Separate Coding of Moderate Sedation Among Changes to CPT Codes for 2017
News, Denial management
The American Medical Association did not hold back in its update of the CPT codes for 2017. Not only did it remove the icon indicating inclusion of moderate sedation and add a new modifier and star icon for covered telemedicine services, but it revised and expanded laryngoplasty codes and overhauled the codes for physical, occupational, and athletic evaluations and re-evaluations, among other changes.
Moderate sedation: The AMA added new codes 99151 through 99157 to describe moderate sedation and deleted the bull’s eye icon that appeared in the CPT book next to 446 codes. The icon signified that the code included moderate (conscious) sedation. These changes mean that moderate sedation now has to be reported separately from the procedure using the new codes. The new codes replace 99143 through 99150 and change the amount of intraservice time to “first 15 minutes” from “first 30 minutes.”
Telemedicine services: New modifier 95 is to be added to codes describing telemedicine services provided in real time using interactive audio and video—these codes will be flagged with a new star icon in the CPT book for 2017. Modifier 95 is very similar to Medicare’s modifier GT (Via interactive audio and video telecommunications systems). Under Medicare, appending modifier GT to a code indicates that the beneficiary was present at an eligible originating site when the telehealth service was provided.
95 Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system
Laryngoplasty: The codes for procedures on the larynx have been revised and expanded for 2017. For example, code 31584 has been expanded from “Laryngoplasty; with open reduction of fracture” to “Laryngoplasty; open reduction and fixation (e.g., plating) of fracture, includes tracheostomy, if performed.” The AMA has also added new laryngoplasty code 31591 Laryngoplasty, medialization, unilateral.
Physical, occupational, athletic evaluations and re-evaluations: The six codes in the range 97001 through 97006 have been replaced by 12 codes in the range 97161 through 97172. The four codes in each area describe evaluations of low, moderate, and high complexity in addition to re-evaluation of an established plan of care.
Among the other changes AMA made to its CPT code system for 2017 are basing flu vaccine codes on dosage instead of age, aligning the rules for presumptive drug screens with Medicare’s, and replacing epidural codes 62310-62319 with new codes 62120-62327, which specify whether the procedure was provided with imaging (fluoroscopy or CT) or without.