Operating Microscope and Allergy Revisions Top List of 2002 CPT Changes
Published on Thu Nov 01, 2001
An advance look at the 2002 CPT manual reveals a few changes that otolaryngologists should carefully note:
Revision of code 69990 to exclude microscope used to assist in placement.
Revision of professional services codes for allergy preparation.
Deletion of modifier -60 (altered surgical field).
CPT 2002 revised the descriptors of dozens of codes, but most of the changes are cosmetic and do not impact how services are reported. Revision of Antigen Preparation Codes
Several codes in the Allergen Immunotherapy section have been revised:
95144 professional services for the supervision of preparation and provision of antigens for allergen immunotherapy; single dose vials (specify number of vials)
95145 professional services for the supervision of preparation and provision of antigens for allergen immunotherapy (specify number of doses); single stinging insect venom)
95146 two single stinging insect venoms
95147 three single stinging insect venoms
95148 four single stinging insect venoms
95149 five single stinging insect venoms
95165 professional services for the supervision of preparation and provision of antigens for allergen immunotherapy; single or multiple antigens (specify number of doses)
95170 whole body extract of biting insect or other arthropod (specify number of doses).
The addition of the word "preparation" to these codes should eliminate confusion among carriers about how to process claims for both the preparation and the injection of one or more allergens, says Teresa Thompson, CPC, an otolaryngology and allergy coding and reimbursement specialist in Sequim, Wa. CPT now instructs otolaryngologists who provide both components (i.e., injection and preparation of allergens) to do component billing, as none of the complete service codes (i.e., 95120-95134) are appropriate in most circumstances. CPT makes the distinction between injection and provision code clear, explicitly stating that the injection codes do not include "provision" of allergens.
Still, many otolaryngology coders report that some carriers have bundled 95165 with 95115 (professional services for allergen immunotherapy not including provision of allergenic extracts; single injection) or 95117 ( two or more injections) even though these codes were not edited in the National Correct Coding Initiative. Many coding specialists attributed the edits to carrier confusion over what was actually covered by 95165, in part because the previous descriptor for 95165 listed only the "supervision of provision" and did not explicitly include preparation (which is the main part of the service). Modifier -60 Deleted, Modifier -22 Revised
The deletion of modifier -60, which was introduced last year, is a disappointment for otolaryngologists, who often perform procedures that involve altered surgical fields, typically as a result of prior surgery.
In 2001, the new modifier was welcomed, and otolaryngologists hoped it would make it easier to obtain additional reimbursement for procedures that were much more difficult because the patient had previously had surgery.
Unfortunately, a few weeks after the [...]
