Not a great surprise if these updated CPT codes push medical coding companies back to the confusion. Medical coding is the toughest than anything else in the revenue cycle management process. Even the slightest mistake can bring huge loss for the hospitals or healthcare professionals. It’s the matter of revenue loss in dollars!

Not many of healthcare professionals can really do the coding work as it adds a huge burden apart from the time spent on patient care. Healthcare professionals are mostly advised to leave their billing and coding works to outsourcing companies. Medical coding companies stand unique in helping healthcare professionals get their payments without any loss.

We all know the medical coding changes that happen every year. Each year medical coding companies struggle a lot to keep up to their standards by following CPT coding updates and guidelines for following years. 2021 has brought lot of changes too. There are new codes, deleted ones and revised as well. All seems like getting a new coding set ready for the upcoming bills.

Let’s have a look at CPT coding updates that medical coding companies should mostly focus on.

Evaluation and Management (E/M) coding:

  • Many extensive changes are made to evaluation and management office and outpatient service codes. These changes are for the codes 99202-99215.
  • Important and essential revisions to E/M codes and guidelines were already discussed in August and September 2020.The release takes place now!
  • The mostly noticed changes to the code descriptors for 99202-99215 includes the deletion of history and physical examination which earlier stood as a important key component.
  • Healthcare professionals are instead allowed to determine the E/M levels based on medical decision making or time of encounter or services rendered.
  • Medical Decision Making also have got new and revised definitions added for elements in 2021.

CPT coding updates for Medical Coding Companies:

1.Surgery/musculoskeletal system:

  • A new guideline for endoscopy and arthroscopy subsection was added which actually specifies the size limit for loose bodies or foreign bodies removed in arthroscopic procedures.
  • Medical coding companies are advised to report appropriate codes while using loose bodies or foreign bodies those act as equal or larger to the diameter of the arthroscopic cannula used for that particular procedure.
  • The differentiation takes place between loose bodies and foreign bodies removal in arthroscopic procedures through cannula which requires extra cannula removal.
  • Earlier, there was nothing like defined threshold of loose body size for applicable arthroscopic procedure codes.

New Guidelines:

  • Arthroscopic removal of loose bodies or foreign bodies with codes 29819, 29834, 29861, 29874, 29894, 29904 can be reported only when the loose bodies or foreign bodies are equal to or larger than the diameter of the arthroscopic cannulas that’s used for specific procedures, and can only be removed through a cannula larger than that’s used for the specific procedure or through a separate or different incision or through a portal that has been enlarged to allow removal of the loose or foreign bodies.

Revised codes:

  • 29822: This is the code used for Arthroscopy, shoulder, surgical; debridement, limited, 1 or 2 discrete structures for example; humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anchor complex, labrum, articular capsule, articular side of the rotator cuff, bursal side of the rotator cuff, sub acromial bursa, foreign bodies.
  • 29823: This code is used for Arthroscopy, shoulder, surgical; debridement, extensive, 3 or more discrete structures for example; humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anchor complex, labrum, articular capsule, articular side of the rotator cuff, bursal side of the rotator cuff, sub acromial bursa, foreign bodies.

2.Surgery/nervous system:

  • Deleted codes include the codes under the spine or spinal cord subsection, the cervical laminectomy codes 63180, Laminectomy and section of dentate ligaments, with or without dural graft, cervical; 1 or 2 segments and 63182, Laminectomy and section of dentate ligaments, with or without dural graft, cervical; more than 2 segments, were deleted due to the reason, they were less utilized by professionals.

Revised codes:

  • 64455: This code is used for Injections, anesthetic agents, and/or steroid; plantar common digital nerves for example; Morton’s neuroma.
  • 64479: This code is used for Injections, anesthetic agents, and/or steroid; transforaminal epidural, with imaging guidance fluoroscopy or CT, cervical or thoracic, single level.
  • 64480:This code is used for Injections, anesthetic agents, and/or steroid; transforaminal epidural, with imaging guidance fluoroscopy or CT, cervical or thoracic, each additional level . They will have to be listed separately in addition to the code of primary procedures.
  • 64483: This code is used for Injections, anesthetic agents, and/or steroid; transforaminal epidural, with imaging guidance fluoroscopy or CT, lumbar or sacral, single level.
  • 64484: This code is used for Injections, anesthetic agents, and/or steroid; transforaminal epidural, with imaging guidance fluoroscopy or CT, lumbar or sacral, each additional level and should be listed separately in addition to code for primary procedure.

New code for Category III:

  • 0594T : This code is used for Osteotomy, humerus, with insertion of an externally controlled intramedullary lengthening device, including intraoperative imaging, initial and subsequent alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device.

Deleted codes for Category III:

  • 0396T has been deleted. In order to report intraoperative use of kinetic balance sensor for implant stability during knee replacement arthroplasty, use the unlisted code 27599, Unlisted procedure, femur or knee.

Hope you got the information on CPT coding changes that medical coding companies must keep an eye on. For suggestions, please comment below. Don’t forget to follow us on Facebook, Instagram, LinkedIn and Twitter. Do subscribe our YouTube channel for more videos on healthcare.