The American Medical Association (AMA) publishes the Current Procedural Terminology code set changes every year, usually in September, for the upcoming new year. The changes impacting CPT 2020 were released on September 4, 2019. There was a total of 394 CPT code changes, of which, 58 affect the surgery center market. 2020 CPT Code Changes include 38 new codes, 35 revised code descriptions and 17 deleted codes.
Outlined below are the sections and codes that will have the biggest impact in Ambulatory Surgery Centers.
NEW CPT CODES
Specific codes have been created for both genicular nerve and sacroiliac joint nerve procedures with comprehensive directives by the AMA listed within the parentheticals of these codes.
- CPT 64454– Injection(s), anesthetic agent(s) and/or steroid; genicular nerve branches, including imaging guidance, when performed
(Do not report 64624 in conjunction with 64454). (Do not report 64454 in conjunction with 64624). (64454 requires injecting all of the following genicular nerve branches: superolateral, superomedial, and inferomedial. If all 3 of these genicular nerve branches are not injected, report 64454 with modifier 52).
- CPT 64624– Destruction by neurolytic agent, genicular nerve branches including imaging guidance, when performed
(Do not report 64624 in conjunction with 64454.) (64624 requires the destruction of each of the following genicular nerve branches: superolateral, superomedial, and inferomedial. If a neurolytic agent for the purposes of destruction is not applied to all of these nerve branches, report 64624 with modifier 52.)
- CPT 64451– Injection(s), anesthetic agent(s) and/or steroid; nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography)
(For injection, anesthetic agent, nerves innervating the sacroiliac joint, use 64451.) (Do not report 64451 in conjunction with 64493, 64494, 64495, 77002, 77012, 95873, 95874.) (For injection, anesthetic agent, nerves innervating the sacroiliac joint, with ultrasound, use 76999.)
- CPT 64625– Radiofrequency ablation, nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography)
(Do not report 64625 in conjunction with, 64636, 77002, 77003, 77012, 95873, 95874.) (For radiofrequency ablation, nerves innervating the sacroiliac joint, with ultrasound, use 76999.)
- CPT 62328– Spinal puncture, lumbar, diagnostic
- CPT 62329 – Spinal puncture, lumbar, therapeutic
Grafting codes have been added to provide greater detail describing different tissue-grafting procedures.
- CPT 15769– Grafting of autologous soft tissue, other, harvested by direction excision (eg, fat, dermis, fascia)
- CPT 15771 – Grafting of autologous fast harvested by liposuction technique to trunk, breasts, scalp, arms, and/or legs; 50cc or less injectate
- CPT 15773 – Grafting of autologous fat harvested by liposuction technique to face, eyelids, mouth, neck, ears, orbits, genitalia, hands and/or feet; 25 cc or less injectate
- CPT 20926– Tissue grafts, other (eg, paratenon, fat, dermis
- CPT 19304 – Mastectomy, Subcutaneous
EYE & OCCULAR ADNEXA
A new cataract technique has been added to the eye section.
- CPT 66987– Complex cataract with endoscopic cyclophotocoagulation
- CPT 66988 – Cataract with endoscopic cyclophotocoagulation
- CPTs 66982 and 66984– now includes in the description “without endoscopic cyclophotocoagulation”
- CPT 46948– Hemorrhoidectomy, internal, by transanal hemorrhoidal dearterialization, 2 or more groups
- CPT 0249T– Hemorrhoidectomy, internal, by transanal hemorrhoidal dearterialization, 2 or more groups
It can be a tedious task to search through all updates each year and an even more challenging task to try to pull out information that is relevant to ASCs. It may seem overwhelming; however, it is necessary to ensure accurate and compliant coding for your surgery center. To prevent an increase in denials in 2020, educating your physicians and billing department on all the CPT code changes is recommended. Routine audits are a good way to safeguard your surgery center throughout the year. As Herbert Hoover once said, “About the time we can make the ends meet, somebody moves the ends.”