2015 CPT Updates

2015 CPT ChangesPrepared by Advanced Billing Consultants

Copyright 2014 | Advanced Billing Consultants, Inc.

More Selective Modifiers to 59:

The –X{EPSU} modifiers

XE: Separate Encounter (patient treated twice)

XS: Separate structure (two different types of lesions)

XP: Separate Practitioner (2 different providers on same

day

XU: Unusual non-overlapping service (2 unrelated

procedures)


E&M Changes

99481 and 99482 replaced by 99184


Chronic Care Management

New code: 99490- chronic care management services, at

least 20 minutes of clinical staff time directed by a

physician or other qualified health care professional,

per calendar month, with the following required

elements:

multiple (two or more) chronic conditions expected to last

at least 12 months, or until the death of the patient,

Chronic conditions place the patient at significant risk of

death, acute exacerbation/decompensation, or functional

decline,

Comprehensive care plan established, implemented,

revised or monitored


Complex Chronic Care

Management

Deleted: 99488

Add on: 99489 to 99487

Each additional 30 minutes of clinical staff time


Advanced Care Planning

Face to face encounter, not requiring the patient

New codes: 99497 for first 30 mins and 99498 for each

additional 30 mins


Anesthesia

Deleted: 00452, 00622, 00634


Surgical Package

The definition is clarified to indicate the History and

Physical are included in the procedure


Arthrocentesis

Revised: 20600, 20605, 20610- without ultrasound

guidance

New:

20604: small joint with ultrasound guidance

20606: intermediate joint or bursa with ultrasound

guidance

20611: major joint or bursa with ultrasound guidance


Ablation of Bone Tumors

Revise: 20982 include the adjacent soft tissue

New: 20983

Ablation therapy for reduction or eradication of 1 or more

bone tumors including adjacent soft tissue when involved

by tumor extension, percutaneous, including imaging

guidance when performed; cryoablation


Open Treatment of Rib

Fractures

Deleted: 21800, 21810, 0245T, 0246T, 0247T, 0248T

New open treatment of rib fracture(s):

21811: 1-3 ribs

21812: 4-6 ribs

21813: 7 or more ribs


Percutaneous Vertebroplasty

Deleted: 22520, 22521, 22522

New: Percutaneous vertebroplasty

22510: cervivothoracic

22511: lumbrosacral

22512: each additional cervivothoracic or lumbosacral

vertebral body


Percutaneous Vertebral

Augmentation

Deleted: 22523, 22524, 22525

New: Percutaneous vertebral augmentation, 1 vertebral

body

22513: thoracic

22514: lumbar

22515: each additional thoracic or lumbar vertebral body


Total Disc Arthroplasty

Revised: 22856 is now the parent code for 22858

New:

22858: second level, cervical

0375T: cervical, three or more levels (not an add on to

22856)


Arthrodesis of Sacroiliac Joint

Revised: 27280 to indicate open procedure

New:

27279: arthrodesis, sacroiliac joint, percutaneous or

minimally invasive, with image guidance, includes

obtaining bone graft when performed, and placement of

transfixing device (mod 50 allowed)


Musculoskeletal

Deleted: 29020, 29025, 29715

Revised: 27370 to indicate the injection is performed

for contrast


Pacemaker or Implantable

Defibrillator

Deleted: 0322T, 0323T, 0324T, 0326T, 0327T

New:

33270: insertion or replacement of permanent subcutaneous implantable defibrillator system, with subcutaneous electrode, including defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parameters, when performed

33271: insertion of subcutaneous implantable defibrillator electrode

33272: removal of subcutaneous implantable defibrillator electrode

33273: repositioning of previously implanted subcutaneous implantable defibrillator electrode


Cardiovascular

Deleted: 33472, 36469, 36822

New:

34839: Physician planning of a patient-specific fenestrated

visceral aortic endograft requiring a minimum of 90

minutes of physician time


ECMO or ECLS

Deleted: 33960, 33961, 36822

New codes:

33946: ECMO/ECLS provided by physician; imitation, veno-

venous

33947: initiation, veno-arterial

33948: daily management, each day, veno-venous

33949: daily management, each day, veno-arterial


ECMO or ECLS Cont’dCPT Technique Age Tunneling Status

Open

Percutaneou

s Thoracotomy Sternotomy

Birth-

5 6+ Insertion

Repositio

n Removal

33951 X X X

33952 X X X

33953 X X X

33954 X X X

33955 X X X X

33956 X X X X

33957 X X X

33958 X X X

33959 X X X

33962 X X X

33963 X X X X

33964 X X X X

33965 X X X

33966 X X X

33969 X X X

33984 X X X

33985 X X X X

33986 X X X XCopyright 2014 | Advanced Billing Consultants, Inc.

ECMO or ECLS Cont’d

New add-on codes:

33987: arterial exposure with creation of graft conduit to

facilitate arterial perfusion for ECMO/ECLS

33988: Insertion of left heart vent by thoracic incision for

ECMO/ECLS

33989: Removal of left heart vent by thoracic incision for

ECMO/ECLS


Transcatheter Procedures

Revised: 37215, 37216, 37217

New: 37218: Transcatheter placement of intravascular

stent(s), intrathoracic common carotid artery or

innominate artery, open or percutaneous antegrade

approach, including angioplasty, when performed, and

radiological supervision and interpretation


Endovascular

Rebascularization

Revised: 37236, 37237


Digestive System

Deleted: 42508


Esophagoscopy

Revised: 43194, 43197, 43215, 43216, 43247, 43250

Deleted: 43350

New: 43180: esophagoscopy, rigid, transoral with

diverticulectomy of hypopharynx or cervical esophagus,

with cricopharyngeal myotomy, includes use of

telescope or operating microscope and repair, when

performed


Endoscopy

CPT 2015 divided the endoscopy, small intestine and

stomal subsection into two separate sections which

results in many revisions and new codes

1. Small intestine endoscopy

2. Stomal endoscopy


Endoscopy, Small Intestine

Revised: 44360, 44363


Endoscopy, Stomal

Revised: 44380, 44385, 44386, 44388, 44390, 44391,

44392

Deleted: 44383, 44393, 44397

New:

44381, 44384, 44401, 44402, 44403, 44404, 44405, 44406,

44407, 44408


Endoscopy

Revised: 45330, 45332, 45333, 45334, 45337, 45378,

45379, 45380, 45381, 45382, 45384, 45385, 45386,

45391, 45392, 45340

Deleted: 45355, 45383, 45387, 45339, 45345

New: 45388, 45389, 45399, 45346, 45347, 45349, 45350,

45390, 45393, 45398


Digestive System: Colon

New: 45399


Anus: Endoscopy

Revised: 46600

Deleted: 0226T, 0227T

New: 46601, 46607


Liver

New: 47383: Ablation, 1 or more liver tumor(s),

percutaneous, cryoblation


Urinary

New: 52441: Cystourethroscopy, with insertion of

permanent adjustable transprostatic implant, single

inplant

52442: Each additional permanent adjustable

transprostatic implant


Maternity Care and Delivery

Introductory guidelines clarify the visit when pregnancy

is confirmed is not part of antepartum care


Nervous System

Revised: 61055

Deleted: 61334, 61440, 61470, 61490, 61542, 61609,

61875, 62116


Myelography

Revised: 62284

New: 62302, 62303, 62304, 62305


Transversus Abdominis Plane

Block

New: 64486, 64487, 64488, 64489

Deleted: 64752, 64761, 64870


Eye and Ocular Adnexa

Deleted: 66165

Revised: 66180, 66185, 67399

New: 66179, 66184


Auditory System

Deleted: 69400, 69401, 69405


Radiology

Deleted: 72291, 72292, 74291, 76645, 76950

New: 76641, 76642 (breast ultrasounds), 77061, 77062,

77063


Bone/Joint Studies

Deleted: 77082

New:

77085: DXA with vertebral fracture assessment

77086: vertebral fracture assessment only


Radiation Oncology

Deleted: 77305, 77310, 77315, 77326, 77327, 77328

New: 77306, 77307, 77316, 77317, 77318


Radiation Treatment Delivery

Deleted: 77403, 77404, 77406, 77408, 77409, 77411,

77413, 77414, 77416, 77418, 77421

Revised: 77401, 77402, 77407, 77412

New: 77385, 77386, 77387


Drug Assay and Drug Testing

All codes deleted and replaced with new codes

Codes specify purpose of the test

See CPT book for the presumptive drug class A and B

lists and the definitive drug classes


Molecular Pathology

New codes: 81246, 81288, 81313

Revised: 81245, 81402, 81403, 81404, 81405


MAAA

New: 81519: oncology (breast), mRNA, gene expression

profiling by real-time RT-PCR of 21 genes, utilizing

formalin-fixed paraffin embedded tissue, algorithm

reported as recurrence score


Chemistry

Revised: 82541, 82542, 82543, 82544, 84600

Deleted: 82980, 83008, 83055, 83071, 83634

New: 83006


Transfusion Medicine

Revised: 86900, 86901, 86902, 86904, 86905, 86906


Microbiology

Deleted: 87001, 87620, 87621, 87622

Revised: 87501, 87502, 87503, 87631, 87632, 87633

New: 87505, 87506, 87507, 87623, 87624, 87625, 87806


Surgical Pathology

Deleted: 88343, 88349

Revised: 88342, 88360, 88361, 88365, 88367, 88368

New: 88341, 88344, 88364, 88366, 88373, 88374, 88369,

88377


Reproductive Medicine

Procedures

New: 89337


Vaccines

New HPV and Flu: 90651, 90630

Revised: 90654, 90721, 90723, 90734


Gastroenterology

New: 91200


Ophthalmology

New: 92145


Implantable & Wearable

Cardiac Device Evaluations

New: 93260, 96261

Revised: 93282, 93283, 93284, 93287, 93289, 93295,

93296


Echocardiography

New: 93355


Intracardiac Electrophysiological

Procedures/Studies

New: 93644

Revised: 93642


Noninvasive Physiologic

Studies & Procedures

New: 93702


Cerebrovascular Arterial

Studies

New: 93895


Neurostimulators, Analysis-

Programming

Revised: 95972


Central Nervous System

Assessments/Tests

Revised: 96110 (with scoring and documentation

New: 96127: Brief emotional/behavior assessment, with

scoring and documentation per standardized instrument


Active Wound Care

Managment

Revised: 97605, 97606: utilizing DME

New: 97607, 97608: utilizing disposable, non-durable

medical equipment


Other Services and

Procedures

New: 99188


Adaptive Behavior Assessment

Mid year 2014 changes:

New: 0659T, 0360T, 0360T, 0362T, 0363T, 0364T, 0365T,

0366T, 0367T, 0368T, 0369T, 0370T, 0371T, 0372T


Exposure Adaptive Behavior

Treatment

Mid year 2014 changes:

New: 0373T, 0374T


Value Based Payment Modifier

Groups of 10 or more eligible professionals should make

sure they are participating in PQRS to avoid 2%

reduction in Medicare payments for 2016. This is based

on 2014 performance

For more specific info:

http://www.cms.gov/Medicare/Medicare-Fee-for-

Service-

Payment/PhysicianFeedbackProgram/ValueBasedPaymen

tModifier.html


http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeedbackProgram/ValueBasedPaymentModifier.html

References

AAPC. “2015 CPT Updates” (2014). Web 12 Dec 2014.

www.aapc.com

American Medical Association. “ Changes. An Insiders

View.” (2014)


http://www.aapc.com/

Healthcare

2015 CPT Updates