Podiatry Coding & Billing Alert

Hint: Don’t miss new codes 10004 through 10008.

It’s CPT^® update season once again, and you don’t want to fall behind. Make sure you’re ready now and are aware of how the latest revisions, deletions, and additions will impact your podiatry practice.

“Although there aren’t many podiatry-specific changes this year, it’s still important to prepare for CPT^® 2019 and to know how these updates will impact your practice,” says Arnold Beresh, DPM, CPC, CSFAC,  in West Bloomfield, Michigan.

“Preparation and understanding of the new CPT^® and HCPCS codes effective January 1, 2019 is essential,” emphasizes Cynthia A. Swanson, RN, CPC, CEMC, CHC, CPMA, senior manager of healthcare consulting for Seim Johnson in Omaha, Nebraska. “Practitioners, coders and billers must be educated and updated regarding the CPT^® and HCPCS coding changes to help ensure codes are being submitted accurately for compliance purposes and proper reimbursement is received.”

Additionally, any related internal policies/procedures outlining coding/billing of services and related medical record documentation should be reviewed at a minimum on an annual basis to incorporate the new changes, Swanson adds.

Read on to learn more about how these upcoming changes may affect your podiatry practice.

Catch These Fine Needle Aspiration Additions

Additions: CPT^® 2019 will bring several fine needle aspiration (FNA) additions your way. They are as follows:

• +10004 (Fine needle aspiration biopsy, without imaging guidance; each additional lesion (List separately in addition to code for primary procedure)
• 10005 (…, including ultrasound guidance; first lesion)
• +10006 (…, including ultrasound guidance; each additional lesion (List separately in addition to code for primary procedure)
• 10007 (…, including fluoroscopic guidance; first lesion)
• 10008 (…, including fluoroscopic guidance; each additional lesion (List separately in addition to code for primary procedure).

Example: Suppose your podiatrist performs a FNA biopsy including ultrasound guidance for three lesions. You would report 10005, +10006, and +10006 to represent each of the lesions.

Look at These Shiny New Skin Biopsy Codes, Plus 2 Deletions

Additions: You will also see new skin biopsy codes for CPT^® 2019.

For tangential biopsy codes, you will gain these codes:

• 11102 (Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); single lesion)
• +11103 (… each separate/additional lesion (List separately in addition to code for primary procedure)).

And, you can add these two punch biopsy codes:

• 11104 (Punch biopsy of skin (including simple closure, when performed); single lesion)
• +11105 (… each separate/additional lesion (List separately in addition to code for primary procedure)).

Lastly, don’t miss your two new incisional biopsy choices:

• 11106 (Incisional biopsy of skin (eg, wedge) (including simple closure, when performed); single lesion)
• +11107 (… each separate/additional lesion (List separately in addition to code for primary procedure)).

Example: The podiatrist performs a punch biopsy on a single lesion on the patient’s foot. He also performs a simple closure. You would report 11104 for this service. And, as the descriptor indicates, the simple closure is included, when performed.

Deletions: CPT^® 2019 will also see several skin biopsy deletions. Codes 11100 (Biopsy of skin, subcutaneous tissue and/or mucous membrane (including simple closure), unless otherwise listed; single lesion) and +11101 (Biopsy of skin, subcutaneous tissue and/or mucous membrane (including simple closure), unless otherwise listed; each separate/additional lesion (List separately in addition to code for primary procedure)) have been deleted.

Now, instead of 11100, you will report new codes 11102, 11104, or 11106.

Also, instead of +11101, you will report new codes 11103, 11105, or 11107.

Highlight These Allograft Additions

When your podiatrist performs an allograft, he takes bone or tissue from one person and, after it has been processed, transplants it into another person. As of January 1, you will have additional options for reporting this.

Additions: In 2019, you will now be able to look to these new allograft codes:

• +20932 (Allograft, includes templating, cutting, placement and internal fixation, when performed; osteoarticular, including articular surface and contiguous bone (List separately in addition to code for primary procedure))
• 20933 (…; hemicortical intercalary, partial (ie, hemicylindrical) (List separately in addition to code for primary procedure))
• +20934 (…; intercalary, complete (ie, cylindrical) (List separately in addition to code for primary procedure)).