Orthopedic Coding Alert

Question: I know that the CPT^® 2021 codes will be published soon, and I was wondering if there were any big changes for orthopedic practices next year?

Florida Subscriber

Answer: Aside from the giant changes to office evaluation and management (E/M) visits (see cover story) — which will affect all coders — it doesn’t look like there’s much ortho-specific in terms of additions, deletions, and revisions in CPT^® 2021.

Two revisions that you might want to note are for codes 29822 (Arthroscopy, shoulder, surgical; debridement, limited) and 29823 (… debridement, extensive). In 2021, the definitions will add the underlined text to each code descriptor:

• 29822 (Arthroscopy, shoulder, surgical; debridement, limited, 1 or 2 discrete structures (eg, humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anchor complex, labrum, articular capsule, articular side of the rotator cuff, bursal side of the rotator cuff, subacromial bursa, foreign body[ies]))
• 29823 (Arthroscopy, shoulder, surgical; debridement, extensive 3 or more discrete structures (eg, humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anchor complex, labrum, articular capsule, articular side of the rotator cuff, bursal side of the rotator cuff, subacromial bursa, foreign body[ies]))

Impact: “The changes to code 29822 and 29823 are very important, lending significant clarity to the codes,” reports Heidi Stout, BA, CPC, COSC, PCS, CCS-P, with Coder on Call, Inc., in Milltown, New Jersey.

T code shakeup: There are a few changes in the T code section that might be of interest to orthopedic coders. In 2021, CPT^® will add the following T codes:

• 0594T (Osteotomy, humerus, with insertion of an externally controlled intramedullary lengthening device, including intraoperative imaging, initial and subsequent alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device)
• 0609T (Magnetic resonance spectroscopy, determination and localization of discogenic pain (cervical, thoracic, or lumbar); acquisition of single voxel data, per disc, on biomarkers (ie, lactic acid, carbohydrate, alanine, laal, propionic acid, proteoglycan, and collagen) in at least 3 discs)
• 0610T (… transmission of biomarker data for software analysis)
• 0611T (… postprocessing for algorithmic analysis of biomarker data for determination of relative chemical differences between discs)
• 0612T (… interpretation and report)

Deletion: CPT^® 2021 will also delete 0595T (Removal of humeral externally controlled intramedullary lengthening device).

T code refresher: You’ll find the T codes section toward the back of your CPT^® book, whether it’s a 2020 or 2021 edition. T codes, also called Category III Codes, are “temporary codes for emerging technology, services, procedures, and service paradigms. Category III codes allow for the collection of specific data,” according to CPT^®. Payment for these codes is not guaranteed, and you’ll need to work out the details with your payers before reporting any T codes so you’ll know if the service is covered.