As we move towards the end of 2018, we will be soon having lot of updates in ICD 10 and CPT codes. New ICD 10 codes get effective from 1st october, every year and new CPT codes get effective from 1st of January.

This year also, there are lot of new ICD 10 codes and CPT codes. We have already discussed about new & deleted ICD 10 codes previously. Today, we will learn about new CPT codes for 2019, which will be effective from 1st January 2019. Below are the main section having new CPT codes in 2019.

Three new remote patient monitoring codes
Two interprofessional internet consultation codes
New and revised codes for skin biopsy, FNA (Fine Needle Aspiration biopsy), adaptive behavior analysis and central nervous system evaluations, including psychological and neuropsychological testing.

Table of Contents

New cpt codes for remote monitoring services for E/M subsection in 2019

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 ( …; device[s] supply with daily recording[s] or programmed alert[s] transmission, each 30 days)

As per CPT codebook “Codes 99453 and 99454 are used to report remote physiologic monitoring services (eg, weight, blood pressure, pulse oximetry) during a 30-day period,”

Also, there is a new CPT code for “remote physiologic monitoring treatment management services” subsection.

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)

As per CPT codebook 2019, “Use 99457 for time spent managing care when patients or the practice do not meet the requirements to report more specific services

Also, there are two new CPT codes for “interprofessional consult” in 2019.

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)

Revised and New CPT codes fro FNA in 2019

CPT code 10021 has been revised in 2019. The FNA (Fine needle aspiration) codes now will be coded based on the number of lesion. FNA for first lesion will be reported with procedure code 10021 and additional lesion will be reported with new CPT codes.

10021 – “Fine needle aspiration biopsy; without imaging guidance; first lesion.”

10004 (Each additional lesion [List separately in addition to code for primary procedure]).

Four new CPT codes for primary and add-on pairing will be available to report for Fine needle aspiration with ultrasound guidance exam (10005-10006).

Similarly for FNA with fluoroscopic guidance will have new code from 10007-10008, CT guidance (10009-10010) or MRI (10011-10012).

As per 2019 CPT codebook, both primary and add-on codes should be used once per lesion sampled during a single session. And when multiple biopsies are perfomed with different guidance, use appropriate primary code with an add-on codes.

But, when a provider performs a FNA and core biopsy on the same lesion, then do not report the imaging guidance for the core needle biopsy.

The FNAB (Fine Needle Aspiration Biopsy) involves aspiration of material with a fine needle and cytological examination of the cells. A core needle biopsy involves obtaining a core sample with a larger bore needle and histopathologic examination of the tissue, the guidance states.

Read aslo: Best coding guide for Central venous catheter placement CPT codes

Deleted and New CPT codes for skin biopsy in 2019

Below two procedure codes have been deleted in 2019

11100 (Biopsy of skin, subcutaneous tissue and/or mucous membrane [including simple closure]

+11101 (…; each separate/additional lesion [List separately in addition to code for primary procedure])

Below Six New CPT codes for 2019 for skin biopsy

11102 Tangential biopsy of skin [eg, shave, scoop, saucerize, curette]; single lesion)

+11103 (…, each separate/additional lesion [List separately in addition to code for primary procedure])

11104 Punch biopsy (includes a simple closure when performed)

+11105 (…, each separate/additional lesion [List separately in addition to code for primary procedure])

11106 Incisional biopsy such as a wedge (includes a simple closure when performed)

+11107 (…, each separate/additional lesion [List separately in addition to code for primary procedure])

New CPT code for Knee arthrography in 2019

The knee arthrography CPT code 27370 will be deleted from 2019 and it is going to be replaced with a new CPT code 27369.

27369 Injection procedure for contrast knee arthrography or contrast enhanced CT/MRI knee arthrography

For imaging guidance and CT/MRI exam followed by knee arthrography you can use the below codes.

77002 Fluoroscopic needle guidance

73701 Computed tomography, lower extremity; with contrast material[s]

73702 ….without & with contrast

73722 MRI any joint LE with contrast

73723 MRI any joint LE with & without contrast

For radiological supervision and interpretation use CPT code 73580.

73580 Radiologic examination, knee, arthrography, radiological supervision and interpretation).

New CPT codes for PICC line placement in 2019

For central venous catheter placement procedures, codes will be revised in 2019 and will include the imaging guidance as well. CPT code 36584 has been revised and will now include the imaging guidance as well.

36584 Replacement, complete, of a peripherally inserted central venous catheter [PICC], without subcutaneous port or pump, through same venous access, including all imaging guidance, image documentation, and all associated radiological supervision and interpretation required to perform the replacement)

Below two new codes have been added and will include imaging guidance

36572 (Insertion of peripherally inserted central venous catheter [PICC], without subcutaneous port or pump, including all imaging guidance, image documentation, and all associated radiological supervision and interpretation required to perform the insertion; younger than 5 years of age)

36573 (…; age 5 years or older)

The above CPT codes 36584, 36572 and 36573 bundled all the imaging services or the chest x-ray exam (71045-71048) performed to check the final position of catheter tip.

References:

http://blog.supercoder.com/coding-updates/

https://www.icd10monitor.com/ama-releases-2019-cpt-code-set

https://pbn.decisionhealth.com/Blogs/Detail.aspx?id=200750