2015 Coding Changes New Codes for Pain Management

2014-11-30_1356Here comes your 2015 Coding Changes New Codes for Pain Management. Get to know them to avoid denials in the coming year. You will see these codes are no longer billable with imaging guidance as a separate service.

2015 Coding Changes New Codes for Pain Management

6 New Codes for Vertebroplasty or Kyphoplasty Procedure 

22510 – Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; cervicothoracic
22511 – … lumbosacral
+22512 – … each additional cervicothoracic or lumbosacral vertebral body (List separately in addition to code for primary procedure)
*** (Use 22512 in conjunction with 22510, 22511)
(Do not report 22510, 22511, 22512 in conjunction with 20225, 22310, 22325, 22327 when performed at the same level as 22510, 22511, 22512)

22513 – Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (e.g., kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; thoracic
22514 – … lumbar
+22515 – … each additional thoracic or lumbar vertebral body (List separately in addition to code for primary procedure).
*** (Use 22515 in conjunction with 22513, 22514)
(Do not report 22513, 22514, 22515 in conjunction with 20225, 22310, 22315, 22325, 22327 when performed at the same level as 22513, 22514 ,22515)

Keypoints:
1. These codes will replace your Codes 22520 to 22525
2. These codes are billed and coded unilateral or bilateral. Modifier 50 (Bilateral), Modifier LT, RT (Left and Right) will apply.
3. Modifier 51 does not apply to your “add-on” codes +22512, +22515
4. All these 6 codes are inclusive with “moderate sedation” represented by a red “bullseye”
5. Code 22510 with “cervicothoracic” means you can now bill the cervical region rather than choosing the unlisted code in 2014 Code 22899 – “unlisted procedure, spine”.
6. Since the new codes are “inclusive of all imaging guidance” – in 2015, you can no longer bill the radiological codes for guidance – 

72291 – Radiological supervision and interpretation, percutaneous vertebroplasty, vertebral augmentation, or sacral augmentation (sacroplasty), including cavity creation, per vertebral body or sacrum; under fluoroscopic guidance
72292 – … under CT guidance.

2015 Coding Changes New Codes for Pain Management

Myleography Coding:

In 2015, we have a revised 62284 – “Injection procedure for myelography and/or computed tomography, spinal (other than C1-C2 and posterior fossa)”
*** Revised Description in 2015
62284 – “Injection procedure for myelography and/or computed tomography, lumbar (other than C1-C2 and posterior fossa).”
(Do not report 62284 in conjunction with 62302,62303,62304, 62305, 72240, 72255, 72265, 77270)

Your 4 New Codes via Lumbar Injection Myleography
62302 Myleography via lumbar injection, including radiological supervision and interpretation; cervical
62303 … thoracic
62304 … lumbosacral
62305 2 or more regions (eg lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical)

72265 Myleography, lumbosacral, radiological supervision and interpretation
(When both 62284 and 72265 are performed by the same physician or other qualified health care professional for lumbosacral myelography, use 62304)

Drug Screening Codes:

Presumptive Drug Class Screening

80300 Drug screen, any number of drug classes from Drug Class List A, any number of non-TLC devices or procedures (eg, immunoassay) capable of being read by direct optical observation, including instrumented-assisted with performed (eg, dipsticks, cups, cards ,cartridges) per date of service

80301 single drug class method, by instrumented test systems, (eg, discrete multichannel chemistry analyzers utilizing immunoassay or enzyme assay), per date of service

80302 Drug screen presumptive, single drug class from Drug Class List B, by immunoassay (eg, ELSIA) or non-TLC chromography without mass spectrometry (eg, GC, HPLC), each procedure

80303 Drug screen, any number of drug classes persumptive, single or multiple drug class method; thin layer chromatography procedure(s) (TLC) (eg, acid, neutral alkaloid plate)per date of service
80304 not otherwise specified presumptive procedures (eg, TOF, MALDI, LDTD, DESI, DART) each procedure

Definitive Drug Testing

(Use 80320-80377 to report definitive drug class procedures. Definitive testing may be qualitative, quantitative, or a combination of qualitative and quantitative for the same patient on the same date of service

82541 Column chromatography/mass spectrometry (eg GC/MS or HPLC/MS) non-drug analysis not elsewhere specified qualitative single stationary and mobile phase
82542 Column chromatography/mass spectrometry
82543 Column chromatography/mass spectrometry
82544 Column chromatography/mass spectrometry

(For column chromatography/mass spectrometry for drugs or substances, see Drug Assay 80300, 80301 ,80302 80303 80304 80320-80377 or specific analyzer code(s) in the Chemistry section.

Joint Injection Codes

Revised      20600 Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); without ultrasound guidance 

New Code  20604 with ultrasound guidance, with permanent recording and reporting
(Do not report 20600, 20604 in conjunction with 76942)
(If fluoroscopic, CT, or MRI guidance is performed, see 77002, 77012, 77021)

Revised    20605 Arthrocentesis, aspiration, and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow, or ankle, olecranon bursa); without ultrasound guidance

New Code  20606 with ultrasound guidance, with permanent recording and reporting
(Do not report 20605, 20606 in conjunction with 76942)
(If fluoroscopic, CT, or MRI guidance is performed, see 77002, 77012, 77021)

Revised  20610 Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder hip, knee, subacromial bursa); without ultrasound guidance

New Code  20611 with ultrasound guidance, with permanent recording and reporting
(Do not report 20610, 20611 in conjunction with 76942)
(If fluoroscopic, CT, or MRI guidance is performed, see 77002, 77012, 77021)

References: CPT Changes 2015, CPT Code Book 2015

 

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