Storify News | Clue in to these 2019 CPT® guidelines for more precise reporting.
CPT® code and descriptor changes often involve CPT® guidelines changes. In fact, many of the 2019 AMA CPT® code changes require coders and physicians to review the guideline changes. Are you up to speed on the latest CPT® guidelines?
Dig into the following questions and answers to see if you are on top of your game.
Question 1: Has CPT® 2019 added any new guidelines to go along with new transcatheter codes 33274 and 33275?
Answer: Yes, CPT® 2019 has included new guidelines for codes 33274 and 33275. So, when you report these two AMA CPT® codes, make sure you follow these guidelines:
- Do not report 33274 together with 33275
- Do not report 33274 or 33275 together with 75820 (femoral venography), 76000 or +77002 (fluoroscopy), +76937 (ultrasound guidance for vascular access), or +93566 (right ventriculography).
Note that you should not use 33274 or 33275 together with 93451 or 93453 (heart catherization), 93456, 93457, 93460, 93461 (catheter placement), or codes 93530 through 93533 unless the cardiologist performed the complete right heart cath for indications separate from the leadless pacemaker procedure.
Question 2: Do 2019 AMA CPT® coding books include more details about codes 29540, 29580, and 29581?
Answer: Yes, the 2019 CPT® book has added more clarification under several codes in the “Strapping-Any Age” section, including 29540. Next time you need to report these codes, be sure to review these CPT® guidelines:
- 29540 — Do not report 29540 together with 29580 or 29581 for the same extremity.
- 29580 — Never use 29580 together with 29540 or 29581 for the same extremity.
- 29581 — Never report 29581 together with 29540 or 29580 for the same extremity.
Heed This: According to CPT®, you should also never report 29540, 29580, or 29581 in conjunction with codes 36465 through +36483 for the same extremity.
Question 3: In CPT® 2019, skin biopsy codes 11102-11107 are distinguished using three different techniques. When physicians perform different biopsy techniques in one session, the reporting becomes more complex. What does the AMA CPT® guidelines say?
Answer: According to the latest CPT® guidelines, only one primary skin biopsy in the range 11102-11107 can be used per encounter, irrespective of the biopsy technique. If the provider performs more than one technique, look to the “each additional lesion” code that matches the technique of the additional biopsies.
Question 4: What’s new to the new PICC CPT® guidelines?
Answer: Not only should you use the new PICC codes, but also keep tabs on the new guidelines that go along with the codes. CPT®, through the guidelines and parenthetical notes, identifies specific rules you need to follow while reporting codes 36572, 36573, and 36584, including:
- Never use 71045 through 71048 to document the final catheter position on the same day of service as 36572, 36573, or 36584.
- As the codes 36572, 36573, and 36584 include confirmation of the catheter tip location, the provider who reports image-guided PICC insertion cannot code the confirmation of the catheter tip location separately.
- If the provider performs a 36572, 36573, or 36584 service, but doesn’t confirm the catheter tip’s location, then you should add modifier 52 to the proper code.
- Never report codes 36572 or 36573 together with +76937 or +77001.
Plus, don’t forget to check the latest CPT® guidelines as you dig into the PICC revisions for 36568 and 36569. Not sure where to find them?
Keep the 2019 CPT® Guidelines at Your Fingertips!
Clearly, coders must have an in-depth understanding of current coding guidelines and stay abreast of changes and updates to the CPT® code set. This means you need to have a resource with the latest CPT® guidelines, complete official codes, descriptors, code usage advice, illustrations, and other handy features. You’ll find all this and more in the AMA CPT® 2019 Professional Edition – the only code book with the official CPT® guidelines!