Nail These FAQs to Secure Your 2019 Claims & Reimbursement!
Keep your medical coding books handy.
Physician practices have been using the new CPT® and ICD-10 codes for a while now, and many have struggled with the best ways to incorporate them into their practice. In this article we cover some frequently-asked questions (FAQs) relating to 2019 code changes along with answers that can guide your reporting:
Question 1: Our gastroenterologist removed a PEG tube for a patient in the office and did not replace it. We are not sure which code to use here. Should we use the new code 43762?
Answer: No, in this situation, you cannot use the 2019 code 43762 as this code only applies if the gastroenterologist removed the PEG tube and then placed another one. In its place, the best bet for a PEG tube removal in the office is to report the proper outpatient E/M code – 99201-99215 – which you should choose based on the physician’s documentation.
Question 2: How should we report ulcerative blepharitis of the left upper eyelid following the overhaul of blepharitis codes?
Answer: As you know, new codes in 2019 ICD-10 coding books expanded the blepharitis codes to allow you a way to report additional eyelids, when affected. But that does not mean there are new codes for every blepharitis condition.
If the patient has ulcerative blepharitis of the left upper eyelid, you’ll report H01.014 (Ulcerative blepharitis, left upper eyelid). Here you’ll report it the same way as you reported in 2018.
What’s different though is that in the 2019 new code set, you can report just one code when more than one eyelid is affected with blepharitis, contrary to the old way, which requires you to bill multiple codes when you treat multiple eyelids. The new codes include: H01.00A, H01.00B, H01.01A, H01.01B, H01.02A, and H01.02B.
So, make sure you report blepharitis using the “business as usual” approach unless multiple eyelids are affected.
Question 3: Which of the two new ERG codes – 92273 or 92274 – apply to pattern ERG?
Answer: Sadly, neither of these CPT® codes – 92273 or 92274 – represents the right way to report pattern ERG. The fact is CPT® 2019 introduced not two but three codes, and one of them is a Category III code – 0509T – Electroretinography (ERG) with interpretation and report, pattern (PERG). And, that’s why you may have overlooked it.
For your scenario, the appropriate code would be 0509T as your physician performed a pattern ERG. Look up the introductory note to the section of CPT® where these codes are listed …If the technique used is not specifically named in the descriptors of codes 92273, 92274, or 0509T, go for the unlisted code 92499.
Thus, all of your ERG services will not always fit into one of the three codes mentioned above. In some cases, your best bet will be 92499. That’s why it’s very important to read the documentation carefully to confirm the ERG type prior to selecting the correct code.
Question 4: What’s the difference between the new elastography codes for 2019 – 76981 and 76892?
Answer: CPT® 2019 deleted the temporary ultrasound elastography code +0346T and replaced it with a couple of new codes – 76981 and 76982. The difference between the two procedures depends on the type of tissue being examined. So, for example, if you are performing a US elastography procedure on diseased liver tissue, you will select 76981 as the provider is imaging an organ. On the contrary, if the provider performs a US elastography on diseased tissue not affecting a particular internal organ, you would use the code 76982.
Have More Questions? Here’s a Simple Solution
Are you still facing challenges about which of the 2019 codes to use or how the revisions or deletions impact your procedure and diagnosis coding? Even though it’s a costly annual expense, bottom-line is you really should have new versions of CPT®, ICD-10 and HCPCS medical coding books each year.
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