Coding changes for orthopedic billing happen every year. That is why people can make a career out of medical coding and billing. It seems like all you can do is roll up your sleeves and implement the changes as well as you can.
Digging into the coding changes for 2013 is important. It is just as important, halfway through the year, to review and evaluate your progress as well. The emendations for this year included both new codes and revised codes from previous years. Look at some of the key changes and see how your practice is doing in adjusting to these changes.
- Cast Application
One of the codes related to this procedure, CPT code 29590, was deleted. It referred to manipulation and casting. There were also changes made to the guidelines for applying the first cast and removing it.
- Spine CPT Errata
Look closely at the errors corrected on this one. Notice that changes have been added to spine bone grafts, intervertebral device and instrumentation codes. The changes issued in May 2012 omitted this material.
- Hip Arthroscopy
This change may actually lessen the paperwork burden. CPT code 29916 addresses arthroscopic labral repair of a torn labrum. However, this procedure is included already in the procedures that use CPT codes 29915, 29862 and 29863. Therefore, do not report CPT code 29916 in addition to those codes for a patient.
- Nerve Conduction
There are guideline instructions about reporting on electromyograms and nerve conduction studies. Furthermore, several codes have been deleted in relationship to this latter issue. All the codes from 959000 to 95904 were deleted and replaced by codes 95907 to 95913.
Reporting guidelines have also been clarified. A single conduction study is classified as one of three tests: sensory conduction, motor conduction, or H-reflex. Importantly, notice that each study in this area only counts as a single test when multiple sites on the same nerve undergo testing.
- Extracorporeal Shock Wave: Wound Healing
This year’s changes included two new category III codes for this type of procedure. 0299T deals with the extracorporeal shock wave for integumentary wound healing. It includes topical application and dressing care for the initial wound. 0300T is the code used for each additional wound. However, this should be repeated for each separate wound.
Furthermore, there is an important change to guidelines for using CPT code 28890. It may not be reported along with these two new codes as a separate item.
The spine received two new codes for 2013. CPT code 22586 addresses arthrodesis. It includes disc space preparation, discectomy and more details. CPT code 0309T is an add-on code for 22586 which should be listed separately.
To make sure that you are keeping up with these changes appropriately, review the 2013 CPT Manual or have someone in your practice review it thoroughly. Make updates to your procedures for charge capture. If possible, attend an AAOS (American Academy of Orthopaedic Surgeons) coding course or send someone to such an event.
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