Black Friday Blog: 2 for 1 With 2019 HCPCS and CPT® News in 1 Post!

Exciting news about CPT and HCPCS 2019 updates

Does coding news get you super-excited, even on Black Friday? Well HCPCS 2019 is out for review, and CPT® 2019 already has errata posted. So here’s some news you can use for both code sets … when you get back to your regular work schedule after the holiday!

Filter Through HCPCS Updates With These Areas in Mind

In the 2019 HCPCS file, there are roughly 370 changes. That means we’ve only got space for some highlights here. So what are the trends for additions for clinicians?

Check for new and old changes. You may recognize some of the codes and modifiers marked as 2019 changes in the HCPC2019_Trans_Alpha file available on the CMS HCPCS site. In some cases, the change happened during 2018 quarterly updates. You may be better off filtering the HCPC2019_CONTR_ANWEB file (in the same download folder as the HCPCS2019_Trans_Alpha file) for actions effective on 20190101.

You’ve also got to check for “New Coding Action” files, like those found on the quarterly update page, that are effective Jan. 1, 2019, to find new changes that may not be in other files. (Or choose an online coding resources that takes care of updates and eliminates all that confusion!)

Look at G codes for home visits, CMMI model, and virtual codes. Among the G code changes are new professional service codes for home infusion administration. There are also many new codes for CMMI model services. Store-and-forward remote evaluation and virtual check-in each have new codes, too. And, of course, if you report for MIPS, watch for G-code changes there.

Review 30 J codes including 7 J9xxx codes added: If you report drugs and biologicals, you’ll want to check for changes to your coding among the J code additions. Here are a few examples:

  • J0185 (Injection, aprepitant, 1 mg)
  • J3304 (Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg)
  • J3591 (Unclassified drug or biological used for ESRD on dialysis)
  • J7318 (Hyaluronan or derivative, durolane, for intra-articular injection, 1 mg)
  • J7329 (Hyaluronan or derivative, trivisc, for intra-articular injection, 1 mg)
  • J9153 (Injection, liposomal, 1 mg daunorubicin and 2.27 mg cytarabine).

Keep in mind that the addition of a J code may mean that a similar C code (which is basically OPPS-only) or temporary code will be discontinued. For instance, with the addition of J0185, aprepitant code C9463 will be discontinued.

Don’t forget dozens of Q codes: Speaking of temporary codes, the Q code section has its own set of additions. Most of them include the term centimeter, a clue that there are many new graft codes. There are also biosimilar codes in this section, including MVASU and IXIFI.

Watch for how similar codes differ: To be sure you’re reporting the new codes correctly, pay careful attention to what’s different about codes that are related. New V codes for hearing aids are a good example of just how detail-oriented you need to be to succeed at coding:

  • V5171 (Hearing aid, contralateral routing device, monaural, in the ear (ite))
  • V5172 (… in the canal (itc))
  • V5181 (… behind the ear (bte))
  • V5211 (Hearing aid, contralateral routing system, binaural, ite/ite)
  • V5212 (… ite/itc)
  • V5213 (… ite/bte)
  • V5214 (… itc/itc)
  • V5215 (… itc/bte)
  • V5221 (… bte/bte).

Check CPT® Note Corrections to Keep Coding Up to Date

If you’ve got a CPT® 2019 manual or other resource that doesn’t apply corrections for you, keeping up with errata and correction announcements is crucial to proper coding. On Nov. 14, 2018, the AMA announced the first set of corrections, which you can find on their site.

Even the tiniest change can be important for coding accuracy, so you should review all of the corrections. You may notice in particular the additions to “do not report” instructions that accompany codes, like these notes:

  • Don’t report cognitive assessment and care plan code 99483 with psychological or neuropsychological test admin code 96146.
  • Don’t report cognitive function interventions code 97127 with adaptive behavior treatment codes 97153 and 97155.

There are also a few corrections in parenthetical notes about when to use Category III codes for autologous adipose-derived regenerative cell therapy. If you perform those services, be sure you’re using the updated instructions.

What About You?

Which changes will affect you? How do you keep up with errata and technical corrections for AMA CPT® 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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