Wiki CPT Level 2 - Help

[ABridgman]

I so seldom use Level 2 coding, I am havong a hard time explaining to another coder how to code the CPT Level 2 codes for Hemoglobin A1C Testing

See if I have this right

You have in your CPT codes - the E/M visit - with a 25 modifier
Then you have the 83037 code for the actual test
Then you have another line where the Level 2 coding goes (3044F or 3046F for example)

The E/M visit will reference like all the ICD-10 codes, whereas the other two will reference only the Diabetes code (e.g. E11.9) and the R73.09 code for abnormal glucose

I think I have this right...how to explain it, over the phone to someone else?

Or would someone be kind enough to send me a claim example of this...with PHI removed, of course?

Thanks.

 

[jsalzer50]

Category II codes

I have no clue if the following will help you and the fellow coder you are/were/will be talking to on the telephone, but I hope it does!

Category II codes: From what I know about them, they are optional and used mostly for performance measurement. They lessen the need for record abstraction and chart review and ultimately help physicians, professionals and hospitals to measure the quality of patient care.

According to CPT 2016, "Cross-references to the measures associated with each Category II code and their source are included for reference in the Alphabetical Clinical Topics Listing. In addition, acronyms for the related diseases or clinical condition(s) have been added at the end of each code descriptor to identify the topic or clinical category in which that code is included. A Complete listing of the diseases/clinical conditions, and their acronyms are provided in alphabetical order in the Alphabetical Clinical Topics Listing. The Alphabetical Clinical Topics Listing can be accessed on the website at www.ama-assn.org, under the Category II link." (CPT 2016, page. 667)

One more quote I found useful: "These codes describe clinical components that may be typically included in evaluation and management services or clinical services and, therefore, do not have a relative value associated with them. Category II codes may also describe results from clinical laboratory or radiology tests and other procedures, identified processes intended to address patient safety practices, or services reflecting compliance with state or federal law." (CPT 2016, pg.667)

Sincerely,
Jacob

 

[ABridgman]

I kinda got that much right...was just wondering if the Level 2 coding also goes in Line 24 a-J on the HCFA form. I think it does. I just do nt normally use it since the main physician I bill for does not do lab work in office. This is a consulting client that picks my brains every once in a while.

This is how I told them to do it...I just wanted to see if I could get assurance I had given correct info.

To the best of my knowledge, I did.

In this case, I told them to reference all diagnosis codes for the E/M visit, but only the diabetes code for 83037 and 3044F/3046F