Update Your Codebook: AMA Releases CPT Errata
December 9, the American Medical Association (AMA) released the 2015 Errata and Technical Corrections, some of which may affect how you report certain CPT® codes on claims. The most recent entries include:
- Removal of moderate sedation symbol from 45399 Unlisted procedure, colon
- Removal of code 45399 from Appendix G
Evaluation and Management (E/M), Care Management Services, Complex Chronic Care Management Services
E/M code 99487 now includes “only one semicolon to allow the reporting of add-on code 99489” and reflects “the parent child relationship between the two codes.”
Category I, Integumentary System, Breast, Excision
AMA revises the breast biopsy guidelines for reporting bilateral breast imaging/biopsy services to clarify, “coding for these services is to reflect ‘lesion’ and modality, irrespective of performance on the same or contralateral breast. These revisions also reflect the intent of these codes for reporting combinations of multiple procedures and imaging modalities.”
Surgery, Digestive System, Esophagus, Esophagoscopy
Revisions clarify which codes may be reported with 43229 Esophagoscopy, flexible, transoral; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed):
- Do not report 43229 with 43220 or 43226 for the same lesion.
- Do not report 43229 with 43197, 43198, or 43200.
- For esophagoscopic photodynamic therapy, report 43229 with 96570 or 96571, as appropriate.
Clarification for reporting 43231 Esophagoscopy, flexible, transoral; with endoscopic ultrasound examination includes:
- Do not report 43231 with 43197, 43198, 43200, 43232, or 76975.
- Do not report 43231 more than once, per session.
As for 43232 Esophagoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s), do not report it with 43197, 43198, 43200, 43231, 76942, or 76975. Do not report 43232 more than once, per session.
Surgery, Digestive System, Colon and Rectum, Endoscopy
An important revision posted September 23, 2014 in the errata is a modifier change to the Colonoscopy Decision Tree:
Go Right to the Source
Links, complete corrections, and other information related to the CPT® codebook can be found on the AMA website.