35 Category III Code Updates Announced! Get to Know Them Fast

Four new Category III codes were effective July 1, 2018. But that’s just a warmup to the 35 changes planned for Jan. 1, 2019. Check this summary to see where you need to focus for updates.

Remember: The final list of codes may change before implementation, so be sure you use the final, correct list once the codes are effective.

What Codes Were Effective July 1?

You should already be using these codes for dates of service on and after July 1, 2018:

  • Code 0505T for endovenous femoral-popliteal stent placement “with crossing of the occlusive lesion in an extraluminal fashion”
  • Code 0506T for use of heterochromatic flicker photometry (HFP) to measure macular pigment optical density (MPOD)
  • Code 0507T for imaging meibomian glands and ducts using simultaneous reflective and trans-illuminated light
  • Code 0508T for pulse-echo ultrasound to measure the tibia’s bone density.

What’s Coming Jan. 1, 2019?

With 35 changes on the way Jan. 1, we’ve got a lot of ground to cover. Here’s an overview by specialty to get you on your way.

Eye care:

  • Code 0509T will allow you to report pattern electroretinography (PERG).
  • Code +0514T is an add-on code for intraoperative visual axis identification that you’ll use with extracapsular cataract removal codes 66982 and 66984.

Orthopedics:

  • Existing code 0335T will get an update to simplify the descriptor to state that it’s for sinus tarsi implant insertion. You’ll use new codes 0510T for removal, and 0511T for removal and reinsertion. In simple terms, the sinus tarsi is a space between the ankle and heel.

Wound:

  • For integumentary wound healing, you’ll have new extracorporeal shock wave codes 0512T (initial wound) and +0513T (each additional wound).

Cardiovascular:

  • Codes 0515T-0522T will apply to wireless cardiac stimulation systems for left ventricular pacing. The codes come with about seven paragraphs of new guidelines, so be sure to read those if you’ll be reporting these codes. As you might expect, code options cover insertion, removal, replacement, interrogation, and programming.
  • You’ll use +0523T for intraprocedural coronary fractional flow reserve.
  • Expect to use 0524T for incompetent extremity vein treatment by chemical ablation with balloon isolation.
  • Intracardiac ischemia monitoring will have new range 0525T-0532T.
  • Ischemia also factors into 0541T and 0542T, which apply to myocardial imaging by magnetocardiography for cardiac ischemia detection.

Movement disorders:

  • You’ll have 0533T-0536T for recording movement disorder symptoms for six to 10 days.

Cellular and gene therapy:

  • The AMA posted chimeric antigen receptor T-cell (CAR-T) therapy codes 0537T-0540T with a note to check back for guidelines that are still to come for these new codes.

What About You?

What do you think of Category III codes, which apply to emerging technology and services? Do you like them or wish there were only Category I codes?

About 

Deborah works on a wide range of TCI SuperCoder projects, researching and writing about coding, as well as assisting with data updates and tool development for our online coding solutions. Since joining TCI in 2004, she’s covered the ins and outs of coding for radiology, cardiology, oncology and hematology, orthopedics, audiology, and more.

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