It's time for a quick review of the upcoming CPT-4 changes for 2009. Unfortunately, I
can't give the updates for HCPCS yet, as my manual hasn't shown up yet from Ingenix; always a slave
to the supplier, aren't we? Anyway, this isn't a typical newsletter, since it's giving more specific
information, which means it's relatively short; I know some of you will be pleased.
For 2009, there are 505 changes in regular CPT-4 codes, and 47 for Category III codes;
I'll talk more about those later on. Out of those changes, 70 codes have been deleted,
130 codes are brand new, and 305 codes have been revised. Many of the changes are
just cosmetic, but some of them are drastic, and everyone needs to pay attention and make sure this
information has been given to the correct people.
Most of the critical care inpatient pediatric codes were moved from the 99293 - 99300 range
up to 99471 - 99480, as they were given their own category areas of Inpatient Neonatal and
Pediatric Critical Care, and Initial and Continuing Intensive Care Services. These will
pertain more to physicians than hospitals. The same goes for Newborn Care charges, which have
moved from CPT-4 range 99431 - 99440 up to 99460 - 99465.
The entire range of Hydration and Therapeutic, Prophylactic and Diagnostic Injections and
Infusion charges have been moved from the 90760 - 90779 range and moved to 96360 - 96379,
where they've tried to give better explanations for how to report these CPT-4 codes better. None of the
rules for using these charges have changed. Also, the CPT-4 codes from 90918 - 90925, the
End-Stage Renal Disease Services, have been moved to the 90951 - 90970 range
Many charges within the area of Noninvasive Physiologic Studies and Procedures have been moved
to the Cardiovascular Device Monitoring, Implantable and Wearable Devices area. The CPT-4 codes moved are:
- 93727 to 93291 or 93298
- 93731 to 93280
- 93733 to 93293
- 93734 and 93735 to 93288, 93294 or 93279
- 93736 to 93293
- 93741 and 93742 to 93289, 93295, 93282 or 93292
- 93760 and 93762 were deleted
Laparoscopy charges got a major addition, which was needed, adding six new descriptive surgical charges
in the 49650 to 49659 range. Also, a brand new range of charges and description were added,
Stereotactic Radiosurgery, Cranial, 61795 - 61800.
A high number of radiology charges, 79 to be exact, had some grammatical changes to them, and
4 new charges added to the department, three of them in the clinical brachytherapy area. None of those
changes have impacted how the charges are captured now.
Of course there are a lot more changes that I'm not getting into, but make sure to have your charge
master updated as soon as you can. And remember, I'm available!
Now, let's talk about Category III codes. Most people don't know anything about these charges,
and, truthfully, they're probably not charges that most facilities would think about having on their
charge master until they've provided the service. The purpose of these charges is to track new
technology and procedures that some hospitals begin to provide, and at some point, if the procedures
become significant enough, these codes will become Category 1 codes and that's when insurers will be
able to set up fees for these services. They're either become brand new codes or merged into an already
existing code, which will then have its wording modified.
These codes are monitored for up to 5 years, and if significant enough they'll be added; if
not, they'll either be totally deleted, or recommended to be charged to a miscellaneous code within a
certain area. It's always important, when new services are going to be performed at your facility, to
take the second step of looking through Category III codes to see if your procedure is listed in there
so that the service can be captured and counted, as opposed to going straight to miscellaneous codes
for reporting them. For 2009, 8 category codes from last year have been added to the Category I codes,
and 13 new codes have been added to Category III Codes.
And there you go. I hope you all have your new CPT-4 manuals, and that you'll be ready to share
this information with those departments that have been affected. Making sure your codes are up to
date will prevent too many early denials and keep cash coming in at the rate you're hoping it will.