Part B Insider (Multispecialty) Coding Alert

Published on Mon May 01, 2006 PDF

Fracture care, lung surgery, digestive surgery codes will grow

Some specialties gained more than others from the latest five-year review of work RVUs. For example, cardiothoracic surgery had a large number of codes under consideration, and many increased sharply. But also, many surgical procedures will see impressive increases, including digestive surgery.

Here are some of the biggest specialty winners:

Anesthesiology: 00797 (anesthesia, surgery for obesity) will rise from 8.00 to 11.00 work RVUs.

Surgery: Excision codes 11603-11605 will see slight increases, while 11606 will soar from 3.42 to 4.70. Codes 11620 and 11623-11624 will see slight increases instead of the huge increase the Relative Value Update Committee (RUC) requested. Mastectomy code 19180 will gain ground, from 8.79 to 14.67 work RVUs.

Implant removal code 20680 will rise from 3.34 to 5.86 work RVUs. You'll see slight increases in work RVUs for midface reconstruction codes 21145-21147 and 21395 (Treat eye socket fracture).

You'll see some increases in 24363 (Replace elbow joint), going up from 18.46 to 21.07, plus smaller boosts for 24430 (Repair of humerus) and 26615 (Treat metacarpal fracture). CPT 27416 (Shortening of thigh bone) rises from 13.85 to 17.50, 27709 (Incision of tibia and fibia) goes up from 9.94 to 16.50, and 28805 (Amputation through metatarsal) goes up from 8.38 to 11.25 work RVUs.

Respiratory system surgery: Repair of upper jaw codes 31225 and 31230 will go up significantly. Also, larynx surgery codes 31360-31395 will go up sharply--but not by as much as the RUC recommended. Diagnostic laryngoscopy codes 31575 and 31579 will go up significantly.

Lung surgery codes 32442-32445, 32486-32488, 32540 and 32815 will also gain large amounts, but not as much as the RUC recommended. Also, 32651-32657 will increase by less than the RUC recommended, except for 32653, which goes up by more than the RUC called for.

Digestive system surgery: Tongue excision codes 41130-41135 and 41145-41155 will all see increases, and so will palate/lesion excision code 42120. Tonsil resection codes 42842-42845and pharynx surgery codes 42890-42894 will also rise.

Specialty societies had asked for eight esophagus excision codes to increase by as much as 100 percent, but the Centers for Medicare & Medicaid Services granted smaller, but still significant, increases to all of them. Stomach excision codes 43620-43622 and 43632-43634 will also increase, but not as much as esophagus excision.

Colon excision codes 44141-44144, 44146-44151 and 44155-44156 will all increase their work RVUs significantly. Small intestine suture codes 44602-44603 will rise by around a quarter. Rectal abscess drainage code 45020 will increase from 4.71 work RVUs to 7.75 work RVUs.

Biliary tract repair codes 47760-47785 will rise dramatically, with 47785 increasing its work RVUs from 31.13 to 52.50. Abdomenal incision codes 49002-49010 will also increase, but not quite as sharply.

Ob/Gyn Surgery: Vaginal repair codes 57240-57265 will get a boost in work RVUs. For example, work RVUs for 57240 will rise from 6.06 to 10.56.

Endocrine surgery: Carotid body tumor removal codes 60600-60605 will go up roughly 33 percent.

Neurosurgery: Craniotomy codes 51537-51538 will see major increases in their work RVUs, with 51538 increasing from 26.77 to 38.00. Brain aneurysm surgery codes 61697-61698 and 61702 will also increase. Neurostimulator repair code 63702 will gain 1.30 work RVUs on top of its current 4.22.

Eye surgery: Orbitotomy codes 67414 and 67445 both see decent increases in their work RVUs. Eyelid revision codes 67911 and 67966 will also increase.