Get Your CPT® 2019 Overview of New Codes Here! Part 1

Start your AMA CPT® 2019 update prep with this quick primer on what you can expect when the new code set goes into effect Jan. 1, 2019.

Note: This post will look at new Category I codes with 5 digits (not Cat. III or PLA codes). And remember that the information may change before the new code set is effective. Be sure your code for 2019 dates of service using the final official AMA code set. Also, check coverage and payment rules for the new codes that affect you so you know what to expect from payers.

Overhaul Your FNA Coding

We already touched on fine needle aspiration (FNA) coding changes in a previous post about potential radiology CPT® 2019 updates. But here are a few more details.

Expect a whopping nine additions (10004-10012), one revision (10021), and one deletion (10022) for FNA biopsy. The changes will allow you to report the FNA and specify the type of guidance (ultrasound, fluoro, CT, MR, or none) in a combination code. You’ll use one code for the first lesion and an add-on code for each additional lesion.

See What’s New for Skin biopsy

Watch for your skin biopsy coding options to expand. You’ll have three new sets of codes. Each set has one code for a single lesion and one add-on code for each separate/additional lesion. You’ll base your coding on the biopsy type:

  • Tangential, like shave or curette (11102, 11103)
  • Punch (11104, 11105)
  • Incisional, such as a wedge (11106, 11107).

You’ll use these in place of current biopsy codes 11100 and 11101.

Remember These Allograft Codes Are Add-Ons

Expect three new codes for allografts, one for each of these:

  • Osteoarticular (20932)
  • Hemicortical intercalary, partial (20933)
  • Intercalary, complete (20934).

Watch out: These are add-on codes, so you’ll report them only in addition to a code for the primary procedure.

Stop Using 27370 for Knee Injection

In place of 27370 (Injection of contrast for knee arthrography), you’ll have new code 27369 with a more specific descriptor that clarifies the code represents an injection procedure for contrast knee arthrography or contrast-enhanced CT/MRI knee arthrography. Be sure to check whether the final AMA code set includes guidelines to explain proper use of the code.

Capture Cardiovascular Services With These Cat. I Codes

For those of you who code cardiovascular and cardiothoracic services, stay alert for these changes:

  • Transcatheter permanent leadless pacemaker services (right ventricular): You’ll have 33274 for insertion or replacement, and 33275 for removal of the leadless pacemaker. Similar Cat. III codes 0387T and 0388T will be deleted.
  • Subcutaneous cardiac rhythm monitor services: Expect CPT® 2019 to introduce 33285 for insertion (including programming) and 33286 for removal of a cardiac rhythm monitor. These codes replace 33282 and 33284.
  • Transcatheter implant of wireless pulmonary artery pressure sensor: A new all-in-one code, 33289, will cover a long list of services, from selective pulmonary catheterization and sensor deployment to RS&I.
  • Aortic valve replacement: You’ll have new code 33440 to use when the surgeon performs a Ross-Konno procedure.
  • Aortic hemiarch graft: Check for a comprehensive add-on code in 2019 for aortic hemiarch graft (33866) that includes isolation of arch vessels, anastomosis, and even circulatory arrest or isolated cerebral perfusion.
  • PICC: For PICC without subcutaneous port or pump, you’ll use new code 36572 if the patient is younger than five, and 36573 if the patient is five or older. Those new codes include imaging for the insertion. Existing PICC codes 36568-36569 will be revised to specify “without imaging guidance.”

Stay tuned: This post covers fewer than 30 new codes, so there are about 100 more still to go. Watch for more info on the TCI SuperCoder blog in the future. (Update: Part 2 is now available.) Tip: Check out the TCI Coding Alert or Physician Coder for your specialty for deeper insights into how to use the new codes that affect you.

What About You?

What’s your favorite way to prepare for AMA CPT® updates? Do you prefer to wait until guidelines are available, along with code descriptors?

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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