day
  • 97127 was developed to address a need for identification of all cognitive function intervention services, including services; executive function, reasoning and pragmatic functioning.
  • This also includes use of compensatory strategies for managing the performance of activities.
  • Three New Vaccines
  • 90682 and 90756 – Influenza Vaccines
  • 90750 – Zoster Vaccine Non-Live Intramuscular
  • Anticoagulant Management Services, New INR Home and Outpatient INR monitoring services codes (93792 and 93793)
  • Additional new Medicine codes include:
  • 96573 – Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination / activation of photosensitizing drug(s) provided by a physician or other qualified health care professional, per day.
  • 96574 –Debridement of premalignant hyperkeratotic lesion(s) followed with photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application of illumination / activation of photosensitizing drug(s) provided by a physician or other qualified health care professional.

For a complete listing of all the new codes as well as their descriptions and coding guidelines, please refer to your 2018 CPT codebook.


The Complex Case Management Fax Number Has Changed!
It is now:  608.833.3203