november 2007

New CPT Codes for 2008

Here is a preview of some of the New CPT codes that you may see in an ASC setting starting in 2008.

24357 - Tenotomy, elbow lateral or medial (eg. epicondylitis, tennis elbow, golfer's elbow), percutaneous
A percutaneous tenotomy is performed by inserting the scalpel through the skin to section the extensor carpi radialis brevis (ECRB).
24358 - debridement, soft tissue and/or bone, open
The fascia is incised and the ECRB is exposed, degenerative tissue is excised at the insertion and the tendon may be released. Bone drilling may be performed.
24359 - debridement, soft tissue and/or bone, open with tendon repair or reattachment
The above listed services may be performed along with a tendon repair or reattachment to the insertion with use of sutures or bone anchors.

CPT codes 24350-24356 have been deleted.
How sweet is that! Finally a code set that will simplify your tennis elbow procedures.

27416 - Osteochondral autograft(s), knee, open (eg. mosaicplasty) (includes harvesting of autograft(s).
Note the difference between autograft/allograft. Previously there was only an open code for an OATS procedure with an allograft.

27726 - Repair of fibula nonunion, and/or malunion with internal fixation
Previously there was only a CPT code for the repair of a tibial nonunion or malunion.

27767 - Closed treatment of posterior malleolus fracture; without manipulation
27768 - with manipulation
27769 - Open treatment of posterior malleolus fracture; includes internal fixation, when performed
Do not report these codes with bimalleolar or trimalleor code sets 27808-27823.

28446 - Open osteochondral autograft, talus (includes obtaining graft(s))
Pay particular attention to the parenthetical notes listed under this code.
(For arthroscopic osteochondral talus graft, use 29892)
Per CPT Changes - An Insiders View 2008 both 28446 (open) and 29892 (arthroscopic) are to be used for an autograft procedure. The CPT code description for 29892 does not indicate that it can be used for an OATS procedure so please make a notation next to this code that it would include the OATS.

(For open osteochondral allograft or repairs with industrial grafts, use 27599)
CPT code 27599 referenced above is for an Unlisted Procedure, femur or knee. Since this is an ankle procedure being performed on the talus I would expect the AMA to publish a correction that would recommend using CPT code 27899 Unlisted Procedure, leg or ankle.

CPT Errata can be found at the associated link and it is beneficial to check for updates on error corrections made since the publication of these 2008 CPT codes.
http://www.ama-assn.org/ama1/pub/upload/mm/362/08cptcorrections.pdf

29828 - Arthroscopy, shoulder, surgical; biceps tenodesis
Use this code for an arthroscopic repair of a torn biceps tendon. This replaces S2114 or the Unlisted Arthroscopic code.

29904 - Arthroscopy, subtalar joint, surgical; with removal of loose body or foreign body
29905 - with synovectomy
29906 - with debridement
29907 - with subtalar arthrodesis
This code set was established to report procedures of the subtalar joint (the joint between the talus and calcaneus) for conditions such as sinus tarsi syndrome. For the subtalar arthrodesis the procedure will be performed through a scope with percutaneous bone fixation and a bone graft may or may not be utilized.

CPT codes 49440 - 49465 deal with Placement, Conversion, Replacement and Mechanical Removal of Obstructive Material associated with the different types of percutaneous gastrointestinal tubes.

CPT codes 50385 and 50386 are for transurethral Removal and/or Replacement of indwelling ureteral stents without the use of cystoscopy.

51102 - Aspiration of bladder; with insertion of suprapubic catheter
(See parenthetical notes for reporting of image guidance.)

57285 - Paravaginal defect repair (including repair of cystocele, if performed); vaginal approach
57423 - Paravaginal defect repair (including repair of cystocele, if performed); laparoscopic approach
58570 - 58573 This new code set represents a laparoscopic total hysterectomy with the procedure being reported according to the weight of the uterus (250 grams or less, greater than 250 grams) and whether or not the tube(s) and/or ovary(s) were removed.

68815 - Probing of nasolacrimal duct, with or without irrigation; with transluminal balloon catheter dilation
AMA felt that CPT code 68815 did not accurately describe the placement of the balloon catheter along with subsequent and/or repeated dilation so it developed this CPT code for passage of the balloon to dilate the nasolacrimal duct. Please note that creation of a passageway for the balloon is considered an integral component of the service and not reported separately.

There are also many new CPT codes for placement of needles for subsequent interstitial radioelement application so check the anatomical section involved to see if new codes have been added.