There have been new codes added, updates and codes deleted for ablations, fracture treatment, and percutaneous vertebroplasty.
Ablations of bone tumors have one new code and one revised code.
20982-Ablation, therapy for reduction or eradication of 1 or more bone tumors including adjacent soft tissue, when involved by tumor extension, percutaneous, including guidance when performed; radio frequency.
This revised code includes how the ablation was completed as well as ablation of the adjacent soft tissue when completed on bone tumors. Imaging guidance is included in this code, so one would not need to bill separately for imaging.
20983-Ablation therapy for reduction or eradication of 1 or more tumors including adjacent soft tissue when involved by tumor extension, percutaneous, including guidance when performed; cryoablation.
This is a new code created to report cryoablation as the method of ablation being used. Imaging guidance is included in this code, so one would not need to bill separately for imaging.
Fracture Codes
DELETED CODES
21800-CLOSED TREATMENT OF RIB FRACTURE, UNCOMPLICATED EACH
Strapping and rib belts are no longer performed. The current standard of care is incentive spirometry. For this service and pain control use the correct E/M code.
21810-TREATMENT OF RIB FRACTURE REQUIRING EXTERNAL FIXATION.
The most common rib fracture treatment is internal fixation, however if external rib fixation is used, the correct code would be unlisted procedure 21899. Be prepared to submit medical documentation when billing an unlisted procedure code.
21811-Open treatment of rib fracture(s) with internal fixation, includes thorascopic visualization when performed, unilateral 1-3 ribs.
21812-Open treatment of rib fracture(s) with internal fixation, includes thorascopic visualization when performed, unilateral 4-6 ribs.
21813-Open treatment of rib fracture(s) with internal fixation, includes thorascopic visualization when performed, unilateral 7 or more ribs.
These are new codes that has moved from the Category III codes (an new emerging technology) to a category I code (a standard procedure). Their distinguishing characteristic is the number of ribs described in each procedure. Thorascopic guidance is included in the code so it would not need to be billed separately. Should these services be completed bilaterally (both left and right ribs) a modifier 50 would be added to the code.
Percutaneous Vertebroplasty and Vertebral Augmentation
DELETED CODES
22520-PERCUTANEOUS VERTEBROPLASY (BONE BIOPSY INCLUDED), 1 VERTEBRAL BODY, UNILATERAL OR BILATERAL INJECTION THORACIC
22521-PERCUTANEOUS VERTEBROPLASY (BONE BIOPSY INCLUDED), 1 VERTEBRAL BODY, UNILATERAL OR BILATERAL INJECTION LUMBAR
22522-PERCUTANEOUS VERTEBROPLASY (BONE BIOPSY INCLUDED), 1 VERTEBRAL BODY, UNILATERAL OR BILATERAL INJECTION-EACH ADDITIONAL VERTEBRAL BODY
These previous codes did not include imaging. As it was reported the imaging guidance was used over 75% of the time in these procedures, a new set of codes was created to include the surgical procedure as well as the guidance. These codes are for percutaneous injections. Code 22512 is an add on code that must be reported with one of the primary procedure codes listed.
22510-Percutaneous vertebroplasty (bone biopsy included if performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance, cervicothoracic
22511- Percutaneous vertebroplasty (bone biopsy included if performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance lumbosacral
+22512- Percutaneous vertebroplasty (bone biopsy included if performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance each additional cervicothoracic or lumbosacral body.
DELTED CODES
22523-PERCUTANEOUS VERTEBRAL AUGMENTATION, INCLUDING CAVITY CREATION USING MECHANICAL DEVICE, 1 VERTEBRAL BODY, UNILATERAL OR BILATERAL CANNULATION THORACIC
22524-PERCUTANEOUS VERTEBRAL AUGMENTATION, INCLUDING CAVITY CREATION USING MECHANICAL DEVICE, 1 VERTEBRAL BODY, UNILATERAL OR BILATERAL CANNULATION LUMBAR
22525-PERCUTANEOUS VERTEBRAL AUGMENTATION, INCLUDING CAVITY CREATION USING MECHANICAL DEVICE, 1 VERTEBRAL BODY, UNILATERAL OR BILATERAL CANNULATION-EACH ADDITIONAL VERTEBRAL BODY
These previous codes did not include imaging. As it was reported the imaging guidance was used over 75% of the time in these procedures, a new set of codes was created to include the surgical procedure as well as the guidance. These codes are for percutaneous augmentation using a mechanical device. Code 22515 is an add on code that must be reported with one of the primary procedure codes listed.
22513-Percutaneuos vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device, 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging services, thoracic.
22513- Percutaneuos vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device, 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging services, lumbar
+22515- Percutaneuos vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device, 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging services, each additional thoracic or lumbar vertebral body.
Many of the code updates were due to imaging services now being included in the procedure code. This means less codes needing to be used in claims, making coding easier. However many times when two codes are combined into one, the fee schedule for the same procedure is decreased. Check your new contract rates with insurance carriers to ensure the payment received in the new codes is comparable to the payment received by the two old codes in the previous year. Should there be a large discrepancy, your contracts manager may need to contact your contracted insurance companies to dispute the rate change.
20982-Ablation, therapy for reduction or eradication of 1 or more bone tumors including adjacent soft tissue, when involved by tumor extension, percutaneous, including guidance when performed; radio frequency.
This revised code includes how the ablation was completed as well as ablation of the adjacent soft tissue when completed on bone tumors. Imaging guidance is included in this code, so one would not need to bill separately for imaging.
20983-Ablation therapy for reduction or eradication of 1 or more tumors including adjacent soft tissue when involved by tumor extension, percutaneous, including guidance when performed; cryoablation.
This is a new code created to report cryoablation as the method of ablation being used. Imaging guidance is included in this code, so one would not need to bill separately for imaging.
Fracture Codes
DELETED CODES
21800-CLOSED TREATMENT OF RIB FRACTURE, UNCOMPLICATED EACH
Strapping and rib belts are no longer performed. The current standard of care is incentive spirometry. For this service and pain control use the correct E/M code.
21810-TREATMENT OF RIB FRACTURE REQUIRING EXTERNAL FIXATION.
The most common rib fracture treatment is internal fixation, however if external rib fixation is used, the correct code would be unlisted procedure 21899. Be prepared to submit medical documentation when billing an unlisted procedure code.
21811-Open treatment of rib fracture(s) with internal fixation, includes thorascopic visualization when performed, unilateral 1-3 ribs.
21812-Open treatment of rib fracture(s) with internal fixation, includes thorascopic visualization when performed, unilateral 4-6 ribs.
21813-Open treatment of rib fracture(s) with internal fixation, includes thorascopic visualization when performed, unilateral 7 or more ribs.
These are new codes that has moved from the Category III codes (an new emerging technology) to a category I code (a standard procedure). Their distinguishing characteristic is the number of ribs described in each procedure. Thorascopic guidance is included in the code so it would not need to be billed separately. Should these services be completed bilaterally (both left and right ribs) a modifier 50 would be added to the code.
Percutaneous Vertebroplasty and Vertebral Augmentation
DELETED CODES
22520-PERCUTANEOUS VERTEBROPLASY (BONE BIOPSY INCLUDED), 1 VERTEBRAL BODY, UNILATERAL OR BILATERAL INJECTION THORACIC
22521-PERCUTANEOUS VERTEBROPLASY (BONE BIOPSY INCLUDED), 1 VERTEBRAL BODY, UNILATERAL OR BILATERAL INJECTION LUMBAR
22522-PERCUTANEOUS VERTEBROPLASY (BONE BIOPSY INCLUDED), 1 VERTEBRAL BODY, UNILATERAL OR BILATERAL INJECTION-EACH ADDITIONAL VERTEBRAL BODY
These previous codes did not include imaging. As it was reported the imaging guidance was used over 75% of the time in these procedures, a new set of codes was created to include the surgical procedure as well as the guidance. These codes are for percutaneous injections. Code 22512 is an add on code that must be reported with one of the primary procedure codes listed.
22510-Percutaneous vertebroplasty (bone biopsy included if performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance, cervicothoracic
22511- Percutaneous vertebroplasty (bone biopsy included if performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance lumbosacral
+22512- Percutaneous vertebroplasty (bone biopsy included if performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance each additional cervicothoracic or lumbosacral body.
DELTED CODES
22523-PERCUTANEOUS VERTEBRAL AUGMENTATION, INCLUDING CAVITY CREATION USING MECHANICAL DEVICE, 1 VERTEBRAL BODY, UNILATERAL OR BILATERAL CANNULATION THORACIC
22524-PERCUTANEOUS VERTEBRAL AUGMENTATION, INCLUDING CAVITY CREATION USING MECHANICAL DEVICE, 1 VERTEBRAL BODY, UNILATERAL OR BILATERAL CANNULATION LUMBAR
22525-PERCUTANEOUS VERTEBRAL AUGMENTATION, INCLUDING CAVITY CREATION USING MECHANICAL DEVICE, 1 VERTEBRAL BODY, UNILATERAL OR BILATERAL CANNULATION-EACH ADDITIONAL VERTEBRAL BODY
These previous codes did not include imaging. As it was reported the imaging guidance was used over 75% of the time in these procedures, a new set of codes was created to include the surgical procedure as well as the guidance. These codes are for percutaneous augmentation using a mechanical device. Code 22515 is an add on code that must be reported with one of the primary procedure codes listed.
22513-Percutaneuos vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device, 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging services, thoracic.
22513- Percutaneuos vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device, 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging services, lumbar
+22515- Percutaneuos vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device, 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging services, each additional thoracic or lumbar vertebral body.
Many of the code updates were due to imaging services now being included in the procedure code. This means less codes needing to be used in claims, making coding easier. However many times when two codes are combined into one, the fee schedule for the same procedure is decreased. Check your new contract rates with insurance carriers to ensure the payment received in the new codes is comparable to the payment received by the two old codes in the previous year. Should there be a large discrepancy, your contracts manager may need to contact your contracted insurance companies to dispute the rate change.
RSS Feed