The American Medical Association (AMA) recently released 335 code changes to its 2019 CPT code set, which go into effect on January 1, 2019. It is critical for healthcare providers as well as medical billing and coding companies to stay up-to-date with these coding changes.

CPT Coding

According to AMA President Barbara L. McAneny, M.D. “The latest annual changes to the CPT code set reflect new technological and scientific advancements available to mainstream clinical practice, and ensure the code set can fulfill its trusted role as the health system’s common language for reporting contemporary medical procedures.”

The new CPT codes added include three remote patient monitoring codes that represent how providers use health IT system to connect with their patients in their homes and collect data for care management and care coordination as well as two new inter-professional internet consultation codes (99453 and 99454) that aim to show the increasing importance and prevalence of using non-verbal communication technology to coordinate care between a consulting and treating physician.

New codes

  • Six new codes were added in the Evaluation and Management (E&M) section in CPT.
    • Codes 99451 and 99152 have been added to report assessment and management services. The codes are based on medical consultative time.
    • 99453 and 99454 codes are to be used to report remote physiologic monitoring services during a 30-day period. Other codes in this section (99446-99449 and 99091) have been revised.
    • Code 99457 requires live, interactive communication with the patient/caregiver and 20 minutes or more of clinical staff/physician or other qualified healthcare professional time in a calendar month.

Other coding changes for 2019 include the addition and revision of codes for skin biopsy, fine needle aspiration biopsy, adaptive behavior analysis, and central nervous system assessments, including psychological and neuropsychological testing.

  • Fine needle aspiration (FNA) codes received new instructional notes including the definition of a fine needle aspiration and a core needle biopsy.
  • When using different imaging modalities when more than one lesion is involved, Modifier 59 is to be appended.
  • CPT code 10022 has been deleted and replaced with CPT 10004 for each additional lesion. CPT codes 10005-10012 are added to report the specific imaging guidance (ultrasound, fluoroscopic guidance, CT and MRI).
  • CPT codes 11100 and 11101 for skin biopsies have been deleted. The new codes (11102-11107) for skin biopsies are based on method of removal including tangential (shave, scoop, saucerize, curette), punch and incisional.
  • CPT codes 20932-20934 are added for allografts. CPT 20932 includes templating, cutting, placement and internal fixation; osteoarticular, whereas CPT 20933 is hemicortical, intercalary, partial and CPT 20934 is hemicortical, complete.
  • While CPT code 27369 has been added to report an injection procedure for contrast knee arthrography or contrast enhanced CT/MRI knee arthrography, code 27370 is deleted most likely due to it being reported incorrectly as arthrocentesis or aspiration.
  • New code 33274 is added for reporting a transcatheter insertion or replacement and removal of a permanent leadless pacemaker, right ventricle.
  • While codes 33285 and 33286 have been created for the insertion and removal of a subcutaneous cardiac rhythm monitor, CPT 33289 is for a transcatheter implantation of a wireless pulmonary artery pressure sensor and the new code 93264 is used to report remote monitoring of a wireless pulmonary artery pressure sensor for up to 30 days.
  • Eight new CPT codes 97151-97158 and guidelines are added to Adaptive Behavioral services to address deficient adaptive behaviors.

Further changes in 2019 CPT code set are explained in the ICD-10 monitor article.

Medical coding outsourcing is an ideal option for hospitals, as any practice’s compensation and cash flow depend on timely and accurate coding and submission of medical claims to the insurance companies.