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2005 CPT Coding Update

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Woman without a man is useless - Woman, without a man, is useless ... Mel Gibson. New Codes for Debridement. Because your patients come first. ... – PowerPoint PPT presentation

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Title: 2005 CPT Coding Update


1
2005 CPT Coding Update
  • Steven A. Adams, CPC, CPC-H, COA

http//www.coderscentral.com/beauty.htm
2
Insert the Punctuation
  • Woman without a man is useless

Men
- Woman, without a man, is useless
Women
- Woman without, a man is useless
3
2005 Changes
More Than 350 Changes 1.5 Increase in
Reimbursement
4
Avoiding trouble is largely a matter of knowing
the rules remembering your audience.
5
CPT
What you did
Here Are The Rules
ICD-9
Why you did it
6
Heres Your Audience
  • Criminal Justice Field
  • Accountants
  • Biologists

Most individuals do not have training in the
health care field. CMS and OIG
7
Topics
  • 2005 RVU Update Reimbursements
  • Deductible, Venipuncture and Injection Changes
  • New Codes for Debridement of Skin
  • New Vaginal Repair Codes
  • Coding for Endometrial Cryoablation and Essure
  • Two new Codes for Fetal Doppler Studies
  • New Malignancy Code
  • New Category III Codes

8
Payment Reform Continues
The lovely thing about being 40 is that you can
appreciate 25 year old men more. Colleen
McCullough
9
Worthless Information?
10
Rest of Georgia
Atlanta, Georgia
11
Sample OBGYN Reimbursements
12
Effective 5/23/2005 Medicare Will Begin A
NPI
13
Deductible, Venipuncture and Injection Changes
Whatever women do they must do twice as well as
men to be thought half as good. Luckily, this is
not difficult. Charlotte Whitton
14
Effective 1/1/05 Medicare Deductible is
110
15
Effective 1/1/05 Medicare No Longer Accepts
G0001
16
Effective 1/1/05 Medicare No Longer Accepts
90782
17
New Medicare Injection Codes
18
New Codes for Debridement
I love women, Theyre the best thing ever
created. If they want to be like men and come
down to our level, thats fine. Mel Gibson
19
Debridement
11004 - 1154
11006 - 1450
11005 - 1572
11008 - 1460
  • ?11004 - Debridement of skin, subcutaneous
    tissue, muscle and fascia for necrotizing soft
    tissue infection external genitalia and perineum

?11005 - abdominal wall, with or without fascial
closure
?11006 - external genitalia, perineum and
abdominal wall, with or without fascial closure
?11008 - Removal of prosthetic material or mesh,
abdominal wall for necrotizing soft tissue
infection
20
New Vaginal Repair Codes
My husband and I didnt sign a pre-nuptial
agreement. We signed a mutual suicide
pact. Rosanne Barr
21
Repair Codes
57282 - 964
57283 - 1382
  • ?57282 - Sacrospinous ligament fixation for
    prolapse of vagina Colpopexy, vaginal
    extra-peritoneal approach
  • ? 57283 - Colpopexy, vaginal intra-peritoneal
    approach
  • 57267 - Insertion of mesh or other prosthesis
    for repair of pelvic floor defect, each site,
    vaginal approach - use with 45560, 57240-57265

57267 - 580
22
Endometrial Cryoablation and Essure
My wife and I were happy for ten years. Then we
met. Rodney Dangerfield
23
Cryoablation
0009T
58356 - 760
  • ?58356 - Endometrial cryoablation with ultrasonic
    guidance, including endometrial curettage, when
    performed

Do not report with 58100 - Endometrial sampling
(separate procedure) 58120 - Diagnostic D C
(non-obstetrical) 58340 - Catheterization for
SIS 76700 - Ultrasound, abdominal B-scan 76856 -
Ultrasound, pelvic limited
24
Essure
58565 - 950
  • ?58565 - Hysteroscopy, surgical with bilateral
    fallopian tube cannulation to induce occlusion by
    placement of permanent implants

Do not report with 58555 - Diagnostic
Hysteroscopy (separate procedure) 57800 -
Dilation of cervical canal (non-obstetrical) If
unilateral, append -52
25
Fetal Doppler Studies
The 50-50-90 rule as it applies to women
Anytime you have a 50-50 chance of getting
something right with a woman, theres a 90
probability youll get it wrong. Andy Rooney
26
Doppler Studies
76820 - 194
76821 - 216
76820/26 - 54
76821/26 - 76
  • ?76820 - Doppler velocimetry, fetal umbilical
    artery
  • ? 76821 - Doppler, velocimetry, fetal middle
    cerebral artery

76827 - 212
76827/26 - 62
?76827 - Doppler echocardiography, fetal,
cardiovascular system, pulsed wave and/or
continuous wave with spectral display complete
27
Malignancy
In life, its not who you know thats important,
its how your wife found out. Joey Adams
28
Malignancy Code
58956 - 2718
  • 58956 - Bilateral salpingo-oopherectomy with
    total omentectomy, total abdominal hysterectomy
    for malignancy

Do not report with 49255 - Omentectomy 58150 -
TAH 58180 - Supracervical abdominal hysterectomy
58262 - Vaginal Hysterectomy with removal of
tubes 58263 - Vaginal hysterectomy with removal
of tubes/ovaries and enterocele 58550 -
Laparoscopy, with vaginal hysterectomy 58661 -
Laparoscopy with removal of adnexal
structures 58700 - Salpingectomy 58720 -
Salpingo-oophorectomy 58900 - Biopsy of
ovary 58925 - Ovarian cystectomy 58940 -
Oophorectomy
29
Category III Code Additions
Men are like dogs because they keep coming back.
Ladies are like cats, because if you yell at a
cat just one timetheyre gone. Lenny Bruce
30
Category III Codes
0071T
  • 0071T - Focused ultrasound ablation of uterine
    leiomyomata, including MR guidance total
    leiomyomata volume less than 200 cc of tissue

0072T
  • 0072T - Focused ultrasound ablation of uterine
    leiomyomata, including MR guidance total
    leiomyomata volume greater than 200 cc of tissue

31
Resources
  • coderscentral.com
  • cms.gov
  • lmrp.net
  • gamedicare.com
  • oig.hhs.gov/publications/workplan.html
  • cms.hhs.gov/providerupdate/whatsnew.asp
  • cms.hhs.gov/physicians/cciedits/default.asp
  • medville.com

32
Topics
  • 2005 RVU Update Reimbursements
  • Deductible, Venipuncture and Injection Changes
  • New Codes for Debridement of Skin
  • New Vaginal Repair Codes
  • Coding for Endometrial Cryoablation and Essure
  • Two new Codes for Fetal Doppler Studies
  • New Malignancy Code
  • New Category III Codes

33
Remember
That little barking dog chasing your car down the
street actually thinks hes chasing you out of
his neighborhood. Steven Adams
34
  • Questions?
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