2015 Charge Master Update - HFMA NJ Chapter - Home Pagehfmanj.org/images/downloads/Presentation/nj_hfma_201… · · 2014-12-152015 Charge Master Update Mike Kovar Stacey Harper

2015 Charge Master Update

Mike Kovar Stacey HarperPartner Senior ManagerWeiserMazars LLP WeiserMazars LLP

HFMA NJ ChapterRevenue Integrity CommitteeDecember 16, 2014

Introductions

Mike Kovar has led over 400 charge master, revenue capture, and patient charge compliance reviews. He received his Masters’ in Business Administration from Loyola University of Chicago, is an advanced member of HFMA, and is a frequent speaker nationally on charge master and other revenue capture-related issues.Stacey Harper, RHIA, CPC, CPMA has over 7 years of experience in the charge master, charge capture and coding areas. She previously served as Executive Director of Revenue Integrity and HIM for a large academic medical center in the Midwest.

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Objectives of the Seminar

In our session, we will cover the following: How to prepare your charge master and

related processes for 2015

Charge master and charge capture process changes related to Medicare's implementation of the 2015 Outpatient Prospective Payment System changes

CPT Code additions, revisions, and deletions for 2015

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Charge Master-Other Payors

When updating the charge master understand impact of changes on other payors– Medicaid– Top 3 to 5 managed care payors

Rate sheets and Medicaid provider manual are good resources

Review contract terms/ provider manuals/ remittance advices, etc.

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Charge Master Update The following resources are required:

• 2015 OPPS Final Rule and, if available, January OPPS Medicare Transmittal

• 2015 CPT Manual

• 2015 HCPCS Code listing

• Other major payor information as applicable

5

Charge Master Update-Plan Critical success factors in developing and executing a plan to

implement the 2015 update include:

– Proactive versus reactive approach• Initiate and complete prior to January 1, 2015

– Active Department participation and ownership

– Develop and monitor deadlines

– Implement CPT, HCPCS and UB-04 Revenue Code revisions and verify accuracy

– Educate, educate, educate

6

Charge Master Update-Monitoring

Post implementation of the January 2015 update, monitor results– Set up a tracking mechanism for key charge master changes

• Track for minimum of 3 months• Drug testing in Lab is one area of focus

– Perform a claims review for selected charge master update issues

– Initiate corrective actions as necessary

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Charge Master Update-Medicare Regulatory Process

CMS publishes proposed annual rule changes to OPPS in July/August each year in the Federal Register

– Comments due 30 days post publication in Federal Register

CMS publishes final annual changes to OPPS in October/November each year in the Federal Register

– Implementation January 1 each year

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Charge Master Update-Medicare Regulatory Process

CMS through their sub-regulatory process details required OPPS changes for the MACs using Medicare Program Transmittals

– January OPPS changes published in January transmittal in late December/early January each year

– Additional changes to OPPS issued for implementation in April, July, and October each year

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2015 Hospital Outpatient ProspectivePayment System (OPPS) and Ambulatory Surgery

Payment System (ASC) Final Rule Display copy issued on October 31, 2014

Rule is effective January 1, 2015

2.3% increase in Medicare payments in 2015 to all hospitals including cancer and children’s hospitals and CMHCs (1.8% increase in 2014)

– Estimated payments approximate $56.1 billion

• $5.1 billion increase over 2014

Overall Impact of 2015 OPPS Changes

Impacts on different “hospital categories” are as follows:– urban hospitals 2.3%– rural hospitals 1.9%– sole community rural hospitals 2.2%– urban hospitals 500 + beds 2.5%– major teaching hospitals 3.1%– non-teaching hospitals 2.0%– governmental hospitals 2.1%– proprietary hospitals 1.7%– CMHCs 1.3%

Overall Impact of 2015 OPPS Changes

Overall Impact of 2015 OPPS Changes (cont’d)

CMS has a publicly available file to estimate the impact of the 2015 final OPPS rule on it’s website for every OPPS hospital.

– 2015 OPPS NPRM Facility-Specific Impacts

• http://www.cms.gov/apps/ama/license.asp?file=/Medicare/Medicare-Fee-for-Service-Payment/HospitalOutpatientPPS/Downloads/CMS-1613-P-Addenda.zip

Provider Number

CBSA Code

Total Discounted

Units

Rural Sole Community

and Essential Access

Hospitals

Post Reclassification

Wage Index All Rural

Urban/Rural Geographic

Location Region

Disproportionate Share Patient Percentage

Outpatient Cost-to-Charge Ratio

Estimated 2014 OPPS payment

Estimated 2015 OPPS payment

Estimated 2015 Outlier

PaymentNumber of Beds

Teaching Hospitals Ownership CMHC

Provider Lines

010001 20020 167,323.8 0 0.7722 0 OURBAN ESC 29.6% 0.144 $35,011,510.14 $33,772,315.63 $31,516.88 408 NONE 3 N 292,816

010005 01 197,506.7 0 0.8137 1 RURAL ESC 29.4% 0.202 $20,156,309.67 $20,671,007.37 $18,064.33 196 NONE 3 N 271,019


Top 10 CPT Code Winners-2015 Versus 2014

HCPCS Code Short Descriptor SI

2015 Payment Rate 2014 Payment Rate

2015 Payment Variance

63655 Implant neuroelectrodes J1 $17,099.35 $7,424.49 $9,674.86

64580 Implant neuroelectrodes J1 $17,099.35 $7,424.49 $9,674.86

63685 Insrt/redo spine n generator J1 $26,152.16 $17,232.90 $8,919.26

92933 Prq card stent/ath/angio J1 $14,840.64 $6,363.75 $8,476.89

33221 Insert pulse gen mult leads J1 $16,400.98 $8,387.53 $8,013.45

33229 Remv&replc pm gen mult leads J1 $16,400.98 $8,387.53 $8,013.45

0308T Insj ocular telescope prosth J1 $23,075.30 $15,551.23 $7,524.07

C9602 Perc d-e cor stent ather s J1 $14,840.64 $7,714.02 $7,126.62

C9606 Perc d-e cor revasc w ami s J1 $14,840.64 $7,714.02 $7,126.62

C9607 Perc d-e cor revasc chro sin J1 $14,840.64 $7,714.02 $7,126.62


Top 10 CPT Code Losers-2015 Versus 2014

HCPCS Code Short Descriptor SI

2015 Payment Rate 2014 Payment Rate

2015 Payment Variance

A9543 Y90 ibritumomab, rx K $16,966.82 $44,161.14 -$27,194.32

C9741 Impl pressure sensor w/angio T $2,575.33 $15,509.99 -$12,934.66

33225 L ventric pacing lead add-on N $10,588.40 -$10,588.40

37233 Tibper revasc w/ather add-on N $9,119.70 -$9,119.70

92925 Prq card angio/athrect addl N $8,842.66 -$8,842.66

C9601 Perc drug-el cor stent bran N $7,714.02 -$7,714.02

C9603 Perc d-e cor stent ather br N $7,714.02 -$7,714.02

C9605 Perc d-e cor revasc t cabg b N $7,714.02 -$7,714.02

C9608 Perc d-e cor revasc chro add N $7,714.02 -$7,714.02

23473 Revis reconst shoulder joint T $3,362.99 $9,732.07 -$6,369.08

Updates Affecting OPPS Payments

Approximately 161 million (versus 158 million in 2014) final action claims for services provided in a hospital outpatient setting from January 1, 2013 through December 31, 2013 were used to calculate the 2015 rates

Single/”pseudo” claims process used in previous years was again used for 2015 rate setting purposes

– Medicare lists bypassed HCPCS Codes to determine single claims in Addendum N

Updates Affecting OPPS Payments CMS has created 25 comprehensive APCs (C-APCs) for 2015

(219 procedures)– Comprehensive APC defined as a classification for provision of a

primary service and all adjunctive services• Single payment for all services• Status J1 created for this classification• Add-on device dependent CPT Codes will be packaged as

SI=N• Pacemaker/AICD Insertions, Stent Insertions included in this

classification• Only excludes services not covered by Medicare Part B or

are not payable under OPPS• For 2015, CMS will require the reporting of a device C-code

for all procedures currently assigned a device-dependent APC in 2014

Updates Affecting OPPS Payments• Includes the following:

Diagnostic procedures, laboratory tests and other diagnostic tests, and treatments that assist in delivery of the primary procedure;

Visits and evaluations associated with the procedure; Uncoded services and supplies used during the service; Outpatient services similar to therapy delivered by

therapists and non-therapists; Durable medical equipment as well as prosthetic and

orthotic supplies and items delivered as part of the comprehensive service;

Any other components reported with HCPCS Codes except excluded services on next page;

All drugs, biologicals and radiopharmaceuticals regardless of cost, except pass-through drugs and those drugs that are typically self administered unless they function as packaged supplies





Updates Affecting OPPS Payments Complexity adjustment modified from OPPS 2014

– Complexity adjustment applied when:

• Qualifying J1 Status Indicator CPT Code combinations; and

• CPT Code combinations of “J1” services and certain add-on CPT Codes

– When one of the above conditions are met, the original C-APC will be complexity adjusted to the next higher C-APC within the same clinical family assuming the reassignment is clinically appropriate and the reassignment would not create a two times rule violation in the receiving APC

Updates Affecting OPPS Payments– Criteria for a CPT Code combination to receive a complexity

adjustment due to the CPT combination representing a costly, complex service are as follows:

• Frequency threshold of 25 or more claims with the CPT Code combination

• Cost threshold where there is violation of the 2 times rule-comprehensive mean geometric cost of the CPT Code combination exceeds the comprehensive mean geometric cost of the lowest CPT Code assigned to the C-APC

– Addendum J lists the CPT Code combinations that qualify for a complexity adjusted payment



Updates Affecting OPPS PaymentsAddendum J for CY2015 complexity adjustments of combinations of comprehensive HCPCS codes

Primary HCPCS Code Primary Short Descriptor

Primary SI

Primary APC Assignment

Secondary or Device Add-on HCPCS Code Secondary Short Descriptor

Secondary SI

Secondary APC

Assignment

Complexity Adjusted APC Assignment

61885 Insrt/redo neurostim 1 array J1 0039 61885 Insrt/redo neurostim 1 array J1 0039 0318

61885 Insrt/redo neurostim 1 array J1 0039 64553 Implant neuroelectrodes J1 0061 0318

61885 Insrt/redo neurostim 1 array J1 0039 64569 Revise/repl vagus n eltrd J1 0061 0318

64590 Insrt/redo pn/gastr stimul J1 0039 64555 Implant neuroelectrodes J1 0061 0318

64590 Insrt/redo pn/gastr stimul J1 0039 64575 Implant neuroelectrodes J1 0061 0318

64590 Insrt/redo pn/gastr stimul J1 0039 64590 Insrt/redo pn/gastr stimul J1 0039 0318

64555 Implant neuroelectrodes J1 0061 63650 Implant neuroelectrodes J1 0061 0039

64581 Implant neuroelectrodes J1 0061 64581 Implant neuroelectrodes J1 0061 0039

36870 Percut thrombect av fistula J1 0083 36870 Percut thrombect av fistula J1 0083 0229

92920 Prq cardiac angioplast 1 art J1 0083 92920 Prq cardiac angioplast 1 art J1 0083 0229

92920 Prq cardiac angioplast 1 art J1 0083 92921 Prq cardiac angio addl art N 0229

33207 Insert heart pm ventricular J1 0089 33225 L ventric pacing lead add-on N 0655

33208 Insrt heart pm atrial & vent J1 0089 33225 L ventric pacing lead add-on N 0655


Primary HCPCS Code Primary Short Descriptor

Primary SI

Primary APC Assignment

Secondary or Device Add-on HCPCS Code Secondary Short Descriptor

Secondary SI

Secondary APC

Assignment


33208 Insrt heart pm atrial & vent J1 0089 93650 Ablate heart dysrhythm focus J1 0085 0655

33224 Insert pacing lead & connect J1 0089 33216 Insert 1 electrode pm-defib J1 0090 0655

33228 Remv&replc pm gen dual lead J1 0089 33225 L ventric pacing lead add-on N 0655

33233 Removal of pm generator J1 0090 33225 L ventric pacing lead add-on N 0089

33282 Implant pat-active ht record J1 0090 93619 Electrophysiology evaluation J1 0085 0089

33282 Implant pat-active ht record J1 0090 93620 Electrophysiology evaluation J1 0085 0089

57260 Repair of vagina J1 0202 57288 Repair bladder defect J1 0202 0385

57265 Extensive repair of vagina J1 0202 57288 Repair bladder defect J1 0202 0385

57282 Colpopexy extraperitoneal J1 0202 57260 Repair of vagina J1 0202 0385

57282 Colpopexy extraperitoneal J1 0202 57265 Extensive repair of vagina J1 0202 0385

57282 Colpopexy extraperitoneal J1 0202 57285 Repair paravag defect vag J1 0202 0385

57282 Colpopexy extraperitoneal J1 0202 57288 Repair bladder defect J1 0202 0385

57282 Colpopexy extraperitoneal J1 0202 58262 Vag hyst including t/o J1 0202 0385

57283 Colpopexy intraperitoneal J1 0202 57285 Repair paravag defect vag J1 0202 0385

57283 Colpopexy intraperitoneal J1 0202 57288 Repair bladder defect J1 0202 0385

57285 Repair paravag defect vag J1 0202 57288 Repair bladder defect J1 0202 0385

57288 Repair bladder defect J1 0202 57250 Repair rectum & vagina J1 0202 0385

57288 Repair bladder defect J1 0202 58260 Vaginal hysterectomy J1 0202 0385

57288 Repair bladder defect J1 0202 58263 Vag hyst w/t/o & vag repair J1 0202 0385

57288 Repair bladder defect J1 0202 58270 Vag hyst w/enterocele repair J1 0202 0385


Primary HCPCS Code Primary Short Descriptor Primary SIPrimary APC Assignment

Secondary or Device Add-on HCPCS Code Secondary Short Descriptor Secondary SI

Secondary APC Assignment


58262 Vag hyst including t/o J1 0202 57288 Repair bladder defect J1 0202 0385

37221 Iliac revasc w/stent J1 0229 37236 Open/perq place stent 1st J1 0229 0319

37225 Fem/popl revas w/ather J1 0229 37221 Iliac revasc w/stent J1 0229 0319

37225 Fem/popl revas w/ather J1 0229 37236 Open/perq place stent 1st J1 0229 0319

37226 Fem/popl revasc w/stent J1 0229 37221 Iliac revasc w/stent J1 0229 0319

37226 Fem/popl revasc w/stent J1 0229 37225 Fem/popl revas w/ather J1 0229 0319

37226 Fem/popl revasc w/stent J1 0229 37226 Fem/popl revasc w/stent J1 0229 0319

37226 Fem/popl revasc w/stent J1 0229 37236 Open/perq place stent 1st J1 0229 0319

37226 Fem/popl revasc w/stent J1 0229 C9600 Perc drug-el cor stent sing J1 0229 0319

37241 Vasc embolize/occlude venous J1 0229 37238 Open/perq place stent same J1 0229 0319

37242 Vasc embolize/occlude artery J1 0229 37221 Iliac revasc w/stent J1 0229 0319

37242 Vasc embolize/occlude artery J1 0229 37236 Open/perq place stent 1st J1 0229 0319

37243 Vasc embolize/occlude organ J1 0229 37221 Iliac revasc w/stent J1 0229 0319

37243 Vasc embolize/occlude organ J1 0229 37236 Open/perq place stent 1st J1 0229 0319

37244 Vasc embolize/occlude bleed J1 0229 37221 Iliac revasc w/stent J1 0229 0319

37244 Vasc embolize/occlude bleed J1 0229 37236 Open/perq place stent 1st J1 0229 0319

37244 Vasc embolize/occlude bleed J1 0229 37238 Open/perq place stent same J1 0229 0319

92928 Prq card stent w/angio 1 vsl J1 0229 C9601 Perc drug-el cor stent bran N 0319

C9600 Perc drug-el cor stent sing J1 0229 33208 Insrt heart pm atrial & vent J1 0089 0319

C9600 Perc drug-el cor stent sing J1 0229 33210 Insert electrd/pm cath sngl J1 0090 0319

C9600 Perc drug-el cor stent sing J1 0229 37221 Iliac revasc w/stent J1 0229 0319

C9600 Perc drug-el cor stent sing J1 0229 37236 Open/perq place stent 1st J1 0229 0319

C9600 Perc drug-el cor stent sing J1 0229 92924 Prq card angio/athrect 1 art J1 0229 0319

C9600 Perc drug-el cor stent sing J1 0229 C9600 Perc drug-el cor stent sing J1 0229 0319

C9600 Perc drug-el cor stent sing J1 0229 C9601 Perc drug-el cor stent bran N 0319

C9600 Perc drug-el cor stent sing J1 0229 C9605 Perc d-e cor revasc t cabg b N 0319

C9604 Perc d-e cor revasc t cabg s J1 0229 C9600 Perc drug-el cor stent sing J1 0229 0319

C9604 Perc d-e cor revasc t cabg s J1 0229 C9601 Perc drug-el cor stent bran N 0319

C9604 Perc d-e cor revasc t cabg s J1 0229 C9604 Perc d-e cor revasc t cabg s J1 0229 0319

C9604 Perc d-e cor revasc t cabg s J1 0229 C9605 Perc d-e cor revasc t cabg b N 0319

Updates Affecting OPPS Payments For the following Composite APCs (Status Indicator Q3), no

changes in 2015

– Extended Assessment and Management (APC 8009)– LDR Prostate Brachytherapy (APC 8001)– Mental Health Services (APC 0034)– Multiple Imaging (APCs 8004, 8005, 8006, 8007 and

8008)

Composite APCs for Cardiac Resynchronization Therapy (APC 0108) and EP Evaluation and Ablation (APC 8000) have been eliminated Both now paid as C-APCs

Packaging Policy Changes for 2015

Packaging Policy Changes for 2015 Ancillary services/procedures with a geometric mean cost of $100 or less

will be conditionally packaged– Only paid if that is only service on claim– Excluded are preventive services that would be otherwise packaged

Packaging Policy Changes for 2015 Ancillary services/procedures with a geometric mean cost of $100 will be

conditionally packaged– Also excluded are:

• Certain psychiatric and counseling services that are considered by CMS to be visits and not ancillary such as psychotherapy, etc.

• Drug administration and add-on drug administration CPT Codes– “We are examining various alternative payment policies

for drug administration services…..”

Status Indicator X (Ancillary Services) is being eliminated since most services are now conditionally packaged as Status Indicator Q1 (STV Packaged)– CPT Codes previously “X” and not “Q1” will be assigned as Status

Indicator “S” (Significant Procedure Not Discounted)

Packaging Policy Changes for 2015 Ancillary services/procedures with a geometric mean cost of $100 will be

conditionally packaged– Many, many procedures and tests are now packaged

• Check that list of CPT Codes with Comment Indicator “CH” and Status Indicator “Q1”

• Partial list is included on the next page– Includes many radiology exams, EKGs, laceration repairs,

surgical pathology and cytology tests Prosthetic supplies that were paid separately in 2014 will now be packaged

into the related surgical procedure– This includes not only the prosthetic supplies related to an implanted

device but also the implanted device– Status Indicator changed from “A” to “N” for all DMEPOS prosthetic

supplies

Packing Policy Changes for 2015

HCPCS Code Short Descriptor CI SI APC Payment Rate 12001 Rpr s/n/ax/gen/trnk 2.5cm/< CH Q1 0012 $98.4670160 X-ray exam of nasal bones CH Q1 0260 $59.3471021 Chest x-ray frnt lat lordotc CH Q1 0260 $59.3471022 Chest x-ray frnt lat oblique CH Q1 0261 $94.9871023 Chest x-ray and fluoroscopy CH Q1 0261 $94.9871030 Chest x-ray 4/> views CH Q1 0261 $94.9871035 Chest x-ray special views CH Q1 0260 $59.3471100 X-ray exam ribs uni 2 views CH Q1 0260 $59.3471101 X-ray exam unilat ribs/chest CH Q1 0261 $94.9871110 X-ray exam ribs bil 3 views CH Q1 0261 $94.9873020 X-ray exam of shoulder CH Q1 0260 $59.3473500 X-ray exam of hip CH Q1 0260 $59.3473560 X-ray exam of knee 1 or 2 CH Q1 0260 $59.3473562 X-ray exam of knee 3 CH Q1 0261 $94.9873564 X-ray exam knee 4 or more CH Q1 0261 $94.9873565 X-ray exam of knees CH Q1 0260 $59.3473600 X-ray exam of ankle CH Q1 0261 $94.9873610 X-ray exam of ankle CH Q1 0261 $94.9873620 X-ray exam of foot CH Q1 0260 $59.3473630 X-ray exam of foot CH Q1 0260 $59.3473650 X-ray exam of heel CH Q1 0260 $59.3473660 X-ray exam of toe(s) CH Q1 0260 $59.3474000 X-ray exam of abdomen CH Q1 0260 $59.3474010 X-ray exam of abdomen CH Q1 0260 $59.3474020 X-ray exam of abdomen CH Q1 0261 $94.98

Updates Affecting OPPS Payments-Other Issues

• Calculation of the Adjusted Medicare Payment from the National Unadjusted Medicare Payment

– Assuming the following: APC 0019=$380.32; Wage index for NY CBSA 35644= 1.3147

• Labor adjusted portion of full national adjusted payment= $300.00 (.60 * $380.32 * 1.3147)

• The nonlabor-related portion of the full national unadjusted payment = $152.13 (.40 * $380.32)

• Total Adjusted Medicare Payment= $452.13 ($300.00 + $152.13)

• National beneficiary copayment cannot exceed 40% of the APC payment in 2015 and cannot be less than 20% of the OPD fee schedule amount

– Beneficiary copayment collected is limited to the amount of the inpatient deductible.

OPPS APC Group Policies






OPPS APC Group Policies Process for new CPT Codes effective January 1, 2016

– Under the current process, CPT Codes effective January 1 are given interim Status Indicator and APC assignments until the following year’s OPPS Rule when Status Indicators and APCs are finalized for the previous year’s new CPT Codes

– The following process will be implemented for January 1, 2016

• New and revised CPT Codes that are received too late for inclusion in the 2016 OPPS Proposed Rule would not be used by CMS until January 1, 2017

– HCPCS G-codes would be created by CMS to describe the predecessor CPT Codes for the new or revised CPT Codes that are part of the annual 2016 CPT Code update

OPPS APC Group Policies Process for new CPT Codes effective January 1, 2016

• For new CPT Codes that are released publicly by the AMA prior to the proposed 2016 rule, Status Indicators and APCs will be assigned for 2016

• CMS is hoping that AMA adjusts the timeline for the release of the new CPT Codes to allow the new, revised, and deleted CPT Codes to be included in the Proposed OPPS Rule each year.

– AMA requested a delay until 2017 but CMS refused

2015 OPPS APC Specific Policies APCs are being restructured in 3 areas this year:

– In ophthalmology, the number of APCs reduced from 24 levels in 2014 to 13 levels in 2015

– For female reproductive APCs, there is restructuring of the APCs resulting in 5 APC levels in 2015 versus 7 APC levels in 2014

– For cystourethroscopy and other genitourinary procedures, there is restructuring of the APCs resulting in 4 APC levels in 2015 versus 5 APC levels in 2014

2015 OPPS APC Specific Policies For image-guided breast biopsies, APC 037 is being deleted and all CPT Codes

reassigned to APC 005 resulting in a $350 increase in payment





2015 Payment Changes for Devices Pass-through Devices

– Devices with pass through status eligible for pass through payment for at least 2 years but not more than 3 years

– Devices no longer eligible for pass through payment are packaged into the cost of the procedure

– As of January 1, 2015, there is one device eligible for pass-through payment

• C1841 Retinal prosthesis, includes all internal and external components

– Pass-through status scheduled to expire as of January 1, 2016

2015 Payment Changes for Devices For replaced devices that there is at least 50% credit, current

2014 policy continues– Credit amount reported in the amount field for Value Code “FD”

• Value Code FD=Credit received from manufacturer for replaced medical device

2015 Payment Changes for Drugs, Biologicals, and Radiopharmaceuticals

For drugs and biologicals, pass-through payment is the amount by which the drug or biological exceeds the portion of the otherwise applicable Medicare OPD fee schedule that is associated with the drug or biological (SI=G)

Due to the postponement of the Part B Drug Competitive Acquisition Program, CMS pays the rate paid in the physician's office setting for all drugs and biologicals with pass-through status

– ASP + 6%


9 drugs with pass-through status ending December 31, 2014


22 drugs/biologicals have pass-through status (SI=G) in 2015






$95 per day cost threshold for separate payment (SI=K) of non-pass through drugs with payment at ASP+6% ($90 in 2014)

Packaging determinations will be made on a drug-specific basis rather than a HCPCS Code-specific basis for those HCPCS codes that describe the same drug or biological but different doses

Non-pass-through therapeutic radiopharmaceuticals (per day cost of $95) payment is ASP + 6%

Currently one diagnostic radiopharmaceutical with pass-through payment

• A9520 (previously C1204) Technetium Tc 99m tilmanocept, diagnostic, up to 0.5 millicuries

Pass-through status granted October 1, 2013

Blood clotting factors under OPPS to be paid at ASP+6%


Methodology for calculating high cost versus low cost skin substitutes is changing for 2015

– In 2014, skin substitutes with a July 2013 ASP + 6% amount above $32 per square cm were classified as “high cost”

– In 2015, skin substitutes with a weighted average mean unit cost (MUC) above $25 per square cm using 2013 claims data will be classified as “high cost”



Other 2015 OPPS Payment and Coding Changes

Hospital coding and payment for visits

– Current single HCPCS Code G0463 for clinic visits will continue to be used in 2015

– No changes to current ED level structure

– For critical care CPT Code 99291, current policy continues in 2015 that conditionally packages ancillary services reported on same day as the critical care services

Other 2015 OPPS Payment and Coding Changes

• Inpatient only list is detailed in Addendum E

• One CPT Code added to the inpatient only list in 2015– CPT 22222-Osteotomy of spine, including discectomy, anterior

approach, single vertebral segment; thoracic

• Two CPT Codes removed from the inpatient only list in 2015– CPT 63043-Laminonotomy with decompression of nerve root, each

additional cervical interspace– CPT 63044-Laminonotomy with decompression of nerve root, each

additional lumbar interspace

2015 Nonrecurring Policy Changes• Collecting data on services furnished in off-campus provider-based

departments– Increased trend toward hospitals acquisition of physician practices,

integration of those practices as hospital departments, and resultant increase in physician services being provided in hospital setting

• CMS interested in how this trend affects payment under MPFS and OPPS

• Conditions required for a provider to treat off-campus facility as provider based are included under 42 CFR 413 .65

– Campus defined as physical area immediately adjacent to the providers main buildings, other areas and structures that are not strictly contiguous to the main buildings but are located within 250 yards of the main buildings, and other areas determined on an individual case basis, by the CMS regional office, to be part of the provider’s campus

2015 Nonrecurring Policy Changes

• CMS to create a HCPCS modifier to be reported on the CMS-1450 for hospital outpatient services

– Voluntary reporting of the modifier in 2015 and required in 2016

– HCPCS modifier “PO” - Services, procedures and/or surgeries furnished at off-campus provider based outpatient departments

• CMS to create two new “Place of Service” (POS) Codes to be reported on the CMS-1500 for physician services

– Voluntary reporting of the modifier in 2015 and required in 2016

– POS 22 to be deleted and replaced with 2 new POS codes

OPPS Payment Status and Comment Indicators

• Addendum B of the Federal Register is your "guide"– Pay attention to items with the following status indicators changes:

• “X"-This status indicator will be deleted and replaced with either “Q1” or “S”

• Complete list of 2015 status indicators are listed in Addendum D1

OPPS Payment Status and Comment Indicators

• Addendum B of the Federal Register is your "guide"– Pay attention to items with the following comment indicators:

• "CH"-Active HCPCS code with change in status indicator or APC assignment or active HCPCS code that is being discontinued.

• "NI"-New code for 2015 or existing code with substantial change in 2015 with code descriptor or APC assignment

CPT Code Revisions

Determine what the CPT Code revision impacts

Revise charge master and related subsystems

Provide education to clinical department

Verify the CPT codes are revised accurately

Determine if pricing change is required

Monitor and test CPT Codes

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CPT Code Additions Determine if new CPT Code is new service or replaces a deleted CPT

Code

Determine if new CPT Code is reimburseable– Category 3 CPT Codes implemented by CMS in July

Determine if new CPT Code requires a pricing revision



Verify the CPT codes are added correctly

Monitor and test CPT Codes

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CPT Code Deletions

Determine if there is a replacement for CPT Code deletion– Determine replacement CPT Code



Verify the CPT codes are deleted

Monitor and test replacement CPT Codes

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Laboratory

Major changes to the Drug Assay Section (Note that CMS is not implementing these changes in 2015-all are Status Indicator B))

– Drug Assay section divided into two major categories:

• Presumptive Drug Class procedures– Identifies possible use or non-use of a drug or a drug class– Includes immunoassays (EIA, ELISA, etc.), enzymatic methods, and

chromatographic methods without mass spectrometry

• Definitive Drug Class procedures– Qualitative or quantitative tests to identify possible use or non-use of

a drug– Includes gas chromatography with mass spectrometry and liquid

chromatography mas spectrometry but excludes immunoassays and enzymatic methods

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Laboratory

Presumptive Drug Class Screening

• Divided into Drug Class List A or Drug Class List B

• Drug Class List A typically consists of method in which results are capable of being read by:

– direct optical observation; or – by instrumented test systems such as discrete multichannel

chemistry analyzers using immunoassay or enzyme assay• Drug Class List B typically consists of methods that require more

resources than a List A” drug test– Manual process such as ELISA

70

Laboratory

Presumptive Drug Class Screening

• CPT Code structure is based on type of method and whether Drug Class A or B

– Separate CPT Codes for Thin Layer Chromatography (TLC) and separate CPT Codes for non-TLC methods:

– For Class A Drugs, use 80300 for any number of drug classes with non-TLC method per date of service

– For Class A Drugs, use 80303 for any number of drug classes using TLC per date of service

– For Class A Drugs, use 80301 for single drug class method, non-TLC per date of service

– For Class B Drugs, use 80302 for any number of drug classes with non-TLC method each procedure

– For Class B Drugs, use 80303 for any number of drug classes using TLC per date of service

– For either Drug Class A or B, not otherwise specified method such as DART, DESI, each procedure

71

Laboratory

Definitive Drug Testing

• Definitive drug testing methods include:– Gas chromatography with spectrometry– Liquid chromatography mass spectrometry– Excludes immunoassays and enzymatic assays

• Definitive drug classes listing provides:– Drug classes and associated CPT Codes– Listing of drugs included in the drug class– Metabolites not listed may be reported using parent drug code– Drug classes may contain one or more CPT Codes based on the

number of analytes– Includes CPT Codes 80320 through 80377

72

Laboratory

Several changes to the Molecular Pathology Section

– Several CPT Codes added to the Tier 1 molecular pathology procedures

– For CPT Codes 81400-81408, numerous revisions to genes tested

– New section created for Genomic Sequencing procedures and Molecular Multianalyte Assays

• CPT Codes 81410 through 81471

73

Laboratory In Surgical Pathology, there were a number of changes to “correct”

problems– In 2014, CPT Codes were added/revised related to immunohistochemistry

antibody slides:• 88342 revised to “Immunohistochemistry, each separately identifiable

antibody per block, first separately identifiable antibody per slide”• 88343 was added- “Immunohistochemistry, each separately identifiable

antibody per block, each additional separately identifiable antibody per slide”

– In 2015, CPT Codes were again added/revised related to immunohistochemistry antibody slides:

• 88342 revised to “Immunohistochemistry, per specimen, initial single antibody stain procedure”

• 88343 was deleted• 88341 was added- “Immunohistochemistry, per specimen, each

additional single antibody stain procedure”• 88344 was added- “Immunohistochemistry, per specimen, each

multiplex antibody stain procedure” (replaces G0461 and G0462)• More than one unit of 88341, 88342 or 88344 cannot be reported for

same antibody

74

Laboratory CPT Additions

For Presumptive Drug Class Screening, the following CPT Codes were added:

75

2015 CPT Code Description Department80300 DRUG SCREEN LIST A ANY NMBR NON TLC DEVICES Laboratory80301 DRUG SCREEN LIST A SINGLE DRUG CLASS METHOD Laboratory80302 DRUG SCREEN PRESUMPTIVE 1 CLASS METHOD LIST B Laboratory80303 DRUG SCREEN PRSMPTV 1/MULT CLASS METHOD TLC Laboratory80304 DRUG SCREEN PRSMPTV 1/MULT CLASS METHOD Laboratory


For Definitive Drug Class Screening, the following CPT Codes were added:

76

2015 CPT Code Description Department80163 DRUG SCREEN QUANTITATIVE DIGOXIN FREE Laboratory80165 DRUG SCREEN QUANT DIPROPYLACETIC ACID FREE Laboratory80320 DRUG SCREEN QUANTITATIVE ALCOHOLS Laboratory80321 DRUG SCREEN QUANT ALCOHOLS BIOMARKERS 1 OR 2 Laboratory80322 DRUG SCREEN QUANT ALCOHOLS BIOMARKERS 3 OR MORE Laboratory80323 ALKALOIDS NOT OTHERWISE SPECIFIED Laboratory80324 DRUG SCREEN QUANT AMPHETAMINES 1 OR 2 Laboratory80325 DRUG SCREEN QUANT AMPHETAMINES 3 OR 4 Laboratory80326 DRUG SCREEN QUANT AMPHETAMINES 5 OR MORE Laboratory80327 DRUG SCREEN QUANT ANABOLIC STEROID 1 OR 2 Laboratory80328 DRUG SCREEN QUANT ANABOLIC STEROID 3 OR MORE Laboratory80329 DRUG SCREEN ANALGESICS NON‐OPIOID 1 OR 2 Laboratory80330 DRUG SCREEN ANALGESICS NON‐OPIOID 3‐5 Laboratory80331 DRUG SCREEN ANALGESICS NON‐OPIOID 6 OR MORE Laboratory80332 ANTIDEPRESSANTS SEROTONERGIC CLASS 1 OR 2 Laboratory80333 ANTIDEPRESSANTS SEROTONERGIC CLASS 3‐5 Laboratory80334 ANTIDEPRESSANTS SEROTONERGIC CLASS 6 OR MORE Laboratory80335 ANTIDEPRESSANTS TRICYCLIC OTHER CYCLICALS 1 OR 2 Laboratory



77

2015 CPT Code Description Department80336 ANTIDEPRESSANTS TRICYCLIC OTHER CYCLICALS 3‐5 Laboratory80337 ANTIDEPRESSANTS TRICYCLIC OTHER CYCLICALS 6/MORE Laboratory80338 ANTIDEPRESSANTS NOT OTHERWISE SPECIFIED Laboratory80339 ANTIEPILEPTICS NOT OTHERWISE SPECIFIED 1‐3 Laboratory80340 ANTIEPILEPTICS NOT OTHERWISE SPECIFIED 4‐6 Laboratory80341 ANTIEPILEPTICS NOT OTHERWISE SPECIFIED 7/MORE Laboratory80342 ANTIPSYCHOTICS NOT OTHERWISE SPECIFIED 1‐3 Laboratory80343 ANTIPSYCHOTICS NOT OTHERWISE SPECIFIED 4‐6 Laboratory80344 ANTIPSYCHOTICS NOT OTHERWISE SPECIFIED 7/MORE Laboratory80345 DRUG SCREENING BARBITURATES Laboratory80346 DRUG SCREENING BENZODIAZEPINES 1‐12 Laboratory80347 DRUG SCREENING BENZODIAZEPINES 13 OR MORE Laboratory80348 DRUG SCREENING BUPRENORPHINE Laboratory80349 DRUG SCREENING CANNABINOIDS NATURAL Laboratory80350 DRUG SCREENING CANNABINOIDS SYNTHETIC 1‐3 Laboratory80351 DRUG SCREENING CANNABINOIDS SYNTHETIC 4‐6 Laboratory80352 DRUG SCREENING CANNABINOIDS SYNTHETIC 7/MORE Laboratory80353 DRUG SCREENING COCAINE Laboratory80354 DRUG SCREENING FENTANYL Laboratory80355 DRUG SCREENING GABAPENTIN NON‐BLOOD Laboratory



78

2015 CPT Code Description Department80356 DRUG SCREENING HEROIN METABOLITE Laboratory80357 DRUG SCREENING KETAMINE AND NORKETAMINE Laboratory80358 DRUG SCREENING METHADONE Laboratory80359 DRUG SCREENING METHYLENEDIOXYAMPHETAMINES Laboratory80360 DRUG SCREENING METHYLPHENIDATE Laboratory80361 DRUG SCREENING OPIATES 1 OR MORE Laboratory80362 DRUG SCREENING OPIOIDS AND OPIATE ANALOGS 1 OR 2 Laboratory80363 DRUG SCREENING OPIOIDS AND OPIATE ANALOGS 3 OR 4 Laboratory80364 DRUG SCREENING OPIOIDS & OPIATE ANALOGS 5/MORE Laboratory80365 DRUG SCREENING OXYCODONE Laboratory80366 DRUG SCREENING PREGABALIN Laboratory80367 DRUG SCREENING PROPOXYPHENE Laboratory80368 DRUG SCREENING SEDATIVE HYPNOTICS Laboratory80369 DRUG SCREENING SKELETAL MUSCLE RELAXANTS 1 OR 2 Laboratory80370 DRUG SCREENING SKEL MUSCLE RELAXANTS 3 OR MORE Laboratory80371 DRUG SCREENING STIMULANTS SYNTHETIC Laboratory80372 DRUG SCREENING TAPENTADOL Laboratory80373 DRUG SCREENING TRAMADOL Laboratory80374 DRUG SCREEN STEREOISOMER ANALYSIS 1 DRUG CLASS Laboratory80375 DRUG/SUBSTANCE DEFINITIVE QUAL/QUANT NOS 1‐3 Laboratory80376 DRUG/SUBSTANCE DEFINITIVE QUAL/QUANT NOS 4‐6 Laboratory80377 DRUG/SUBSTANCE DEFINITIVE QUAL/QUANT NOS 7/MORE Laboratory


For Tier 1 Molecular Pathology Procedures, there were several additions:

79

2015 CPT Code Description Department81246 FLT3 GENE ANLYS TYROSINE KINASE DOMAIN VARIANTS Moleculary Pathology81288 MLH1 GENE ANALYSIS PROMOTER METHYLATION ANALYSIS Moleculary Pathology81313 PCA3/KLK3 PROSTATE SPECIFIC ANTIGEN RATIO Moleculary Pathology


For Genomic Sequencing Procedures, the following CPT Codes were added:

80

2015 CPT Code Description Department81410 AORTIC DYSFUNCTION/DILATION GENOMIC SEQ ANALYSIS Moleculary Pathology81411 AORTIC DYSFUNCTION/DILATION DUP/DEL ANALYSIS Moleculary Pathology81415 EXOME SEQUENCE ANALYSIS Moleculary Pathology81416 EXOME SEQUENCE ANALYSIS EACH COMPARATOR EXOME Moleculary Pathology81417 EXOME RE‐EVAL OF PREVIOUSLY OBTAINED EXOME SEQ Moleculary Pathology81420 FETAL CHROMOSOMAL ANEUPLOIDY GENOMIC SEQ ANALYS Moleculary Pathology81425 GENOME SEQUENCE ANALYSIS Moleculary Pathology81426 GENOME SEQUENCE ANALYSIS EACH COMPARATOR GENOME Moleculary Pathology81427 GENOME RE‐EVALUATION OF PREC OBTAINED GENOME SEQ Moleculary Pathology81430 HEARING LOSS GENOMIC SEQUENCE ANALYSIS 60 GENES Moleculary Pathology81431 HEARING LOSS DUP/DEL ANALYSIS Moleculary Pathology81435 HEREDITARY COLON CA GENOMIC SEQ ANALYS 7 GENES Moleculary Pathology81436 HEREDITARY COLON CA SYND DUP/DEL ANALYS 8 GENES Moleculary Pathology81440 NUCLEAR MITOCHONDRIAL 100 GENE GENOMIC SEQ Moleculary Pathology81445 TARGETED GENOMIC SEQ ANALYS DNA ANALYS 5‐50 GENE Moleculary Pathology81450 GENOMIC SEQ ANALYS DNA&RNA ANALYS 5‐50 GENE Moleculary Pathology81455 GENOMIC SEQ ANALYS DNA&RNA ANALYS 51/MORE GENES Moleculary Pathology81460 WHOLE MITOCHONDRIAL GENOME Moleculary Pathology81465 WHOLE MITOCHONDRIAL GENOME ANALYSIS PANEL Moleculary Pathology81470 X‐LINKED INTELLECTUAL DBLT GENOMIC SEQ ANALYS Moleculary Pathology81471 X‐LINKED INTELLECTUAL DBLT DUP/DEL GENE ANALYS Moleculary Pathology81519 ONCOLOGY BREAST MRNA GENE EXPRESSION 21 GENES Moleculary Pathology


Other additions include:

81

2015 CPT Code Description Department83006 GROWTH STIMULATION EXPRESSED GENE 2 Laboratory87505 NFCT AGENT DNA/RNA GASTROINTESTINAL PATHOGEN Laboratory87506 IADNA‐DNA/RNA GI PTHGN MULTIPLEX PROBE TQ 6‐11 Laboratory87507 IADNA‐DNA/RNA GI PTHGN MULTIPLEX PROBE TQ 12‐25 Laboratory87623 IADNA HUMAN PAPILLOMAVIRUS LOW‐RISK TYPES Laboratory87624 IADNA HUMAN PAPILLOMAVIRUS HIGH‐RISK TYPES Laboratory87625 IADNA HUMAN PAPILLOMAVIRUS TYPES 16 & 18 ONLY Laboratory87806 IAADIADOO HIV1 ANTIGEN W/HIV1 & HIV2 ANTIBODIES Laboratory


Other additions in Pathology include:

82

2015 CPT Code Description Department88341 IMHISTOCHEM/CYTCHM EA ADDL ANTIBODY SLIDE Pathology88344 IMHISTOCHEM/CYTCHM EA MULTIPLEX ANTIBODY SLIDE Pathology88364 IN SITU HYBRIDIZATION EA ADDL PROBE STAIN Pathology88366 IN SITU HYBRIDIZATION EA MULTIPLEX PROBE STAIN Pathology88369 M/PHMTRC ALYS ISH QUANT/SEMIQ MNL PER SPEC EACH Pathology88373 M/PHMTRC ALYS ISH QUANT/SEMIQ CPTR PER SPEC EACH Pathology88374 M/PHMTRC ALYS ISH QUANT/SEMIQ CPTR EACH MULTIPRB Pathology88377 M/PHMTRC ALYS ISH QUANT/SEMIQ MNL EACH MULTIPRB Pathology89337 CRYOPRESERVATION MATURE OOCYTE(S) Pathology0357T CRYOPRESERVATION IMMATURE OOCYTE(S) Pathology

Laboratory CPT Deletions

83

2014 CPT Code Description Department

Replacement 2015 CPT Code

80100 DRUG SCR QUAL MLT DRUG CLASSES CHROM EA PX Laboratory 80300‐8030480101 DRUG SCR QUAL 1 DRUG CLASS METH EA DRUG CLASS Laboratory 80300‐8030480102 DRUG CONFIRMATION EACH PROCEDURE Laboratory 80300‐8030480103 TISSUE PREPARATION DRUG ANALYSIS Laboratory 80300‐8030480104 DRUG SCRN QUAL MLT CLASS NONCHROMOTOGRAPHIC EACH Laboratory 80300‐8030480152 DRUG SCREEN QUANTITATIVE AMITRIPTYLINE Laboratory 80335‐8033780154 DRUG SCREEN QUANTITATIVE BENZODIAZEPINES Laboratory 80346, 8034780160 DRUG SCREEN QUANTITATIVE DESIPRAMINE Laboratory 80335‐8033780166 DRUG SCREEN QUANTITATIVE DOXEPIN Laboratory 80335‐8033780172 DRUG SCREEN QUANTITATIVE GOLD Laboratory 8037580174 DRUG SCREEN QUANTITATIVE IMIPRAMINE Laboratory 80335‐8033780182 DRUG SCREEN QUANTITATIVE NORTRIPTYLINE Laboratory 80335‐8033780196 DRUG SCREEN QUANTITATIVE SALICYLATE Laboratory 80329‐8033180440 THYROTROPIN RELEAS HORMONE HYPRPROLACTINEMIA Laboratory 84146


84



82000 ASSAY ACETALDEHYDE BLOOD Laboratory None82003 ASSAY OF ACETAMINOPHEN Laboratory 80329‐8033182055 ALCOHOL ANY SPECIMEN EXCEPT BREATH Laboratory 80320‐8032282101 ALKALOIDS URINE QUANTITATIVE Laboratory 8032382145 AMPHETAMINE/METHAMPHETAMINE Laboratory 80324‐8032682205 BARBITURATES NOT ELSEWHERE SPECIFIED Laboratory 8034582520 COCAINE/METABOLITE Laboratory 8035382646 ASSAY OF DIHYDROCODEINONE Laboratory 8036182649 ASSAY OF DIHYDROMORPHINONE Laboratory 8036182651 ASSAY OF DIHYDROTSTOSTERONE Laboratory 80327, 8032882654 ASSAY OF DIMETHADIONE Laboratory 80339‐8034182666 ASSAY OF EPIANDROSTERONE Laboratory 80327, 8032882690 ASSAY OF ETHCHLORVYNOL Laboratory 8032082742 ASSAY OF FLURAZEPAM Laboratory 80346, 8034782953 GLUC TOLBUTAMIDE TOLERANCE TST Laboratory None82975 ASSAY OF GLUTAMINE Laboratory 8217, 82128, 8282980 ASSAY OF GLUTETHIMIDE Laboratory None83008 ASSAY OF GUANOSINE MONOPHOSPHATE CYCLIC Laboratory None83055 HEMOGLOBIN SULFHEMOGLOBIN QUALITATIVE Laboratory None83071 ASSAY OF HEMOSIDERIN QUANTITATIVE Laboratory None83634 LACTOSE URINE QUANTITATIVE Laboratory None83805 ASSAY OF MEPROBAMATE Laboratory 80369, 8037083840 METHADONE Laboratory 80358


85



83858 METHSUXIMIDE Laboratory 80339‐8034183866 MUCOPOLYSACCHARIDES ACID SCREEN Laboratory None83887 ASSAY OF NICOTINE Laboratory 8032383925 OPIATE(S) DRUG AND METABOLITES EACH PROCEDURE Laboratory 80361‐8036484022 ASSAY OF PHENOTHIAZINE Laboratory 80342‐8034484127 PORPHYRINS FECES QUALITATIVE Laboratory None87001 ANIMAL INOCULATION SMALL ANIMAL W/OBSERVATION Laboratory None87620 IADNA PAPILLOMAVIRUS HUMAN DIRECT PROBE TQ Laboratory 87623‐8762587621 IADNA PAPILLOMAVIRUS HUMAN AMPLIFIED PROBE TQ Laboratory 87623‐8762587622 IADNA PAPILLOMAVIRUS HUMAN QUANTIFICATION Laboratory 87623‐8762588343 IMHISTOCHEM/CYTCHM EA ADDL ANTIBODY SLIDE Pathology 883440059T CRYOPRESERVATION OOCYTES Pathology 89337

Laboratory Drug Testing CMS Exceptions

For drug screening of drug classes, the new CPT Codes-80300 through 80304 are Status Indicator B – The HCPCS Codes used by CMS were changed in 2015 to Status

Indicator N• G0431 Drug screen, qualitative; multiple drug classes by highly

complex method per patient encounter– Used for instrument driven testing and chromatographic

methods– 80301, 80302, 80303 and 80304 are probably the

comparable 2015 CPT Codes• G0434 Drug screen, other than chromatographic; any number of

drug classes, by CLIA waived test or moderate complexity test, per patient encounter

– Used for CLIA waived tests and dipsticks, cups, cassettes– 80300 is probably the comparable 2015 CPT Code

86


CMS is not accepting the new drug codes created by the AMA and has developed alternative HCPCS Codes

87

2015 CMS HCPCS Description Deleted 2014 CPT Code 2015 CPT Code

G6030 Assay of amitriptyline 80152 80335,80336, or 80337

G6031 Assay of benzodiazepines 80154 80346, 80347

G6032 Assay of desipramine 80160 80335,80336, or 80337

G6034 Assay of doxepin 80166 80335,80336, or 80337G6035 Assay of gold 80172 80375

G6036 Assay of Imipramine 80174 80335,80336, or 80337

G6037 Assay of nortiptyline 80182 80335,80336, or 80337

G6038 Assay of salicylate 80196 80329,80330 or 80331

G6039 Assay of acetaminophen 82003 80329,80330 or 80331

G6040 Assay of ethanol 82055 80320, 80321, or 80322G6041 Assay of urine alkaloids 82101 80323



88

2015 CMS HCPCS Description Deleted 2014 CPT Code 2015 CPT Code

G6042 Assay of amphetamines 82145 80324,80325, or 80326G6043 Assay of barbiturates 82205 80345G6044 Assay of cocaine 82520 80353

G6045 Assay of dihydrocodeinone 82646 80361

G6046 Assay of dihydromorphinone 82649 80361

G6047 Assay of dihydrotestosterone 82651 80327, 80328

G6048 Assay of dimethadione 82654 80339, 80340, or 80341

G6049 Assay of Epiandrosterone 82666 80327, 80328G6050 Assay of Ethchlorvynol 82690 80320

G6051 Assay of flurazepam 82742 80346, 80347

G6052 Assay of meprobamate 83805 80369, 80370G6053 Assay of methadone 83840 80358

G6054 Assay of methsuximide 83858 80339, 80340, or 80341



89

2015 CMS HCPCS Description

Deleted 2014 CPT Code 2015 CPT Code

G6055 Assay of nicotine 83887 80323

G6056Opiate(s),drug and metabolites, each procedure 83925

80361, 80362, 80363, or 80364

G6057 Assay of phenothiazine 84022 80342,G6058 drug confirmation 80102 Many

Laboratory CPT Revisions

90

2015 CPT Code Description Department80162 DRUG SCREEN QUANTITATIVE DIGOXIN TOTAL Laboratory80164 DRUG SCREEN QUANT DIPROPYLACETIC ACID TOTAL Laboratory80171 DRUG SCREEN QUANTITATIVE GABAPENTIN Laboratory80299 QUANTITATION DRUG NOT ELSEWHERE SPECIFIED Laboratory84600 ASSAY OF VOLATILES Laboratory86900 BLOOD TYPING SEROLOGIC ABO Laboratory86901 BLOOD TYPING SEROLOGIC RH (D) Laboratory86902 BLOOD TYPE ANTIGEN DONOR REAGENT SERUM EACH Laboratory86904 BLOOD TYPING ANTIGEN SCREEN PATIENT SERUM/UNIT Laboratory86905 BLOOD TYPING RBC ANTIGENS OTH/THN ABO/RH D EACH Laboratory86906 BLOOD TYPING SEROLOGIC RH PHENOTYPING COMPLETE Laboratory87501 INFECTIOUS AGENT DNA/RNA INFLUENZA EA TYPE Laboratory87502 INFECTIOUS AGENT DNA/RNA INFLUENZA 1ST 2 TYPES Laboratory87503 NFCT AGENT DNA/RNA INFLUENZA 1/> TYPES EA ADDL Laboratory87631 IADNA RESPIRATRY PROBE & REV TRNSCR 3‐5 TARGETS Laboratory87632 IADNA RESPIRATRY PROBE & REV TRNSCR 6‐11 TARGETS Laboratory87633 IADNA RESPIRATRY PROBE & REV TRNSCR 12‐25 TARGET Laboratory88342 IMHISTOCHEM/CYTCHM INIT ANTIBODY STAIN PROCEDURE Pathology88360 M/PHMTRC ALYS TUMOR IMHCHEM EA ANTIBODY MANUAL Pathology88361 M/PHMTRC ALYS TUMOR IMHCHEMEA ANTBDY CMPTR ASST Pathology88365 IN SITU HYBRIDIZATION 1ST PROBE STAIN Pathology88367 M/PHMTRC ALYS ISH CPTR‐ASST TECH 1ST PROBE STAIN Pathology88368 M/PHMTRC ALYS IN SITU HYBRIDIZATION EA PROBE MNL Pathology

Radiology For myelograms, the imaging and lumbar injection procedures are compressed

into a single CPT Code for 2015: 62302-cervical 62303-thoracic 62304-lumbosacral 62305-2 or more regions

Arthrocentesis is now frequently done under ultrasound guidance. New 2015 CPT Codes created that compress the arthrocentesis and ultrasound guidance into a single CPT Code; 20604 small joint 20606 intermediate joint 20611 large joint If arthrocentesis done under fluoroscopic, CT or MRI guidance , report

surgical and imaging components separately 20600, 20605 or 20610 plus 77002, 77012, or 77021

91

Radiology For vertebroplasties and kyphoplasties, CPT Codes for the procedures were

deleted: 22520 through 22525 along with the related imaging components: 72291 and 72292. Combined surgical/imaging CPT Codes were created: 22510-22512 for vertebroplasties 22513-22515 for kyphoplasties

In Ultrasound, CPT 76645- “Ultrasound, breast, unilateral or bilateral” was deleted and replaced: 76641-Breast unilateral 76642-Breast bilateral

In Mammography, CPT Codes were added for digital breast tomosynthesis 77061-Digital breast tomosynthesis, unilateral (Not paid by Medicare SI=E) 77062-Digital breast tomosynthesis, bilateral (Not paid by Medicare SI=E) G0279-Add on code for Digital breast tomosynthesis(SI=A $57) ? 77063 Screening digital breast tomosynthesis, bilateral(SI=A $57)

This is an add-on Code to 77057 Screening Mammography

92

Radiology CPT Additions The following CPT Codes were added in Diagnostic Radiology and DEXA

93

2015 CPT

Code Description Department62302 MYELOGRAPHY VIA LUMBAR INJECTION RS&I CERVICAL Diagnostic Radiology62303 MYELOGRAPHY VIA LUMBAR INJECTION RS&I THORACIC Diagnostic Radiology62304 MYELOGRAPHY VIA LUMBAR INJECT RS&I LUMBOSACRAL Diagnostic Radiology62305 MYELOGRAPHY VIA LUMBAR INJECTION RS&I 2+ REGIONS Diagnostic Radiology77085 DXA BONE DENSITY STUDY AXIAL SKELETON DEXA Radiology77086 VERTEBRAL FRACTURE ASSESSMENT VIA DXA DEXA Radiology

Radiology CPT Additions The following CPT Codes were added in Interventional Radiology

94

2015 CPT

Code Description Department20604 ARTHROCNT ASPIR&/INJ SMALL JT/BURSAW/US REC RPRT Interventional Radiology20606 ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/US Interventional Radiology20611 ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US Interventional Radiology20983 ABLATJ BONE TUMOR CRYO PERQ W/IMG GDN WHEN PRFMD Interventional Radiology, CT, MRI22510 PERQ VERTEBROPLASTY UNI/BI INJX CERVICOTHORACIC Interventional Radiology22511 PERQ VERTEBROPLASTY UNI/BI INJECTION LUMBOSACRAL Interventional Radiology22512 VERTEBROPLASTY EACH ADDL CERVICOTHOR/LUMBOSACRAL Interventional Radiology22513 PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULATION Interventional Radiology22514 PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ LMBR Interventional Radiology22515 PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ EACH Interventional Radiology27279 ARTHRODESIS SACROILIAC JOINT PERCUTANEOUS Interventional Radiology37218 TCATH STENT PLACEMT ANTEGRADE CAROTID/INNOMINATE Interventional Radiology47383 ABLATION 1/> LIVER TUMOR PERQ CRYOABLATION Interventional Radiology, CT, MRI0340T ABLATE PULM TUMORS W/PLEURA/CHEST WALL EXTSN Interventional Radiology0347T PLACE INTERSTITIAL DEVICE(S) IN BONE FOR RSA Interventional Radiology0348T RADIOSTEREOMETRIC ANALYSIS SPINE EXAM Interventional Radiology0349T RADIOSTEREOMETRIC ANALYSIS UPPER EXTREMITY EXAM Interventional Radiology0350T RADIOSTEREOMETRIC ANALYSIS LOWER EXTREMITY EXAM Interventional Radiology0351T INTRAOP OCT BREAST OR AXILL NODE EACH SPECIMEN Interventional Radiology0352T OCT BREAST OR AXILL NODE SPECIMEN I&R Interventional Radiology0353T OCT OF BREAST SURG CAVITY REAL TIME INTRAOP Interventional Radiology0354T OCT BREAST SURG CAVITY REAL TIME/REFERRED I&R Interventional Radiology

Radiology CPT Additions The following CPT Codes were added in Ultrasound/Mammography

95

2015 CPT

Code Description Department76641 US BREAST UNI REAL TIME WITH IMAGE COMPLETE Ultrasound/Mammography76642 US BREAST UNI REAL TIME WITH IMAGE LIMITED Ultrasound/Mammography77061 DIGITAL BREAST TOMOSYNTHESIS UNILATERAL Mammography77062 DIGITAL BREAST TOMOSYNTHESIS BILATERAL Mammography77063 SCREENING DIGITAL BREAST TOMOSYNTHESIS BI Mammography

Radiology CPT Deletions The following CPT Codes were deleted in Diagnostic Radiology and

DEXA

96


Replacement 2015 CPT

Code74291 CHOLECYST ORAL CNTRST ADDL/REPEAT XM/MULT DAY XM Diagnostic Radiology None77082 DXA BONE DENSITY STUDY VERTEBRAL FRACTURE Radiology DEXA 77086

Radiology CPT Deletions The following CPT Codes were deleted in Interventional Radiology

97



22520 PERCUTANEOUS VERTEBROPLSTY THORACIC W/WO BONE BX Interventional Radiology 2251022521 PERCUTANEOUS VERTEBROPLASTY LUMBAR W/WO BNE BX Interventional Radiology 2251122522 PERCUTANEOUS VERTEBROPLASTY EA ADDL THRC/LMBR Interventional Radiology 2251222523 PERCUTANEOUS VERTEBRAL AUGMENTATION THORACIC Interventional Radiology 2251322524 PERCUTANEOUS VERTEBRAL AUGMENTATION LUMBAR Interventional Radiology 2251422525 PERQ VERTEBRAL AUGMENTATION EA ADDL THRC/LMBR Interventional Radiology 2251572291 RAD S&I PERQ VRTPLS/SACRPLSTY PR VRT BODY FLUO Interventional Radiology 22510‐2251572292 RAD S&I PERQ VRTPLS/SACRPLSTY PER VRT BODY CT Interventional Radiology 22510‐22515

Radiology CPT Deletions The following CPT Codes were deleted in Ultrasound:

98



76645 US BREAST REAL TIME W/IMAGE DOCUMENTATION Ultrasound Mammography 76641, 76642

Radiology CPT Revisions The following CPT Codes were revised in Diagnostic Radiology

99

2015 CPT Code Description Department27370 INJECTION KNEE ARTHROGRAPHY Diagnostic Radiology62284 INJECTION PROCEDURE MYELOGRAPHY/CT LUMBAR Diagnostic Radiology

Radiology CPT Revisions The following CPT Codes were revised in Interventional Radiology

100

2015 CPT Code Description Department20600 ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US Interventional Radiology20605 ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US Interventional Radiology20610 ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US Interventional Radiology20982 ABLATION BONE TUMOR RF PERQ W/IMG GDN WHEN DONE Interventional Radiology, CT, MRI27280 ARTHRODESIS SACROILIAC JOINT W/OBTAINING GRAFT Interventional Radiology37215 TCAT IV STENT CRV CRTD ART EMBOLIC PROTECJ Interventional Radiology37216 TCAT IV STENT CRV CRTD ART W/O EMBOLIC PROTECJ Interventional Radiology37217 TCATH STENT PLACEMT RETROGRAD CAROTID/INNOMINATE Interventional Radiology37236 OPEN/PERQ PLACEMENT INTRAVASCULAR STENT INITIAL Interventional Radiology37237 OPEN/PERQ PLACEMENT INTRAVASCULAR STENT EA ADDL Interventional Radiology61055 CISTERNAL/LATERAL C1‐C2 PUNCTURE W/INJECTION Interventional Radiology

0075T TCAT PLMT XTRC VRT CRTD STENT RS&I PRQ 1ST VSL Interventional Radiology0076T TCAT PLMT XTRC VRT CRTD STENT RS&IPRQ EA VSL Interventional Radiology0200T PERQ SAC AGMNTJ UNI W/WO BALO/MCHNL DEV 1/> NDL Interventional Radiology0201T PERQ SAC AGMNTJ BI W/WO BALO/MCHNL DEV 2/> NDLS Interventional Radiology

Radiation Oncology Radiation treatment delivery CPT Code structure significant revised in 2015

In previous years, CPT codes were based on both the number of treatment areas and the megavoltage (MeV) used

In 2015, assuming > 1MeV, (megavoltage) is no longer used as part of the CPT Code structure. CPTs are compressed from 12 CPT Codes into three based on the following

criteria for simple, intermediate and complex: Simple (CPT 77402)-All of the following criteria is met (None of the

intermediate or complex criteria is met): single treatment area, one or two ports, and two or fewer simple blocks

Intermediate (CPT 77407)-Any of the following criteria are met (None of the complex criteria is met): two separate treatment areas, three or more ports on a single treatment area, or three or more simple blocks

Complex (CPT 77412)-Any of the following criteria are met: three or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, field-in-field or other tissue compensation that does not meet IMRT guidelines or electron beam

101

Radiation Oncology Intensity Modulated Radiation Treatment (IMRT) delivery CPT Code structure

significant revised in 2015

In previous years, there was a single CPT-77418 for IMRT regardless of complexity/location of treatment

In 2015, IMRT is split into 2 CPTs based on complexity:

Simple (CPT 77385)-Any of the following: prostate, breast, and all sites using physical compensator based IMRT

Complex (CPT 77386)-Includes all other sites if not using physical compensator based IMRT

102

Radiation Oncology CPT Additions Teletherapy planning and Brachytherapy planning now include basic

dosimetry (77300)

103

2015 CPT Code Description Department77306 TELETHX ISODOSE PLN SMPL W/DOSIMETRY CALCULATION Radiation Oncology77307 TELETHX ISODOSE PLN CPLX W/BASIC DOSIMETRY Radiation Oncology77316 BRACHYTX ISODOSE PLN SMPL W/DOSIMETRY CAL Radiation Oncology77317 BRACHYTX ISODOSE PLN INTERMED W/DOSIMETRY CAL Radiation Oncology77318 BRACHYTX ISODOSE PLN CPLX W/DOSIMETRY CAL Radiation Oncology77385 INTENSITY MODULATED RADIATION TX DLVR SIMPLE Radiation Oncology77386 INTENSITY MODULATED RADIATION TX DLVR COMPLEX Radiation Oncology77387 GUIDANCE FOR LOC OF TARGET VOL RADIAJ TX DLVR Radiation Oncology

Radiation Oncology CPT Deletions

104



76950 US GUIDANCE PLACEMENT RADIATION THERAPY FIELDS Radiation Oncology 7738777305 TELETHERAPY ISODOSE PLAN SIMPLE Radiation Oncology 7730677310 TELETHERAPY ISODOSE PLAN INTERMEDIATE Radiation Oncology 77306, 7730777315 TELETHERAPY ISODOSE PLAN COMPLETE Radiation Oncology 7730777326 BRACHYTHERAPY ISODOSE PLAN SIMPLE Radiation Oncology 7731677327 BRACHYTHERAPY ISODOSE PLAN INTERMEDIATE Radiation Oncology 7731777328 BRACHYTHERAPY ISODOSE PLAN COMPLEX Radiation Oncology 7731877403 RADJ DLVR 1 AREA 1/PRLL OPSD PORTS SMPL 6‐10MEV Radiation Oncology 7740277404 RADJ DLVR 1 AREA 1/PRLL OPSD PORTS SMPL 11‐19MEV Radiation Oncology 7740277406 RADJ DLVR 1 AREA 1/PRLL OPSD PORTS SMPL 20MEV/< Radiation Oncology 7740277408 RADJ DLVR 2 AREAS 3/>PORTS 1 MLT BLKS 6‐1MEV Radiation Oncology 7740777409 RADJ DLVR 2 AREAS 3/>PORTS 1 MLT BLKS 11‐19MEV Radiation Oncology 7740777411 RADJ DLVR 2 AREAS 3/> PORTS 1 TX AREA 20 MEV/< Radiation Oncology 7740777413 RADJ DLVR 3/> AREAS CUSTOM BLKING 6‐10MEV Radiation Oncology 7741277414 RADJ DLVR 3/> AREAS CUSTOM BLKING 11‐19MEV Radiation Oncology 7741277416 RADJ DLVR 3/> AREAS CUSTOM BLKING 20MEV/< Radiation Oncology 7741277418 NTSTY MODUL DLVR 1/MLT FLDS/ARCS PR TX SESSION Radiation Oncology 7730177421 STRSC X‐RAY GDN LOCLZJ TARGET VOL DLVR RADJ THER Radiation Oncology 773870197T IFXJ LOCLZ&TRAKG TRGT/PT MTN DUR RADTX EA FXJ Radiation Oncology 77387

Radiation Oncology CPT Revisions CPT Code revisions include:

105

2015 CPT Code Description Department77401 RADIATION TX DELIVERY SUPERFICIAL&/ORTHO VOLTA Radiation Oncology77402 RADIATION TREATMENT DELIVERY 1 MEV >= SIMPLE Radiation Oncology77407 RADIATION TX DELIVERY 1 MEV >= INTERMEDIATE Radiation Oncology77412 RADIATION TREATMENT DELIVERY 1 MEV >= COMPLEX Radiation Oncology

Cardiology CPT Codes created for subcutaneous implantable defibrillators

– CPT 33270 Insertion or replacement of permanent subcutaneous implantable defibrillator system

– CPT 33271 Insertion subcutaneous implantable defibrillator electrode

– CPT 33272 Removal subcutaneous implantable defibrillator electrode

– CPT 33273 Repositioning of previously implanted subcutaneous implantable defibrillator electrode

– CPT 93260 Programming device evaluation (in person) with iterative adjustment of device to test device function, implantable subcutaneous lead defibrillator system

– CPT 93261 Interrogation device evaluation (in person) with analysis includes connection, recording and disconnection, implantable subcutaneous lead defibrillator system

– 93644 EP evaluation of subcutaneous

106

Cardiology In echocardiography, a new CPT Code (93355) added for TEE guidance related

to:

– Transcatheter intracardiac or great vessel structural intervention such as:

• TAVR, transcatheter pulmonary valve replacement, mitral valve repair, etc.

– CPT Code 93355 includes diagnostic TEE, administration of contrast, Doppler, color flow and 3D when performed

107

Cardiology CPT Additions

108

2015 CPT Code Description Department33270 INS/RPLCMNT PERM SUBQ IMPLTBL DFB W/SUBQ ELTRD Invasive Cardiology33271 INSJ OF SUBQ IMPLANTABLE DEFIBRILLATOR ELECTRODE Invasive Cardiology33272 RMVL OF SUBQ IMPLANTABLE DEFIBRILLATOR ELECTRODE Invasive Cardiology33273 REPOS PREVIOUSLY IMPLANTED SUBQ IMPLANTABLE DFB Invasive Cardiology93260 PRGRMG DEV EVAL IMPLANTABLE SUBQ LEAD DFB SYSTEM Cardiology93261 INTERROGATION EVAL F2F IMPLANT SUBQ LEAD DEFIB Cardiology93355 ECHO TEE GUID TCAT ICAR/VESSEL STRUCTURAL INTVN Cardiology

Cardiology EP Study CPT Additions

109

2015 CPT Code Description Department93644 EPHYS EVAL SUBQ IMPLANTABLE DEFIBRILLATOR EP Study

Cardiology CPT Deletions

110



0319T INS/REPLCMT SUBQ IMPLT DEFIB SYSTEM W/SUBQ ELTRD Cardiology

33240, 33241, 33262, 33270, 33271, 33272, 33273, 93260, 93261, 93644

0320T INSERTION SUBCUTANEOUS DEFIBRILLATOR ELECTRODE Cardiology

33240, 33241, 33262, 33270, 33271, 33272, 33273, 93260, 93261, 93644

0321T INSERTION SUBQ IMPLT DEFIB PLS GEN W/SUBQ ELTRD Cardiology

33240, 33241, 33262, 33270, 33271, 33272, 33273, 93260, 93261, 93644

0322T REMOVAL SUBQ IMPLT DEFIB PULSE GENERATOR Cardiology

33240, 33241, 33262, 33270, 33271, 33272, 33273, 93260, 93261, 93644

0323T RMVL W/REPLCMT SUBQ IMPLT DEFIB PULSE GENERATOR Cardiology

33240, 33241, 33262, 33270, 33271, 33272, 33273, 93260, 93261, 93644

0324T REMOVAL SUBCUTANEOUS DEFIBRILLATOR ELECTRODE Cardiology

33240, 33241, 33262, 33270, 33271, 33272, 33273, 93260, 93261, 93644

0325T REPOSITN SUBQ IMPLANT DEFIB ELECTRODE/PULSE GEN Cardiology

33240, 33241, 33262, 33270, 33271, 33272, 33273, 93260, 93261, 93644

0326T EPHYS EVAL SUBQ IMPLT DEFIB PRGRMG/REPRGRMG Cardiology

33240, 33241, 33262, 33270, 33271, 33272, 33273, 93260, 93261, 93644

0327T IMPLT SUBQ DEFIB SYS INTERROGATION DEVICE EVAL Cardiology

33240, 33241, 33262, 33270, 33271, 33272, 33273, 93260, 93261, 93644

0328T IMPLT SUBQ DEFIB SYS PROGRAMMING DEVICE EVAL Cardiology

33240, 33241, 33262, 33270, 33271, 33272, 33273, 93260, 93261, 93644

Cardiology CPT Revisions

The following CPT Codes were revised:

111

2015 CPT Code Description Department33215 RPSG PREV IMPLTED PM/DFB R ATR/R VENTR ELECTRODE Invasive Cardiology33216 INSJ 1 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB Invasive Cardiology33217 INSJ 2 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB Invasive Cardiology33218 RPR 1 TRANSVNS ELTRD PRM PM/PACING IMPLNTBL DFB Invasive Cardiology33220 RPR 2 TRANSVNS ELECTRODES PRM PM/IMPLANTABLE DFB Invasive Cardiology33223 RELOCATE SKIN POCKET IMPLANTABLEDEFIBRILLATOR Invasive Cardiology33224 INSJ ELTRD CAR VEN SYS ATTCH PREV PM/DFB PLS GEN Invasive Cardiology33225 INSJ ELTRD CAR VEN SYS TM INSJ DFB/PM PLS GEN Invasive Cardiology33230 INSJ IMPLNTBL DEFIB PULSE GEN W/EXIST DUAL LEADS Invasive Cardiology33231 INSJ IMPLNTBL DEFIB PULSE GEN W/EXIST MULTILEADS Invasive Cardiology33240 INSJ IMPLNTBL DEFIB PULSE GEN W/1 EXISTING LD Invasive Cardiology33241 REMOVAL IMPLANTABLEDEFIB PULSE GENERATOR ONLY Invasive Cardiology33243 RMVL 1/DUAL CHAMBER DEFIB ELECTRODE BY THORACOM Invasive Cardiology

Cardiology CPT Revisions

The following CPT Codes were revised:

112

2015 CPT Code Description Department33244 RMVL1/DUAL CHMBR IMPLTBL DFB ELTRD TRANSVNS XTRJ Invasive Cardiology33249 INSJ/RPLCMT PERM DFB W/TRNSVNS LDS 1/DUAL CHMBR Invasive Cardiology33262 RMVL IMPLTBL DFB PLSE GEN W/REPL PLSE GEN 1 LEAD Invasive Cardiology33263 RMVL IMPLTBL DFB PLSE GEN W/RPLCMT PLSE GEN 2 LD Invasive Cardiology33264 RMVL IMPLTBL DFB PLS GEN W/RPLCMT PLS GEN MLT LD Invasive Cardiology93282 PRGRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB Cardiology93283 PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB Cardiology93284 PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB Cardiology93287 PERI‐PX DEV EVAL & PROG SING/DUAL/MULTI LEAD DFB Cardiology93289 INTERROG EVAL F2F 1/DUAL/MLT LEADS IMPLTBL DFB Cardiology93295 INTERROGATION EVAL REMOTE </90 D 1/2/MLT LD DFB Cardiology93296 INTERROGATION REMOTE </90 D TECHNICIAN REVIEW Cardiology

Endoscopy Continued expansion of CPT Codes choices in the following areas:

Ileoscopy

Colonoscopy

Sigmoidoscopy

Anoscopy

113

Endoscopy CPT Additions

114

2015 CPT Code Description Department43180 ESOPHAGOSCP RIG TRANSORAL HYPOPHARYNX CRV ESOPH Endoscopy44381 ILEOSCOPY STOMA W/BALLOON DILATION Endoscopy44384 ILEOSCOPY STOMA W/PLMT OF ENDOSCOPIC STENT Endoscopy44401 COLONOSCOPY STOMA ABLATION LESION Endoscopy44402 COLONOSCOPY STOMA W/ENDOSCOPIC STENT PLCMT Endoscopy44403 COLONOSCOPY STOMA W/ENDOSCOPIC MUCOSAL RESCJ Endoscopy44404 COLONOSCOPY STOMA W/SUBMUCOSAL INJECTION Endoscopy44405 COLONOSCOPY STOMA W/BALLOON DILATION Endoscopy44406 COLONOSCOPY STOMA W/ENDOSCOPIC ULTRASOUND EXAM Endoscopy44407 COLONOSCOPY STOMA W/US GID NDL ASPIR/BX Endoscopy44408 COLONOSCOPY THROUGH STOMA WITH DECOMPRESSION Endoscopy45346 SIGMOIDOSCOPY FLX ABLATION TUMOR POLYP/OTH LES Endoscopy45347 SIGMOIDOSCOPY FLX PLACEMENT OF ENDOSCOPIC STENT Endoscopy45349 SGMDSC FLX WITH ENDOSCOPIC MUCOSAL RESECTION Endoscopy45350 SIGMOIDOSCOPY FLX WITH WITH BAND LIGATION(S) Endoscopy45388 COLONOSCOPY FLX ABLATION TUMOR POLYP/OTHER LES Endoscopy45389 COLONOSCOPY FLX WITH ENDOSCOPIC STENT PLACEMENT Endoscopy45390 COLONOSCOPY FLX W/ENDOSCOPIC MUCOSAL RESECTION Endoscopy45393 COLONOSCOPY FLEXIBLE WITH DECOMPRESSION Endoscopy45398 COLONOSCOPY FLEXIBLE WITH BAND LIGATION(S) Endoscopy45399 UNLISTED PROCEDURE COLON Endoscopy46601 ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT Endoscopy46607 ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT W/BX Endoscopy52441 CYSTO INSERTION TRANSPROSTATIC IMPLANT SINGLE Endoscopy52442 CYSTO INSERTION TRANSPROSTATIC IMPLANT EA ADDL Endoscopy

0377T ANOSCOPY W/BULKING AGENT INJ FOR FECAL INCONT Endoscopy

Endoscopy CPT Additions

115

2015 CPT

Code Description Department0355T GI TRACT IMAGING INTRALUMINAL COLON WITH I&R Nuclear Medicine

Endoscopy CPT Deletions

116



43350 ESOPHAGOSTOMY FSTLJ ESOPH XTRNL ABDL APPR Endoscopy None44383 ILEOSCOPY STOMA W/TNDSC STENT PLMT Endoscopy 4438444393 COLONOSCOPY STOMA ABLATION LESION Endoscopy 4440145355 COLSC RGD/FLX TABDL VIA COLOTOMY 1/MLT Endoscopy 4539945383 COLSC FLX PROX SPLENIC FLXR ABLTJ LES Endoscopy 4538845387 COLSC FLX PROX SPLENIC FLXR TNDSC STENT PLMT Endoscopy 453890226T ANOSCOPY HIGH RESOLUTION W/SPECIMEN COLLECTION Endoscopy 466010227T ANOSCOPY HIGH RESOLUTION W/BIOPSY Endoscopy 46607

Endoscopy CPT Revisions

117

2015 CPT Code Description Department43194 ESOPHAGOSCOPY RIG TRANSORAL REMOVAL FOREIGN BODY Endoscopy43197 ESOPHAGOSCOPY FLEXIBLE TRANSNASAL DIAGNOSTIC Endoscopy43215 ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY Endoscopy43216 ESPHAGOSCOPY FLEX LESION REMOVAL HOT BX FORCEPS Endoscopy43247 EGD FLEXIBLE FOREIGN BODY REMOVAL Endoscopy43250 EGD FLEX REMOVAL LESION(S) BY HOT BIOPSY FORCEPS Endoscopy44360 ENDOSCOPY UPPER SMALL INTESTINE Endoscopy44363 ENTEROSCOPY > 2ND PRTN W/RMVL FOREIGN BODY Endoscopy44380 ILEOSCOPY THRU STOMA DX W/COLLJ SPEC WHEN PRFMD Endoscopy44385 NDSC EVAL INTSTINAL POUCH DX W/COLLJ SPEC SPX Endoscopy44386 NDSC EVAL INTSTINAL POUCH W/BX SINGLE/MULTIPLE Endoscopy44388 COLONOSCOPY STOMA DX INDUDING COLLJ SPEC SPX Endoscopy44390 COLONOSCOPY STOMA W/RMVL FOREIGN BODY Endoscopy44391 COLONOSCOPY STOMA CONTROL BLEEDING Endoscopy44392 COLONOSCOPY STOMA RMVL LES BY HOT BIOPSY FORCEPS Endoscopy44799 UNLISTED PROCEDURE SMALL INTESTINE Endoscopy45330 SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD Endoscopy

Endoscopy CPT Revisions

118

2015 CPT Code Description Department45332 SIGMOIDOSCOPY FLX W/RMVL FOREIGN BODY Endoscopy45333 SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS Endoscopy45334 SIGMOIDOSCOPY FLX CONTROL BLEEDING Endoscopy45337 SGMDSC FLX W/DCMPRN W/PLMT DCMPRN TUBE Endoscopy45340 SIGMOIDOSCOPY FLX TNDSC BALO DILAT Endoscopy45378 COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD Endoscopy45379 COLONOSCOPY FLX W/REMOVAL OF FOREIGN BODY(S) Endoscopy45380 COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE Endoscopy45381 COLSC FLX WITH DIRECTED SUBMUCOSAL NJX ANY SBST Endoscopy45382 COLSC FLEXIBLE W/CONTROL BLEEDING ANY METHOD Endoscopy45384 COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS Endoscopy45385 COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ Endoscopy45386 COLSC FLEXIBLE W/TRANSENDOSCOPIC BALLOON DILAT Endoscopy45391 COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX Endoscopy45392 COLSC FLX W/US GUID NDL ASPIR/BX W/US RCTM ET AL Endoscopy46600 ANOSCOPY DX W/COLLJ SPEC BR/WA SPX WHEN PRFRMD Endoscopy

Surgery CPT Additions

119

2015 CPT Code Description Department21811 OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 1‐3 RIBS Operating Room21812 OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 4‐6 RIBS Operating Room21813 OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 7+ RIBS Operating Room22858 TOT DISC ARTHRP ANT APPR DISC 2ND LEVEL CERVICAL Operating Room33418 TCAT MITRAL VALVE REPAIR INITIAL PROSTHESIS Operating Room33419 TCAT MITRAL VALVE REPAIR ADDL PROSTHESIS Operating Room34839 PLNNING PT SPEC FENEST VISCERAL AORTIC GRAFT Operating Room66179 AQUEOUS SHUNT EXTRAOCULAR RESERVOIR W/O GRAFT Operating Room66184 REVJ SHUNT EXTRAOCULAR RESERVOIR W/O GRAFT Operating Room

0345T TRANSCATH MITRAL VALVE REPAIR VIA CORONARY SINUS Operating Room0375T TOTAL DISC ARTHRP ANT APPR W/DISCECTOMY CRV 3+ Operating Room0376T ANT SEGMENT INSERT DRAIN W/O RESERVOIR EA ADDL Operating Room

Surgery CPT Deletions

120



21800 CLOSED TX RIB FRACTURE UNCOMPLICATED EACH Operating Room None21810 TX RIB FRACTURE EXTERNAL FIXATION FLAIL CHEST Operating Room 2189929020 APPLICATION TURNBUCKLE JACKET BODY ONLY Operating Room None29025 APPLICATION TURNBUCKLE JACKET BODY W/HEAD Operating Room None29715 REMOVAL/BIVALVING TURNBUCKLE JACKET Operating Room None33472 VALVOTOMY PULM VALVE OPEN HRT W/INFLOW OCCLUSION Operating Room 9299042508 PAROTID DUCT DIVERSION BI W/EXC 1 SUBMNDBLR GLND Operating Room None61334 EXPL ORBIT TRANSCRANIAL W/RMVL FOREIGN BODY Operating Room None61440 CRANIOTOMY SECTION TENTORIUM CEREBELLI SPX Operating Room None61470 CRANIECTOMY SUBOCCIPITAL MEDULLARY TRACTOTOMY Operating Room None61490 CRANIOTOMY LOBOTOMY W/CINGULOTOMY Operating Room None61542 CRANIOTOMY TOTAL HEMISPHERECTOMY Operating Room None61609 TRNSXJ/LIGATION CAROTID ARTERY SINUS W/O REPAIR Operating Room None61875 CRNEC IMPLTJ NSTIM ELTRD CEREBELLAR SUBCORTICAL Operating Room None62116 RDCTJ CRANIOMEGALIC SKULL W/SIMPLE CRANIOPLASTY Operating Room None64752 TRANSECTION/AVULSION VAGUS NRV TRANSTHORACIC Operating Room None64761 TRANSECTION/AVULSION PUDENDAL NERVE Operating Room None64870 ANASTOMOSIS FACIAL‐PHRENIC Operating Room None66165 FSTLJ SCLERA GLAUCOMA IRIDENCLEISIS/IRIDOTASIS Operating Room None

Surgery CPT Deletions

121



69400 EUSTACHIAN TUBE NFLTJ TRANSNSL CATHJ Operating Room 6979969401 EUSTACHIAN TUBE NFLTJ TRANSNSL W/O CATHJ Operating Room None69405 EUSTACHIAN TUBE CATHJ TRANSTYMPANIC Operating Room 697990092T TOT DISC ARTHRP ANT APPR DSKC PREP CRV EA NTRSPC Operating Room 0375T0245T OPEN TX RIB FRACTURE W/INT FIX UNI 1‐2 RIBS Operating Room 21811, 21812, 218130246T OPEN TX RIB FRACTURE W/INT FIX UNI 3‐4 RIBS Operating Room 21811, 21812, 218130247T OPEN TX RIB FRACTURE W/INT FIX UNI 5‐6 RIBS Operating Room 21811, 21812, 218130248T OPEN TX RIB FRACTURE W/INT FIXATION UNI 7/> RIBS Operating Room 21811, 21812, 218130334T STABLJ SI JOINT FOR ARTHRODESIS PERQ/MIN INVAS Operating Room 27279

Surgery CPT Revisions

122

2015 CPT Code Description Department22856 TOT DISC ARTHRP ART DISC ANT APPRO 1 NTRSPC CRV Operating Room66180 AQUEOUS SHUNT EXTRAOC EQUAT PLATE RSVR W/GRAFT Operating Room66185 REVJ AQUEOUS SHUNT EXTRAOCULAR RESERVOIR W/GRAFT Operating Room67399 UNLISTED PROCEDURE EXTRAOCULAR MUSCLE Operating Room

0253T INSERT ANT SGM DRAINAGE DEV W/O RESERVR INT APPR Operating Room

ECMO CPT Additions

123

2015 CPT Code Description Department33946 ECMO/ECLS INITIATION VENO‐VENOUS ECMO/Operating Room33947 ECMO/ECLS INITIATION VENO‐ARTERIAL ECMO/Operating Room33948 ECMO/ECLS DAILY MANAGEMENT EACH DAY VENO‐VENOUS ECMO/Operating Room33949 ECMO/ECLS DAILY MANAGEMENT EA DAY VENO‐ARTERIAL ECMO/Operating Room33951 ECMO/ECLS INSJ OF PRPH CANNULA BIRTH‐5 YRS PERQ ECMO/Operating Room33952 ECMO/ECLS INSJ OF PRPH CANNULA 6 YRS&OLDER PERQ ECMO/Operating Room33953 ECMO/ECLS INSJ OF PRPH CANNULA BIRTH‐5 YRS OPEN ECMO/Operating Room33954 ECMO/ECLS INSJ OF PRPH CANNULA 6 YRS&OLDER OPEN ECMO/Operating Room33955 ECMO/ECLS INSJ OF CENTRAL CANNULA BIRTH‐5 YRS ECMO/Operating Room33956 ECMO/ECLS INSJ OF CENTRAL CANNULA 6 YRS & OLDER ECMO/Operating Room33957 ECMO/ECLS REPOS PERIPH CANNULA PERQ BIRTH‐5 YRS ECMO/Operating Room33958 ECMO/ECLS REPOS PERPH CANNULA PRQ 6 YRS & OLDER ECMO/Operating Room33959 ECMO/ECLS REPOS PERPH CANNULA OPEN BIRTH‐5 YRS ECMO/Operating Room

ECMO CPT Additions

124

2015 CPT Code Description Department33962 ECMO/ECLS REPOS PERPH CANNULA OPEN 6 YRS & OLDER ECMO/Operating Room33963 ECMO/ECLS REPOS CENTRAL PERPH CANNULA BIRTH‐5YRS ECMO/Operating Room33964 ECMO/ECLS ECLS REPOS CENTRAL CNULA 6YRS & OLDER ECMO/Operating Room33965 ECMO/ECLS RMVL OF PERPH CANNULA PERQ BIRTH‐5 YRS ECMO/Operating Room33966 ECMO/ECLS RMVL OF PRPH CANNULA PRQ 6 YRS & OLDER ECMO/Operating Room33969 ECMO/ECLS RMVL OF PERPH CANNULA OPEN BIRTH‐5 YRS ECMO/Operating Room33984 ECMO/ECLS RMVL PRPH CANNULA OPEN 6 YRS & OLDER ECMO/Operating Room33985 ECMO/ECLS REMOVAL OF CENTRAL CANNULA BIRTH‐5 YRS ECMO/Operating Room33986 ECMO/ECLS RMVL OF CENTRAL CANNULA 6 YRS & OLDER ECMO/Operating Room33987 ARTERY EXPOS/GRAFT ARTERY PERFUSION ECMO/ECLS ECMO/Operating Room33988 INSERT LEFT HEART VENT BY THORACIC INC ECMO/ECLS ECMO/Operating Room33989 RMVL LEFT HEART VENT BY THORACIC INCIS ECMO/ECLS ECMO/Operating Room

ECMO CPT Deletions

125



33960 PROLONGED EXTRACORPOREAL CIRCULATION INIT DAY ECMO/Operating Room 33946‐3398933961 PROLONGED EXTRACORPOREAL CIRCULATION EA ADDL DAY ECMO/Operating Room 33946‐3398936822 INSJ CANNULA PROLNG XC‐CIRCJ ECMO SPX ECMO/Operating Room 33946‐33989

Clinic CPT Additions

126

2015 CPT Code Description Department90630 INFLUENZA VACC IIV4 SPLIT VIRUS PRSRV FREE ID Clinic90651 HUMAN PAPILLOMA VIRUS NONAVALENT HPV 3 DOSE IM Clinic91200 LIVER ELASTOGRAPHY W/O IMAG W/I&R Clinic99188 APPLICATION TOPICAL FLUORIDE VARNISH BY PHS/QHP Clinic

0341T QUANT PUPILLOMETRY W/INTERP&REPORT UNILAT/BILAT Clinic0342T THERAPEUTIC APHERESIS W/SELECTIVE HDL DELIP Clinic0346T ULTRASOUND ELASTOGRAPHY Clinic0358T BIA WHOLE BODY SUPINE POSTION WITH I&R Clinic

Clinic CPT Deletions

127



36469 1/MLT NJXS SCLRSG SLNS SPIDER VEINS FACE Clinic None

Clinic CPT Revisions

128

2015 CPT Code Description Department20600 ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US Clinic20605 ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US Clinic20610 ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US Clinic90654 INFLUENZA VACC IIV3 SPLIT VIRUS PRSRV FREE ID Clinic90721 DTAP/HIB VACCINE INTRAMUSCULAR Clinic90723 DTAP‐HEPB‐IPV VACCINE INTRAMUSCULAR Clinic90734 MENINGOCOCCAL CONJ VACCINE QUADRAVALENT IM Clinic

Pharmacy CPT Additions

129

HCPCS Code Short Descriptor SI 2015 Payment Rate

C9025 Injection, ramucirumab G $54.06

C9026 Injection, vedolizumab G $17.03

C9027 Injection, pembrolizumab G $45.75

C9136 Factor viii (eloctate) G $2.10

C9349 Fortaderm, fortaderm antimic G $109.18

C9442 Injection, belinostat G $31.80

C9443 Injection, dalbavancin G $31.59

C9444 Injection, oritavancin G $25.62

C9446 Inj, tedizolid phosphate G $1.25

C9447 Inj, phenylephrine ketorolac G $418.70

J0153 Adenosine inj 1mg N

J0571 Buprenorphine oral 1mg E

J0572 Buprenorphin/nalox up to 3mg E

J0573 Buprenorph/nalox 3.1 to 6mg E

J0574 Buprenorph/nalox 6.1 to 10mg E


130


J0575 Buprenorph/nalox over 10mg E

J0887 Epoetin beta esrd use N

J0888 Epoetin beta non esrd N

J1071 Inj testosterone cypionate N

J1322 Elosulfase alfa, injection G $222.13

J1439 Inj ferric carboxymaltos 1mg G $1.05

J2274 In morphine preservativ free N

J2704 Inj, propofol, 10 mg N

J3121 Inj testostero enanthate 1mg N

J3145 Testosterone undecanoate 1mg G $1.15

J7181 Factor xiii recomb a-subunit G $13.69

J7182 Factor viii recomb novoeight E

J7200 Factor ix recombinan rixubis G $1.22

J7201 Factor ix fc fusion recomb G $3.02

J7327 Monovisc inj per dose K $977.92

J7336 Capsaicin 8% patch K $2.65


131


J9267 Paclitaxel injection N

J9301 Obinutuzumab inj G $54.27

Q4150 Allowrap ds or dry 1 sq cm N

Q4151 Amnioband, guardian 1 sq cm N

Q4152 Dermapure 1 square cm N

Q4153 Dermavest 1 square cm N

Q4154 Biovance 1 square cm N

Q4155 Neoxflo or clarixflo 1 mg N

Q4156 Neox 100 1 square cm N

Q4157 Revitalon 1 square cm N

Q4158 Marigen 1 square cm N

Q4159 Affinity1 square cm N

Q4160 Nushield 1 square cm N

Pharmacy CPT Deletions

132

Deleted HCPCS Code Short Descriptor Suggested HCPCS CodeC9021 Injection, obinutuzumab J9301C9022 Injection, elosulfase alfa J1322C9023 Inj testosterone undecanoate J3145C9133 Factor ix recombinant J7200C9134 Factor xiii a-subunit recomb J7181C9135 Factor ix (alprolix) J7201J0150 Injection adenosine 6 mg J0153J0151 Inj adenosine diag 1mg J0153J0900 Testosterone enanthate inj J3121J1060 Testosterone cypionate 1 ml J1071J1070 Testosterone cypionat 100 mg J1071J1080 Testosterone cypionat 200 mg J1071J2271 Morphine so4 injection 100mg J2270J2275 Morphine sulfate injection J2274J3120 Testosterone enanthate inj J3121J3130 Testosterone enanthate inj J3121J3140 Testosterone suspension inj TBDJ3150 Testosteron propionate inj TBDJ7335 Capsaicin 8% patch J7336J9265 Paclitaxel injection J9267Q9970 Inj ferric carboxymaltos 1mg J1439Q9972 Epoetin beta esrd use J0887Q9973 Epoetin beta non esrd J0888Q9974 Morphine epidural/intratheca J2274

Pain Management CPT Additions These CPT code include the imaging guidance

133

2015 CPT Code Description Department64486 TAP BLOCK UNILATERAL BY INJECTION(S) Pain Management64487 TAP BLOCK UNILATERAL BY CONTINUOUS INFUSION(S) Pain Management64488 TAP BLOCK BILATERAL BY INJECTION(S) Pain Management64489 TAP BLOCK BILATERAL BY CONTINUOUS INFUSION(S) Pain Management

Ophthalmology CPT Additions

134

2015 CPT Code Description Department92145 CORNEA HYSTERESIS DETERMIN IMPULSE STIMJ UNI/BI Ophthalmology0356T INSERT DRUG IMPLANT INTO LACRIMAL CANAL FOR IOP Ophthalmology0378T VISUAL FIELD ASSESSMENT PHYS REVIEW AND REPORT Ophthalmology0379T VISUAL FIELD ASSESSMENT TECH SUPPORT W/INSTRUCT Ophthalmology0380T COMP ANIMATION RETINA IMAGE TIME SERIES ANALYSIS Ophthalmology

Ophthalmology CPT Deletions

135



0181T CORNEAL HYSTERESIS AIR IMPULSE STIMJ BI W/I&R Ophthalmology 92145

Ophthalmology CPT Revisions

136

2015 CPT Code Description Change Department

0191T ANT SEGMENT INSERTION DRAINAGE W/O RESERVOIR INT R Ophthalmology

Mental Health CPT Additions

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2015 CPT Code Description Department96127 BEHAV ASSMT W/SCORE & DOCD/STAND INSTRUMENT Mental Health

0359T BEHAVIORAL IDENTIFICATION ASSESSMENT Mental Health0360T OBSERVATIONAL BEHAV ASSESSMENT FIRST 30 MIN Mental Health0361T OBSERVATIONAL BEHAV ASSESSMENT ADDL 30 MIN Mental Health0362T EXPOSURE BEHAV ASSESSMENT FIRST 30 MIN Mental Health0363T EXPOSURE BEHAV ASSESSMENT ADDL 30 MIN Mental Health0364T ADAPTIVE BEHAVIOR TX BY PROTOCOL FIRST 30 MIN Mental Health0365T ADAPTIVE BEHAVIOR TX BY PROTOCOL ADDL 30 MIN Mental Health0366T GROUP BEHAVIOR TREATMENT FIRST 30 MIN Mental Health0367T GROUP BEHAVIOR TREATMENT ADDL 30 MIN Mental Health0368T BEHAVIOR TX WITH MODIFICATION FIRST 30 MIN Mental Health0369T BEHAVIOR TREATMENT WITH MODIFICATION ADDL 30 MIN Mental Health0370T FAMILY BEHAVIOR TREATMENT GUIDANCE Mental Health0371T MULTIPLE FAMILY GROUP BEHAV TREATMENT GUIDANCE Mental Health0372T BEHAVIOR TREATMENT SOCIAL SKILLS TRAINING GROUP Mental Health0373T EXPOSURE BEHAVIOR TREATMENT FIRST 60 MIN Mental Health0374T EXPOSURE BEHAVIOR TREATMENT ADDL 30 MIN Mental Health

Mental Health CPT Revisions

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2015 CPT Code Description Department96110 DEVELOPMENTAL SCREEN W/SCORING & DOC STD INSTRM Mental Health

Other CPT Additions

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2015 CPT Code Description Department93702 BIS EXTRACELLULAR FLUID ALYS LYMPHEDEMA ASSMNT Vascular Studies93895 CAROTID INTIMA MEDIA & CAROTID ATHEROMA EVAL BI Vascular Studies97607 NEG PRESSURE WOUND THERAPY NON DME </= 50 SQ CM Wound Care97608 NEG PRESSURE WOUND THERAPY NON DME >50 SQ CM Wound Care99184 INITIAT SELECTIVE HEAD/BODY HYPOTHERMIA NEONATE Neonatology

Other CPT Deletions

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99481 TOT BODY SYSTEMIC HYPOTHERMIA CRITICAL NEONATE Neonatology 9918499482 SELECTIVE HEAD HYPOTHERMIA CRITICAL NEONATE Neonatology 991840199T PHYSIOL REC TRMR W/ACCEL & GYRO FREQ&AMPL & I&O Vascular Studies 959990239T BIOIMPEDANCE SPECTROSCOPY LIMB DIFFERENCES Neurology 93702

Other CPT Revisions

97605 and 97606 to be used for Negative pressure wound therapy using DME only

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2015 CPT Code Description Department95972 ELEC ALYS NSTIM PLS GEN CPLX SC/PERPH 1ST HR Neurology97605 NEGATIVE PRESSURE WOUND THERAPY DME </= 50 SQ CM Wound Care97606 NEGATIVE PRESSURE WOUND THERAPY DME >50 SQ CM Wound Care

Wrap up and Question/ Answers

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Presenter Information

Mike Kovar410-916-0824

[email protected]

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Documents

2015 Charge Master Update - HFMA NJ Chapter - Home Pagehfmanj.org/images/downloads/Presentation/nj_hfma_201… · · 2014-12-152015 Charge Master Update Mike Kovar Stacey Harper