Know What’s New for Neuro Coding in CPT® 2018

CPT 2018 update TENS coding

Nerve repair, neurostimulators, and visual evoked potential testing all face some changes when CPT® 2018 becomes effective Jan. 1, 2018. Give your neurology and neurosurgery coding prep a jumpstart with these tips.

Watch for Allograft Nerve Repair Option

If your practice is on the cutting edge and using nerve allografts for repair, you’ll need to know these two new codes:

  • 69412 (Nerve repair; with nerve allograft, each nerve, first strand (cable))
  • +69413 (… with nerve allograft, each additional strand (List separately in addition to code for primary procedure))

A quick review of the descriptors clarifies that you’ll use 69412 to report for the first strand. Then add-on +69413 once per additional strand (meaning each unit of +69413 represents one additional strand).

Term tip: An allograft is a graft taken from someone other than the recipient patient. The donor may be living or a cadaver.

Check for Neurostimulator Coding Revision and Deletion

Need to keep an eye on neurostimulator coding options? Here are two changes to note.

  1. CPT® 2018 will revise 64550 by adding the underlined text to the descriptor: Application of surface (transcutaneous) neurostimulator (eg, TENS unit).
  2. CPT® 2018 will delete 64565 (Percutaneous implantation of neurostimulator electrode array; neuromuscular). The other codes in the same family for “Percutaneous implantation of neurostimulator electrode array” will remain.

Advance prep tip: Throughout the year, you can get a tiny glimpse of upcoming CPT® changes in each CPT® Editorial Summary of Panel Action posted on the AMA site. (You may need to sign in to access documents.) For instance, the September-October 2016 Summary includes this statement: “Accepted revision of code 64550 and deletion of code 64565 to report percutaneous placement of neuromuscular neurostimulator electrode.”

Take In the Bigger VEP Picture.

A group of visual evoked potential codes will see changes. These codes may not all apply to you, but it can be helpful (or just fun for coding enthusiasts) to see how changes connect.

For code 95930, CPT® 2018 will add the underlined text, including moving the crossed-out phrase to another position: Visual evoked potential (VEP) checkerboard or flash testing, central nervous system except glaucoma, checkerboard or flash with interpretation and report.

Cat. III tip: The addition of “except glaucoma” to 95930 makes sense when you consider the addition of 0464T (Visual evoked potential, testing for glaucoma, with interpretation and report). This code was effective Jan. 1, 2017, but it won’t appear in the published manual until 2018 because of the manual publication schedule and the early release of Category III codes.

Another VEP code descriptor saw a change that was effective in 2017, but will first be published in the 2018 manual: 0333T (Visual evoked potential, screening of visual acuity, automated, with report). Adding “report” brings the descriptor in line with both 95930 and 0464T, which both contain the same requirement.

How About You?

Which of these changes are you most excited about? Do you like that Cat. III changes occur more than once a year?

 

About 

Deborah concentrates on coding and compliance for radiology and cardiology, including the tricky world of interventional procedures, as well as oncology and hematology. Since joining The Coding Institute in 2004, she’s also covered the ins and outs of coding for orthopedics, audiology, skilled nursing facilities (SNFs), and more.

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