Prepare Yourself Now for 2019 Neurology Coding Changes

Beginning on January 1, 2019, you’ll have a whole slew of updated neurology CPT® codes to contend with. And, as usual, these CPT® updates will have a big impact on your reimbursement: Your neurology practice won’t receive the payment it deserves if you don’t have a complete understanding of the new codes, warns neurology coding expert Kim Garner-Huey in her audio conference, “2019 CPT® Update for Neurology.”

Let’s take a peek at what’s new for the New Year:

Revise Your Approach to Psych & Behavioral Tests

The 2019 CPT® code set contains major revisions to central nervous system assessments, including psychological and neuropsychological testing, adaptive behavior analysis, and so much more, according to The Coding Network.

Plus: Of the more than 300 CPT® code set changes the American Medical Association (AMA) has released, a healthy handful of them will specifically impact neurology practices.

Here is a sampling of the 2019 neurology coding changes:

Use 8 New Codes for Neurostimulator Use & More

The Centers for Medicare & Medicaid Services (CMS) added the following new neurology CPT® codes for 2019:

• 95836 — Electrocorticogram from an implanted brain neurostimulator pulse generator/transmitter, including recording, with interpretation and written report, up to 30 days
• 95976 — Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [Hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop parameters, and passive parameters) by physician or other qualified health care professional; with simple cranial nerve neurostimulator pulse generator/transmitter programming by physician or other qualified health care professional
• 95977 — … with complex cranial nerve neurostimulator pulse generator/transmitter programming by physician or other qualified health care professional
• 95983 — … with brain neurostimulator pulse generator/transmitter programming, first 15 minutes face-to-face time with physician or other qualified health care professional
• 95984 — … with brain neurostimulator pulse generator/transmitter programming, each additional 15 minutes face-to-face time with physician or other qualified health care professional (List separately in addition to code for primary procedure)
• 96112 — Developmental test administration (including assessment of fine and/or gross motor, language, cognitive level, social, memory and/or executive functions by standardized developmental instruments when performed), by physician or other qualified health care professional, with interpretation and report; first hour
• 96113 — … each additional 30 minutes (List separately in addition to code for primary procedure)
• 96121 — Neurobehavioral status exam (clinical assessment of thinking, reasoning and judgment, [eg, acquired knowledge, attention, language, memory, planning and problem solving, and visual spatial abilities]), by physician or other qualified health care professional, both face-to-face time with the patient and time interpreting test results and preparing the report; each additional hour (List separately in addition to code for primary procedure)

Don’t Overlook Deleted Codes

CMS also odeleted four codes for electronic analysis of implanted neurostimulator pulse generator systems: 95974, 95975, 95978, and 95979.

What’s more: The 2019 neurology coding changes revised the following codes:

• 95970 — Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [Hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop parameters, and passive parameters) by physician or other qualified health care professional; with brain, cranial nerve, spinal cord, peripheral nerve, or sacral nerve, neurostimulator pulse generator/transmitter, without programming
• 95971 — … with simple spinal cord or peripheral nerve (eg, sacral nerve) neurostimulator pulse generator/transmitter programming by physician or other qualified health care professional
• 95972 — … with complex spinal cord or peripheral nerve (eg, sacral nerve) neurostimulator pulse generator/transmitter programming by physician or other qualified health care professional

Stay Current on Emerging Reimbursement Developments

Bad news: CMS has proposed to reduce the AMA/Special Society Relative Value Scale Update Committee (RUC)-passed values for five neurostimulator programming codes, including 95970 and 95983 through 95986, according to the American Association of Neurological Surgeons’ Congress of Neurological Surgeons (AANS/CNS).

Although neurosurgeons don’t typically report these codes, their value fluctuations may affect other neurostimulator codes.

The current work Relative Value Unit (RVU) and RUC-passed work RVU for CPT® code 95970 is 0.45, but the CMS-proposed work RVU is 0.35. The other four codes are new and don’t have a current RVU, but they do have an RUC-passed work RVU:

Bottom line: ‘Tis the season to upgrade your skills and knowledge. Don’t risk payment denials. Instead, start 2019 off on the right foot by making sure you have a firm grasp of the neurology CPT® code changes, including all the rules for using new and revised neurology codes, stresses Kim Garner-Huey in “2019 CPT Update for Neurology.”