AMA Releases Midterm CPT Code Changes

The American Medical Association (AMA) released a host of mid-term CPT® code updates July 1. Among the new releases are vaccine codes for 2013 and 2014, and a number of Category II and III codes.  In addition to reorganization of codes in Category III, 16 codes have been added or changed in the first two categories.
Category I Vaccine Codes
To facilitate immunization reporting, the AMA has released the vaccine codes for reporting beginning Jan. 1 2013. There are several new and revised codes, and a few codes that were recently approved by the U.S. Food and Drug Administration (FDA).
Following FDA approval status, the AMA has removed the “FDA approval pending” indicator from CPT® code 90644 Meningococcal conjugate vaccine, serogroups C & Y and Hemophilus influenza B vaccine (Hib-MenCY), 4 dose schedule, when administered to children 2-15 months of age, for intramuscular use. Please note this change in your 2012 CPT® codebook.
Making its debut in the 2013 CPT® codebook is 90653 Influenza virus vaccine, inactivated, subunit, adjuvanted, for intramuscular use. This new code was released July 1 and will be implemented Jan. 1, 2013 with an “FDA approval pending” indicator.
The following codes are being revised for CPT® 2013 to include the term “trivalent,” which means the vaccine provides immunity to three different pathogenic strains of flu:
90655 Influenza virus vaccine, trivalent, split virus, preservative free, when administered to children 6-35 months of age, for intramuscular use
90656 Influenza virus vaccine, trivalent, split virus, preservative free, when administered to individuals 3 years and older, for intramuscular use
90657 Influenza virus vaccine, trivalent, split virus, when administered to children 6-35 months of age, for intramuscular use
90658 Influenza virus vaccine, trivalent, split virus, when administered to individuals 3 years of age and older, for intramuscular use
90660 Influenza virus vaccine, trivalent, live, for intranasal use
The following two new codes will appear in the 2013 CPT® codebook:
90739 Hepatitis B vaccine, adjust dosage (2 dose schedule), for intramuscular use (this code will have an “FDA approval pending” indicator)
90672 Influenza virus vaccine, quadrivalent, live, for intranasal use
Also for CPT® 2013, look for a revision to the descriptor for existing code 90746 Hepatitis B vaccine, adult dosage (3 dose schedule), for intramuscular use.
Lastly, the following four new codes were accepted at the May 2012 CPT® Editorial Panel meeting for the 2014 CPT® codebook production cycle (with “FDA approval pending” indicators):
90685 Influenza virus vaccine, quadrivalent, split virus, preservative free, when administered to children 6-35 months of age, for intramuscular use
90686 Influenza virus vaccine, quadrivalent, split virus, preservative free, when administered to individuals 3 years of age and older, for intramuscular use
90687 Influenza virus vaccine, quadrivalent, split virus, when administered to children 6-35 months of age, for intramuscular use
90688 Influenza virus vaccine, quadrivalent, split virus, when administered to individuals 3 years of age and older, for intramuscular use
You can download the CPT® Category I Vaccine Codes document from the AMA website.

Category II Codes Update

Category II codes are supplemental tracking codes that can be used for performance measurement. Their use is optional. The AMA has added, deleted, or reinstated several of these codes in the Patient Management (0500F-0584F), Patient History (1000F-1505F), Diagnostic/Screening Processes or Results (3006F-3763F), and Therapeutic, Preventive or Other Interventions (4000F-4563F) sections.
The release date for these codes varies; and some will appear in CPT® 2013 and others not until CPT® 2014.
Download the complete list of Category II code changes from the AMA website.

Category III Codes Update

The AMA is adding a number of Category III temporary codes that describe emerging technology, services, and procedures, some of which will appear in CPT® 2013 and others in CPT® 2014. Category III codes 0291T-0301T, for example, will make their debut in the 2013 CPT® codebook, but were effective Jan. 1, 2012. The same holds true for revised code 0206T Computerized database analysis of multiple cycles of digitized cardiac electrical data from two or more ECG leads, including transmission to a remote center, application of multiple nonlinear mathematical transformations, with coronary artery obstruction severity assessment and codes 0302T-0308T. Whereas, Category III codes 0319T-0328T, accepted at the May 2012 CPT® Editorial Panel meeting, will be effective Jan. 1, 2013, but will not appear in the CPT® codebook until 2014.
For a complete list of new CPT® Category III codes, download the AMA document.
Note: As per the AMA, “Start dates may vary from payer to payer and may differ from the AMA implementation dates. Therefore, check with the payer for specific payer information regarding use of these codes as part of any program.”

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