Code Changes for 2007

For 2007, there were some major changes in CPT-4 codes and HCPCS codes that went in groups, rather than popping a charge in here and there. Understanding that there are many entities that don't always get these changes in a timely manner, otherwise there would never be any charge master work for someone like me, I thought we should take a look at some of these changes, mainly series of changes, which will be three or more codes.

The first surgical series is 15002 - 15005, which replaces 15000 and 15001. These are surgical services related to burns on children, and the new codes better define which area of the body the services are being performed on, as the previous codes only talked about body area in general.

The next surgical series is 17311 - 17315, which replaces and entire series of codes, 17004 - 17010. The minor change was dropping the description of "Chemosurgery" entirely, going only with Mohs micrographic technique, but the major change is, once again, better defining which area of the body the services are being performed on.

The next series, 19300 - 19307, replaces the entire series from 19140 - 19240. The basic purpose of this was to move mastectomy into its own category, rather than leave it under the category of general breast incisions, as none of the descriptions changed.

The next series, 33254 - 33266 (excluding 33261, which already existed), actually replaces one code that captured all of the services, those being operative incisions and reconstruction for atria. They've broken the codes into each of the possible procedures, including two codes, the last two, that are actually more endoscopic procedures than general surgery.

The next series, 33675 - 33677, expands on the code 33681, and the AMA took the unusual step of filling in numbers before a code they then modified. In general, the previous code had to be used for all closures of ventricular septal defects, whether it was single or multiple defects, and now it's been set up so what's being reported will indicate whether it's multiple or one. It's slightly surprising they didn't name the new codes as single, but the assumption must have been that too many people already knew 33681 as an individual code.

The next series, 35302 - 35306, expands on code 35301, thromboendarterectomy (an operation to remove a thrombus, or blood clot, along with the intima and atheromatous [inner layers of an artery] material from an occluded artery), as it now defines which area of the body the procedure is being performed on.

The next series isn't really a series at all, 35537 - 35540. These are all part of the general category of vein bypass grafts, non-synthetic, with these being additional areas of the body being identified separately, replacing 35541 and 35546. There are new codes to identify these same procedures with synthetic grafts, so we'll match them up:

             35537 - aortoiliac; synthetic, 35637
             35538 - aortobi-iliac; synthetic, 35638
             35539 - aortofemoral; synthetic, 35647
             35540 - aortobifemoral; synthetic, 35646

The next series, 49324 - 49326, are extensions of the laparoscopy, abdomen diagnostic procedure, allowing for 3 more ways to show how the procedure was performed, instead of having to do to the unlisted procedure code.

The next series, 58541 - 58444, expands on the laparoscopy/ hysteroscopy surgical category, and, once again, precedes a code within the subset rather than follows it. Before adding this subcategory for supracervical hysterectomy, most would have probably used one of the codes between 58550 - 58554; the new codes are more accurate.

The next series, 77001 - 77003, along with 77011 - 77014, 77021 - 77032, 77051 - 77059, and 77071 - 77084, replace codes 75998, 76003 - 76006, 76012 - 76078, and 76082 - 76096. Radiologic guidance and Breast Mammography have been given their own categories, rather that being lumped under "other procedures".

The next series, 77371 - 77373, is a new category, basically allowing radiation medicine departments to break out stereotactic radiation treatments from the general category they were reporting the procedures under 77370, which didn't quite fit.

There are no real series of code changes for lab, but there are two additions that are timely. Those codes are 86788, West Nile virus, IgM, and 86789, West Nile virus, which, as we know, is a growing problem across the United States, and therefore is now identifiable individually.

The next series, 94002 - 94005, finally allows hospitals, nursing homes, and home care plans the opportunity to capture daily ventilation management services accurately, and it now leads the category under pulmonary.

The next series, 94774 - 94777, are also brand new codes, now allowing for the opportunity to more accurately reflect pediatric home apnea monitoring.

Regarding HCPCS codes, there are really only two major changes to talk about, but each is significant in its own way.

The big change for most people isn't the new code series, C9232 - C9235, which are injection codes, but the elimination of C8950 - C8955, chemotherapy codes for Medicare that will now be captured by the CPT codes 90765 - 90768, 90774, 90775, and 96409 - 96417. All of the CPT-4 codes were added last year, but trying to figure out which codes were wanted by who was confusing in 2006, so that's finally been resolved, although I'm sure there are still many questions that exist when trying to figure out those new codes from last year.