Neurosurgery Coding Alert

Don’t miss: Codes 95974 and +95975 have been deleted.

From several implanted neurostimulator additions, to electronic analysis of implanted neurostimulator pulse generator revisions, you want to make sure your practice is ready for CPT^® 2019. Although these changes won’t become effective until January 1, 2019, now is the perfect time for you to start preparing.

To get ready for the CPT^® changes, Jim Pawloski, BS, MSA, CIRCC, R.T. (R)(CV), coder at William Beaumont Hospital in Royal Oak, Michigan, and Adreima in Phoenix, Arizona, says he keeps up with different professional societies to see if there are any discussion of new codes that may be coming.

“Preparation and understanding of the new CPT^® and HCPCS codes effective January 1, 2019 is essential,” adds Cynthia A. Swanson, RN, CPC, CEMC, CHC, CPMA, senior manager of healthcare consulting for Seim Johnson in Omaha, Nebraska. “Practitioners, coders and billers must be educated and updated regarding the CPT^® and HCPCS coding changes to help ensure codes are being submitted accurately for compliance purposes and proper reimbursement is received.”

Additionally, any related internal policies/procedures outlining coding/billing of services and related medical record documentation should be reviewed at a minimum on an annual basis to incorporate the new changes, Swanson adds.

Read on to learn more about how these upcoming changes may affect your neurosurgery practice.

Check Out These Implanted Neurostimulator Additions

CPT^® 2019 will add new implanted brain neurostimulator codes 95836 (Electrocorticogram from an implanted brain neurostimulator pulse generator/transmitter, including recording, with interpretation and written report, up to 30 days).

Additions: Don’t miss the following two new electronic analysis of implanted neurostimulator codes:

• 95976 (Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [Hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop parameters, and passive parameters) by physician or other qualified health care professional; with simple cranial nerve neurostimulator pulse generator/transmitter programming by physician or other qualified health care professional)
• 95977 (… with complex cranial nerve neurostimulator pulse generator/transmitter programming by physician or other qualified health care professional)
• 95983 (… with brain neurostimulator pulse generator/transmitter programming, first 15 minutes face-to)-face time with physician or other qualified health care professional)
• +95984 (… with brain neurostimulator pulse generator/transmitter programming, each additional 15 minutes face-to-face time with physician or other qualified health care professional (List separately in addition to code for primary procedure)).

Don’t miss: Code +95984 is an add-on code, which means that you should never report this code for the initial programming period. Instead, you will report it right after the appropriate stand-alone code for the initial 15 minutes of programming, according to Gregory Przybylski, MD, immediate past chairman of neuroscience and director of neurosurgery at the New Jersey Neuroscience Institute, JFK Medical Center in Edison, New Jersey.

Observe Intracranial Vasospasm Balloon Dilation Revisions

Revisions: CPT^® 2019 will revise the following two intracranial vasospasm balloon dilation add-on codes. (Terms added to the descriptor are outlined and deleted portions are struck out). As you can see, the word “family” is replaced by “territory.”:

• +61641 (Balloon dilatation of intracranial vasospasm, percutaneous; each additional vessel in same vascular family territory (List separately in addition to code for primary procedure))
• +61642 (… each additional vessel in different vascular family territory (List separately in addition to code for primary procedure)).

Don’t miss: As you can see, the difference between +61641 and +61642 is very slight. You would report +61641 for each additional vessel in the same vascular territory, and you would report +61642 for each additional vessel in a different vascular territory.

Dial into These Electronic Analysis Revisions

Revisions: Highlight the following electronic analysis updates. (Deleted portions of the descriptors are struck out and added portions are underlined for emphasis.):

• 95970 (Electronic analysis of implanted neurostimulator pulse generator system/transmitter (eg, rate contact group[s], pulse interleaving, amplitude, pulse duration width, frequency [Hz], configuration of wave form on/off cycling, burst, magnet mode, battery status dose lockout, electrode selectability patient selectable parameters, output modulation responsive neurostimulation, cycling detection algorithms, impedance closed loop parameters, and patient compliance measurements)passive parameters) by physician or other qualified health care professional; simple or complex brain with brain, cranial nerve, spinal cord, or peripheral (ie, cranial nerve, peripheral nerve,or sacral nerve, neuromuscular) neurostimulator pulse generator/transmitter, without reprogramming programming)
• 95971 (… with simple spinal cord, or peripheral (ie, peripheral nerve (eg, sacral nerve, neuromuscular) neurostimulator pulse generator/transmitter, with intraoperative programming by physician or subsequent programming other qualified health care professional)
• 95972 (… with complex spinal cord, or peripheral (ie, peripheral nerve, sacral nerve, neuromuscular) (except cranial eg, sacral nerve) neurostimulator pulse generator/transmitter, with intraoperative programming by physician or subsequent programming other qualified health care professional).

>Bottom line: >The above code descriptors have gone through extensive revisions, so make sure you carefully read the new descriptors and note which portions have been added and deleted.

Catch Numerous Miscellaneous Deletions

Electronic analysis of implanted complex cranial neurostimulator codes 95974 and +95975 have been deleted. Now, to report these services, you should report new codes 95976 or 95977:

Additionally, the following two codes have been deleted. Now, you should report new codes 95983 or +95984 for these services.

• 95978 (Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, battery status, electrode selectability and polarity, impedance and patient compliance measurements), complex deep brain neurostimulator pulse generator/transmitter, with initial or subsequent programming; first hour)
• +95979 (…; each additional 30 minutes after first hour (List separately in addition to code for primary procedure))