If you missed our webinar this January regarding the 2016 CPT coding changes or want a refresher on the key changes, then dig into this newsletter edition which provides just a few of the highlights.
This year, there were 139 new CPT codes, 136 revised codes and 89 deleted ones. In addition, there were also new guidelines, coding tips and parenthetical instructions.
Surgery Section
In the surgery section there are three (3) new codes of interest used to report thoracic paravertebral block (PVB) by injection (single and additional) or continuous infusion. A paraspinous block completely desensitizes the affected spinal segment- usually for pain relief; i.e. for patients before breast surgery or patients with rib fractures. The new codes are:
64461- Paravertebral block, thoracic, single injection sites (includes imaging guidance, when performed)
+64462- second and any additional injection site(s) (including imaging guidance, when performed) (List separately in addition to code for primary procedure)
64463- Continuous infusion by catheter (includes imaging guidance when performed)
What should I look for?
Typically you would see these codes used in conjunction with surgical procedures. Look for:
- Outliers - Providers who are billing these codes frequently or in an office place of service without any associated surgical procedures.
- Look for unbundling. Per the AMA, Do not report 64461, 64462, 64463 in conjunction with 62310, 62318, 64420, 64421, 64479
, 64480,64490, 64491, 64492, 76942, 77002, 77003
Pathology/Laboratory
In the Pathology and Laboratory section, a new CPT code - 80081 was introduced for an obstetric panel which now includes HIV testing. To report the panel, the following tests must be performed:
Blood count, complete (CBC), and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC), automated (85027) and appropriate manual differential WBC count (85007 or 85009); Hepatitis B surface antigen (HBsAg) (87340); HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies, single result (87389); Antibody, rubella (86762); Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART) (86592); Antibody screen, RBC, each serum technique (86850); Blood typing, ABO (86900) AND Blood typing, Rh (D) (86901)
What Should I look for?
The existing OB panel (80055) includes the same tests except HIV testing- CPT 87389. The name of the game this year will be "unbundling." Watch for providers who continue to b
ill 80055 and 87389 separately instead of the new panel code 80081.
The source of the 2016 coding information and guidance used in this article was obtained from AAPC Coder- http://coder.aapc.com/aapc-coder. Look for more articles throughout the year highlighting changes for 2016
