Thousands of new, deleted and revised medical codes are slated to go live on October 1 this year as part of an annual update arriving two years after the initial rollout of ICD-10. In addition, this year’s American Medical Association updates to the CPT Standard Codebook include a number of key changes for anesthesiology – there are additions, deletions and modifications that cover everything from new conversion factors to concerns about misvalued codes.
Confusion Over Colonoscopy Anesthesia
Those “misvalued codes,” by the way, are something the American Society of Anesthesiologists has taken issue with. A report from the industry group addressing both the new CPT codes and CMS’s 2018 Physician Fee Schedule (PFS) notes that codes 00740 and 00810 have been under review since 2016 and will be deleted in 2018 and replaced with five new codes to more specifically describe anesthesia services for routine gastrointestinal endoscopies.
“ASA did not agree with CMS’s assessment that these codes were potentially misvalued based on the agency’s assertion that the codes should be revalued because of the ‘significant change in the relative frequency with which anesthesia codes are reported with colonoscopy services,’” said the ASA.
In the case of anesthesia for GI endoscopy, for example, “ASA pointed out that CMS itself recognized the importance of screening colonoscopy and took actions that included eliminating beneficiary co-pays and deductibles in many cases for both the procedure and associated anesthesia care to encourage patients to undergo these procedures.” ASA seems to be worried that while the procedures are being valued one way under the new CPT codes, the PFS may not accurately reflect the changes.
CMS Wants to Talk
CMS, meanwhile, said it is open to input from the field: “We would like to start a national conversation about improving the healthcare delivery system (and) making the healthcare system more effective, simple and accessible while maintaining program integrity and preventing fraud.”
The agency is serious about that convo, too: CMS has released a “Request for Information” seeking feedback on “positive solutions to better achieve transparency, flexibility, program simplification and innovation,” adding that “[t]his will inform the discussion on future regulatory action related to the PFS.”
Stay Current – And Compliant
Anesthesia coding and billing expert Kelly Davis will help coding staff, office managers, nurses and anesthesiologists address these issues and more in an audio conference for ProfEdOnDemand, “ICD-10 for Anesthesia Practices.” Starting with a brief introduction to diagnosis coding for anesthesia, Dennis will move on to review updates for specific ICD-10 codes for anesthesiology, highlight continuing education options for coders, and discuss key code differences and the terminology coders must understand for the end of 2017 into 2018.
