First Look: Changes to CPT® 2010 Go Beyond Codes

The CPT® 2010 code book includes some changes that will take many coders by surprise. Here’s a synopsis:

Consult Codes. While the Centers for Medicare & Medicaid Services (CMS) grapples with the idea of deleting these codes, the American Medical Association (AMA) extends their life into 2010 — changing only the language in the outpatient and inpatient coding instructions. For 2010, a consulting physician may assume responsibility for the management of all or a portion of the patient care after completing the consultation. What remains from 2009 are guidelines that say the consult must be requested by another provider, and that a report is returned to the requesting provider with the opinion of the consulting physician.

Evaluation and Management – CEMC

Resequencing of Codes. For 2010, coders will find codes appearing out of sequence, and also parent codes linked to indented codes that have smaller numbers (i.e., 21554 Excision, tumor, soft tissue of neck or anterior thorax, subfascial (eg, intramuscular); 5 cm or greater is a new indented code under 21556 Excision, tumor, soft tissue of neck or anterior thorax, subfascial (eg, intramuscular); less than 5 cm). Place-holding codes in sequential order send the reader to the new location for codes listed out of sequence, and a new icon — a pound sign (#) — identifies codes that are out of sequence.

Fluoroscopy. More codes are seeing the addition of the phrase “with or without fluoroscopy,” further bundling this practice into the main procedure.

Watch EdgeBlast and the Coding Edge for more details.

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5 Responses to “First Look: Changes to CPT® 2010 Go Beyond Codes”

  1. mary says:

    see attached.

  2. Sharon Tomany says:

    I have some questions on the “Consult Codes” situation. I understand that as of 2010 consultation codes have been eliminated entirely. I am a coder for All Children’s Hospital in Florida. This is a multi-speciality hospital. We have children that have many issues at the same time and will need a “consult” from one specialist or several depending on the situation. Am I to understand that the specialist that was consulted will only be able to bill for a initial visit? This would not be a “transfer of care” but at times would be a one time only consult that was requested by the admitting physician.

    Thank you for your help.

  3. diana says:

    CONSULT CODES.. AM I UNDERSTANDING CORRECTLY CANNOT BE USED FOR MEDICARE/MEDICAID PATIENTS BUT CAN BE USED FOR OTHER INSURANCE CARRIERS. THESE CODES ARE IN THE 2010 CPT BOOK..YOUR STATEMENT STATES CMS IS GRAPPLING WITH THE IDEA OF DELETING THESE CODES BUT THE AMA EXTENDS THEM THRU 2010….PLEASE CLARIFY

    THANKS FOR YOUR HELP

  4. Brooke says:

    CMS pulication dated Dec 14, 2009 states:
    “Effective January 1, 2010, the consultation codes are no longer recognized for Medicare Part B payment. Physicians shall code patient evaluation and management visit with E/M codes that represent where the visit occurs and that identify the complexity of the visit performed. In the inpatient hopsital setting and the nursing facility setting all physicians (and qualified nonphysicians where permitted) who perform an initial evaluation and management may bill the initial hospital care codes (99221 – 99223) or nursing facility care codes (99304-99306). As a result of this change,

    I was told my Medicare to use 99201-99205 for new patient “consultaions” in the office in place of 99241-99245, as CMS no longer recognizes them either.

    I am in the process of contacting BlueCross BlueShield, Aetna, ect. to see how they are going to respond to this. United Healthcare states they follow AMA guidelines, implying that they will pay on it as long as it is in the AMA CPT book. We’ll see.

  5. Amy Cunningham says:

    First of all I’m new to the site and I currently live in the Indianapolis,Indiana area. . I have a couple of questions to ask.

    1) Is it possible for me to get an internship in Florida even though we are living in Indiana at the moment? We are wanting to move to Florida but we dont have the money right now to move our household.

    2) Do any of the internships pay you?

    3) How easy is it to find a job coding when you are new “entry level?”

    Thank you

    Amy Cunningham

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