On September 5, the American Medical Association (AMA) released the 2019 Current Procedural Terminology (CPT®) code set, containing more than 500 changed codes—that is, additions, revisions, and deletions. And coders for the ob-gyn specialty haven’t been spared from upheaval. Find out what to expect for your ob-gyn CPT® coding in 2019.
Crucial: You need to understand the relationship between ICD-10-CM, ICD-10-PCS, HCPCS, and CPT® codes within the gynecologic practice of your office—as well as how the new 2019 codes will impact your reimbursement, denial, and ob-gyn auditing processes, according to coding expert Lori-Lynne A. Webb in her 2019 Coding Updates Virtual Boot Camp for Ob-Gyn.
2 New Ob-Gyn Codes Focus on Endourologic Procedure
Pay attention: The CPT® code changes announced earlier this month take effect on January 1, 2019. Here’s a sneak peek.
The newly added codes for the Ob-Gyn specialty include:
- 50436 — Dilation of existing tract, percutaneous, for an endourologic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, with postprocedure tube placement, when performed
- 50437 — Dilation of existing tract, percutaneous, for an endourologic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, with postprocedure tube placement, when performed; including new access into the renal collecting system
- Category III: 0066U — Placental alpha-micro globulin-1 (PAMG-1), immunoassay with direct optical observation, cervico-vaginal fluid, each specimen
More: The AMA also deleted the following code:
- 50395 — Introduction of guide into renal pelvis and/or ureter with dilation to establish nephrostomy tract, percutaneous
And this code was revised:
- 74485 — Dilation of ureter(s) or urethra, radiological supervision and interpretation
6 New E&M Codes are Game-Changers
Among the more significant CPT® coding changes are the six newly added codes in the Evaluation and Management (E&M) section, according to Deborah Grider, CPC, Certified Clinical Documentation Improvement Practitioner, in a recent blog posting for ICD10monitor. The new codes include:
- 99451 — Interprofessional telephone/Internet/electronic health record assessment and management service provided by a consultative physician, including a written report to the patient’s treating/requesting physician or other qualified health care professional, 5 minutes or more of medical consultative time
- 99452 — Interprofessional telephone/Internet/electronic health record referral service(s) provided by a treating/requesting physician or other qualified health care professional, 30 minutes
- 99453 — Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial; set-up and patient education on use of equipment
- 99454 — Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial; device(s) supply with daily recording(s) or programmed alert(s) transmission, each 30 days
- 99457 — Remote physiologic monitoring treatment management services, 20 minutes or more of clinical staff/physician/other qualified health care professional time in a calendar month requiring interactive communication with the patient/caregiver during the month
- 99491 — Chronic care management services, provided personally by a physician or other qualified health care professional, at least 30 minutes of physician or other qualified health care professional time, per calendar month, with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient; chronic conditions place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline; comprehensive care plan established, implemented, revised, or monitored
Reasoning: AMA added these new E&M codes to report assessment and management services, based on medical consultative time, Grider explained. You’ll use new codes 99453 and 99454 to report physiologic monitoring services during a 30-day period, while 99457 requires live, interactive communication with the patient/caregiver and 20 minutes or more of clinical staff/physician or other qualified healthcare professional time in a calendar month.
Stay Current on Coding Updates
These E&M and other CPT® code changes “reflect new technological and scientific advancements available to mainstream clinical practice, and ensure the code set can fulfill its trusted role as the health system’s common language for reporting contemporary medical procedures,” AMA President Barbara McAneny, MD said in a recent statement.
Bottom line: Make sure you have a solid handle on these CPT® coding changes and the recent 2019 ICD-10 code updates that are specific to ob-gyn services and diagnoses, so you can maximize your reimbursement and avoid denials, Webb advises. The coding changes for 2019 will impact both office and surgical coding in ob-gyn clinical practices.
