Part B Insider (Multispecialty) Coding Alert

Published on Sat Sep 12, 2009 PDF

Add these codes to new CPT Codes book when it arrives.

Our CPT books are fountains of knowledge, but there are a few official 2010 CPT category II and III codes that won't appear in a printed book until 2011. Luckily, the AMA lists these codes on its Web site.

What are category II and category III codes? The category II codes were designed for your payer to measure performance activities. "You will report these codes if you're participating in the PQRI program," says Barbara J. Cobuzzi, MBA, CPC, CPC-H, CPC-P, CENTC, CHCC, president of CRN Healthcare Solutions.

The category III codes, on the other hand, are procedure codes that Medicare uses for data collection. "These codes have no RVUs assigned to them, but individual MACs can set fee amounts for them," Cobuzzi says.

"Medicare uses category III codes for tracking purposes, and based on the tracking information, CPT may or may not eventually introduce a category I code for them."

Category II codes that take effect January 1, 2010 are listed on the AMA's Web site, and include the following, among others:

• 3038F -- Pulmonary functiontest performed within 12 months prior to surgery

• 3324F -- MRI or CT scan ordered, reviewed, or requested

• 4340F -- Counseling for women of childbearing potential with epilepsy.

Category III codes that take effect January 1, 2010 are also listed on the AMA's Web site, and include the following, among others:

• 0210T -- Speech audiometry threshold, automated (includes use of computer-assisted device)

• 0216T -- Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, lumbar or sacral; single level.

To read the full list of category II codes, visit www.ama-assn.org/ama1/pub/upload/mm/362/cptcat2codeupdate.pdf. For the category III codes,

visit www.amaassn.org/ama1/pub/upload/mm/362/cptcat3codes.pdf.