Orthopedic Coding Alert

The new edition of CPT also cleans up graft language and introduces new -T- codes Coding inpatient consultations is about to get easier, thanks to a clarification in CPT 2007.

Last month we told you about some of the new CPT changes that will affect orthopedic coders, but the new CPT manual still has more in store for your practice. Check out the following changes that you can apply to your 2007 superbills.
 
CPT Excludes Follow-Up Inpatient Consult Codes You may recall that CPT 2006 deleted follow-up inpatient consult codes (99261-99263) but left the descriptors of the remaining codes the same. CPT 2007 tidies up the descriptors to eliminate the word -initial- and simply refer to these services as -Inpatient consultation for a new or established patient --

This change shouldn't affect the way that coders report their inpatient consult services. -This descriptor change for 99251-99255 was necessary because CPT previously deleted the follow-up consult codes,- says Pat Strubberg, CPC, coder at Patients First Health Care in Washington, Mo. -The word -initial- would be unnecessary and could be confusing for some.-

As in 2006, the physician should report only one consultation per admission. You should use subsequent hospital care codes (99231-99233) or subsequent nursing facility care codes (99307-99310), depending on the site of service, for subsequent services during the same admission.  These subsequent services include visits to complete the initial consultation, monitor progress, revise recommendations, or address a new problem. 

Example: The managing physician asks your surgeon to provide a consultation for a hospital inpatient complaining of right arm and wrist pain. The surgeon documents the request, examines the patient and shares his findings with the managing physician.

In this case, you should report an inpatient consult (99251-99255).

The next day, the managing physician once again asks the surgeon to examine the patient because of new symptoms, this time in the patient's right hand and fingers. For the follow-up visit, claim subsequent hospital care (for instance, 99232, Subsequent hospital care, per day, for the evaluation and management of a patient ...). Even though this visit may look like a consult, you must report it as subsequent care. Get Specific With New Graft Codes CPT 2007 brings you four new codes for surgical skin preparation, which will allow for more precise identification of the procedures your hand surgeon performs -- and which might result in more equitable payments as well.

Out with the old: Previously, CPT listed two codes to identify surgical preparation or creation of graft recipient site by excision (15000 for the first 100 sq cm or 1 percent of body area of infants and children, and 15001 for each additional 100 sq cm or 1 percent of body area of infants and children).

In with [...]