january 2011

WHAT CODERS NEED TO KNOW IN 2011

What kind of gifts, in the form of CPT codes, did the AMA bring us this year?

Here are some of the NEW CPT codes that you’ll see once you unwrap your 2011 CPT Manual:

Integumentary

• Debridement codes 11040 and 11041 have been deleted. To report debridement of epidermis and/or dermis use the wound care management codes 97597 and 97598.
• Debridement codes are reported for injuries, infections, wounds and chronic ulcers. 
• When a single wound is present the code is based on the deepest level of tissue that is debrided.
• With multiple wounds, the coder should add together the surface area for wounds of the same depth, but not wounds from a different depth.
• For example, subcutaneous tissue debridement from a 3sq cm leg wound and 3sq cm abdominal wound with bone debridement from a 6sq cm forearm wound. Since the leg and abdominal wounds are the same depth the coder should add these wounds together and report 11042 for a 6sq cm subcutaneous tissue debridement along with 11044 for the forearm debridement because debridement of the forearm wound was at a different depth (bone) from the other two wounds (subcutaneous tissue).

Pain Management

• The transforaminal injection codes have been revised and now take on the same look as the facet injection codes. Image guidance (fluoroscopy or CT) is required when performing the injection procedure, but the CPT code definitions for 64479-64484 now include fluoroscopic or…
• CT imagining as an inclusive component of the procedure, so 77003 is no longer reported for fluoroscopy in addition to the transforaminal CPT code. 
• Category III codes should be reported when transforaminal or facet injections are performed using ultrasound guidance.
• Epidural, transforaminal or facet injection(s) performed at theT12-L1 interspace/facet would be reported with the appropriate CPT code for the cervical or thoracic level and not a code from the lumbar or sacral level series of codes.
• There are 3 new codes for both the hip arthroscopy (femoroplasty, acetabuloplasty, labral repair) and endoscopic balloon dilation of the sinuses (maxillary, frontal, sphenoid). For those ASC’s performing spinal arthrodesis procedures, you should note that a threaded bone dowel (previously reported as a biomechanical device) is now considered a structural bone allograft and a discectomy for decompression of the spinal cord and/or nerve roots is included in an anterior interbody technique (CPT code 22551) so code 63075 will no longer be additionally reported.

For a complete summary of Additions, Deletions and Revisions see Appendix B at the back of your CPT books.