The AMA has released a preproduction version of CPT® coding updates and changes for 2017. The big news is of course the removal of the circle-with-dot symbol (the “bull’s eye”) from certain codes. The bull’s eye means that the procedure includes the moderate sedation service in ob-gyn procedures like image-guided collection drainage by catheter. This means that you can’t separately report the diagnostic or therapeutic procedure with a moderate sedation code. For a code which no longer has the bull’s eye symbol, you’ll be able to separately report one of the moderate sedation codes if your surgeon sedates a patient for a procedure that they are performing, or for a procedure that someone else is performing.
Codes where the moderate sedation symbol has been removed include:
- 10030 — Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst), soft tissue (eg, extremity, abdominal wall, neck), percutaneous
- 49406 — Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); peritoneal or retroperitoneal, percutaneous
- 49407— … peritoneal or retroperitoneal, transvaginal or transrectal
- 57155 — Insertion of uterine tandem and/or vaginal ovoids for clinical brachytherapy
Now that moderate sedation is to be separately reported, there are new codes to represent the moderate sedation services based on who performs them.
If the moderate sedation is performed by the same surgeon who performed the procedure, you should choose from either 99152 or 99153 and codes 99144 and 99145 will be deleted.
- 99152 — Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient’s level of consciousness and physiological status; initial 15 minutes of intraservice time, patient age 5 years or older
- 99153— … each additional 15 minutes intraservice time (List separately in addition to code for primary service)
If the moderate sedation is performed by a provider who is not performing the procedure, you should choose either 99156 or 99157 and codes 99149 and 99150 will be deleted.
- 99156 — Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports; initial 15 minutes of intraservice time, patient age 5 years or older
- 99157— … each additional 15 minutes intraservice time (List separately in addition to code for primary service).
Another important change is that a regular CPT® code for Laparoscopic Ablation of Fibroids has been added. Under CPT® 2013, the code 0336T was introduced, as a Category III, which stands for Laparoscopy, surgical, ablation of uterine fibroids, including intraoperative ultrasound guidance and monitoring, radiofrequency. CPT® 2017 will bring the regular Category II code, 58674 and the 2013 code 0336T will be deleted. Code 58674 stands for Laparoscopy, surgical, ablation of uterine fibroids, including intraoperative ultrasound guidance and monitoring, radiofrequency.
There are other changes expected and proposed, that might affect practices such as additional specific codes for diagnostic and screening mammography. Medicare has also proposed that each provider must report each included pre and post-op visit so they can gather data, and there are other updates that can affect your bottom line. Join a live session with expert speaker Melanie Witt, RN, MA as she updates your coding knowledge for 2017.
