Category: Medical coding

For the CPT 2024 code set, Category I code 75580 and two parenthetical notes were established to report a noninvasive estimate of coronary fractional flow reserve (FFR) derived from augmentative software analysis of the data set from a coronary computed tomography angiography (CCTA). Category III codes 0501T-0504T and three associated parenthetical notes were deleted to accommodate the new code. This article provides an overview of these changes and additions. Description of Procedure code 75574, 75580  75574          Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material,…

For the CPT 2024 code set, codes 64590 and 64595 were revised. Because both these codes are used to report programming of neurostimulators, similar to codes 95971 and 95972, it is important to know the intent and reporting differences of these four codes. Therefore, the purpose of this article is to highlight the differences and provide instructions regarding reporting codes 64590 and 64595 vs codes 95971 and 95972. Code description of CPT code 64590, 64595, 95971 and 95972  64590    Insertion or replacement of peripheral, sacral, or gastric neurostimulator pulse generator…

Today, I came across a scenario where three modifiers are used together which is very rare. So, I would like to share that scenario which will surely help to use the modifier wisely. Below is the question with the answer as well. Question :An ophthalmologist performs cataract surgery on a patient’s right eye two weeks after performing cataract surgery on the patient’s left eye. The patient has an age-related nuclear cataract. The patient tolerates the procedure well and remains under the surgeon’s care for eight days after the procedure and…

CMS published its HCPCS Quarterly Update in March, which heralded the sum of 94 HCPCS Level II code additions, discontinuations, and definition revisions. The changes became effective April 1. 62 added codes 21 discontinued codes 11 revised codes Below are the Newly added HCPCS codes effective 1st April 2024 A2026 Restrata minimatrix, 5 mg A4271 Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per month A4438 Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each A4564 Pessary, disposable, any type A4593 Neuromodulation stimulator…

CMS created 2 new service codes describing CHI services that auxiliary personnel, including community health workers (CHWs), may perform incidental to the professional services of a physician or other billing practitioner, under general supervision. The billing practitioner initiates CHI services during an initiating visit where the practitioner identifies unmet SDOH needs that significantly limit their ability to diagnose or treat the patient. The new G codes for CHI:  G0019 – Community health integration services performed by certified or trained auxiliary personnel, including a community health worker, under the direction of…

Begining Jan. 1, 2024, qualified healthcare providers can bill an add-on HCPCS Level II code to report the extra time, effort, and associated practice expense involved with caring for Medicare patients across the continuum of healthcare. G2211     Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient’s single, serious condition or a complex condition. (Add-on code, list separately in addition…

The first quarterly release of Coding Clinic focused on the changes and new codes effective April 1, 2024. If you wish to review the updated Official Guidelines for Coding and Reporting, they can be accessed here. Notable changes to the ICD-10 CM coding guidelines include: Section C.1.d.5.b, which speaks to the reporting of sepsis due to a post-procedural infection. This entry reminds us to sequence codes that identify the site of infection first, then follow with the appropriate codes related to sepsis. In addition to the already published listing of codes (grouping T81.41-T81.43 classifying an…

  Coding for Commode HCPCS or cpt code is quite confusing for coders since their are different variety of commode used by old age patients depending on their requirement. If coders can understand the which type of commode of used by the patient then it will be easy to assign the correct and right code. Below I am sharing the HCPCS codes used for commode which might clear your doubts. E0163 Commode chair, mobile or stationary, with fixed arms E0165 Commode chair, mobile or stationary, with detachable arms image credit…

Four new vaccine product codes and two new immune globulin codes were established in the Current Procedural Terminology (CPT) 2024 code set. This article provides an overview of these new codes. Immune Globulins, Serum or Recombinant Products  90380 Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 mL dosage, for intramuscular use  903811 mL dosage, for intramuscular use Vaccines, Toxoids  90589 Chikungunya virus vaccine, live attenuated, for intramuscular use  90679 Respiratory syncytial virus vaccine, preF, recombinant, subunit, adjuvanted, for intramuscular use  90683 Respiratory syncytial virus vaccine, mRNA lipid nanoparticles, for intramuscular…

Two new Category III codes (0811T, 0812T) were added to the CPT 2024 code set for reporting remote multi-day complex uroflowmetry services. Uroflowmetry is the measurement of urine flow during urination. Other existing uroflowmetry codes describe simple uroflowmetry using nonautomated (eg, stop-watch flow rate, mechanical uroflowmeter) equipment (51736) and complex uroflowmetry using automated (eg, calibrated electronic) equipment (51741). These two new codes are used to report remote (eg, at home) multi-day complex uroflowmetry services. This article provides an overview of these changes. Description of code 0811T, 0812T 0811T Remote multi-day…