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6/28/17 at 10:17 AM 0 Comments

Errata: Not Knowing These CPT® 2017 Code Corrections Could Sink Your Claims

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On March 30, 2017, the AMA posted an update to its Errata and Technical Corrections document for CPT® 2017. That correction is a simple addition of a semicolon to gastric emptying imaging study code 78264, but it’s a great reminder to check that your team (or your procedure code lookup tool) has caught all the corrections that apply to you. Here’s a look at some of the changes that could affect your coding choices.

Bring 35321 Back to Your Thromboendarterectomy Options

If you don’t think the corrections are ever big enough to impact your coding accuracy, consider this. On Oct. 17, 2016, AMA published a warning that it left a code out of the printed manual: 35321 (Thromboendarterectomy, including patch graft, if performed; axillary-brachial).

Being aware of the correction in this case saves you from reporting a less appropriate code for an axillary-brachial thromboendarterectomy.

Add ‘Equal to’ in These 7 Descriptors

A symbol causes issues in the long descriptors for seven codes. In each case, the original code descriptor is missing the symbol for “equal to.”

• In the manual, the descriptors for radiation treatment delivery codes 77402, 77407, and 77412 indicate they apply in cases involving greater than 1 MeV. The corrections file revises the descriptors to clarify that the codes are appropriate for greater than or equal to 1 MeV.
• The printed manual makes a similar error in CD4+ cell Category II codes 3496F and 3498F, using a “greater than” symbol that the corrections document revises to “greater than or equal to.”
• Category II code 4194F got a correction to show it applies to a patient receiving greater than or equal to 10 mg prednisone. The printed version, as you can probably guess by this point in the list, includes only the “greater than” symbol.
• “Greater than” didn’t cause all the trouble, though. In the descriptor for the Category II breast cancer stage code 3372F, the corrections document changes the relevant tumor size from less than 1 cm to less than or equal to 1 cm.

For coders who report these services, seeing the corrections can save a lot of frustration. For instance, if documentation of radiation treatment delivery shows 1 MeV, you won’t know which code to use if your only resource is the uncorrected manual. To be confident in your coding, you need to know that the corrected CPT® descriptors say codes 77402, 77407, and 77412 are appropriate for greater than or equal to 1 MeV.

Don’t Send +0159T Into the Sunset Just Yet

Code descriptors aren’t the only CPT® content you’ll find undergoing revision in the corrections document.

Consider +0159T (Computer-aided detection, including computer algorithm analysis of MRI image data for lesion detection/characterization, pharmacokinetic analysis, with further physician review for interpretation, breast MRI (List separately in addition to code for primary procedure)).

In the printed CPT® 2017 manual, this Category III CAD code has a sunset date of January 2017 — a confusing date to see in a 2017 manual. The corrections document changes 2017 to 2022, reflecting an extension.

Term tip: Sunset refers to the archive date for the temporary Category III code five years from initial publication. Within those five years, the Category III code may earn a spot as a more permanent Category I code, or the code may get an extension past the original five-year timeframe.

Make Sense of Moderate Sedation Instruction

The change to moderate sedation coding is one of the biggest changes for medical procedure codes in 2017, eliminating the moderate sedation symbol from hundreds of codes. The practical result of the change is that moderate sedation is no longer bundled into marked procedure codes, so you must report moderate sedation codes to receive reimbursement for sedation services.

If you scoured everything you could find to get up to speed on the new rule, you may have noticed that the printed version of AMA’s CPT® Appendix B, “Summary of Additions, Deletions, and Revisions,” appears to contradict the new rule. The printed Appendix B states that when a provider performs both a procedure marked with a bulls eye and the related moderate sedation, you should not separately report moderate sedation. The published version then shows a horizontal line through a bull’s eye symbol.

Fortunately, a wording correction posted in October clarifies that CPT® 2017 deletes the moderate sedation symbol and that the line through the bulls eye in Appendix B means the symbol has been deleted.

Stay on Top of Corrections Posted Throughout the Year

Because the AMA may update the corrections document at any time, you should have a plan in place to catch corrections. One option is to regularly review the corrections document for CPT® codes online on the AMA’s website.

Another option is to choose an online CPT® code lookup tool that updates its searchable CPT® code set to reflect the changes posted in the corrections document. That way, the CPT® code search tool does the work for you.

CP Blogs do not necessarily reflect the views of The Christian Post. Opinions expressed are solely those of the author(s).