Don’t Let These Deleted CPT® Codes Sink Your 2019 Claims

For claims to succeed, you can’t use deleted CPT® codes. There’s no getting around it. So give your claims their best chance in 2019 by making sure these deleted codes don’t land on your claims.

And of course: You need to know the new codes (see blog post overviews Part 1, Part 2, Part 3) and revisions. Some of the deletions are covered there, as well, but it doesn’t hurt to discuss the changes from multiple angles. The codes below are Category I codes with specific replacement options, but there are other codes that won’t make it into the 2019 AMA CPT® code set. Make sure you have a resource with the complete official codes, descriptors, and guidelines when the 2019 CPT® code set is effective on Jan. 1, 2019.

For CPT® 2019, FNA Is in Focus

In 2018, you have 10022 for fine needle aspiration (FNA) with imaging guidance. If you code FNA, you probably have that code memorized. But you won’t find that code in the CPT® 2019 code set. Instead, you’ll be using 10005-10012, which will specify the type of imaging guidance used.

Know Where to Find Biopsy Type in Documentation

If you report biopsy, be sure to remove 11100 and 11101 from your job aids. In 2018, those codes apply to skin, subcutaneous tissue, and mucous membrane biopsies. But in 2019, you’ll choose from 11102-11107, which allow you to give more specific information about the biopsy type, such as tangential, punch, or incisional.

Kick 27370 Out of Your Systems

Incorrect use of knee arthrography injection code 27370 is leading to its deletion in 2019. The AMA doesn’t specify a cross code with 27370 in the early release file. But you can expect new code 27369 for an injection procedure for contrast knee arthrography or contrast enhanced CT/MRI knee arthrography.

New Term in 33282, 33284 Replacements

Be prepared to say goodbye to patient-activated cardiac event recorder codes 33282 (implant) and 33284 (removal). In their place, you’ll have 2019 codes 33285 for insertion (including programming) and 33286 for removal. The new code descriptors use the terminology “cardiac rhythm monitor.”

Watch Revision Requirement in Gastrostomy Tube Codes

For a gastrostomy tube without guidance, steer clear of 43760 in 2019. Check instead to see if new code 43762 or new code 43763 will fill the bill. They apply to percutaneous gastrostomy tube replacement. You’ll use 43762 when the tract does not require revision and 43763 when the tract requires revision.

Nix 50395 for Nephrostomy Tract Coding

If you code for percutaneous guide introduction and dilation for nephrostomy tract, you know 50395. But in 2019, you’ll need to know 50436 and 50437. Both codes cover existing tract dilation and imaging guidance. The difference is that 50437 applies when the procedure includes new access into the renal collecting system.

Double Up Options for Breast MRI Codes

Breast MRI codes 77058 and 77059 are on their way out, ready to be replaced by four new codes, 77046-77049. The first two new codes apply when no contrast material is used. The final two codes apply when the breast MRI is performed without and then with contrast. Computer-aided detection is included in 77048 and 77049, but it isn’t required. Just like the 2018 codes, the 2019 codes differ based on unilateral or bilateral.

Update Your BRCA1, BRCA2 Coding Knowledge

Path/lab coders need to be aware of the deletion of BRCA1, BRCA2 gene analysis codes 81211, 81213, and 81214. This is all part of an update of the BRCA1, BRCA2 codes, including revision of 81162, 81212, and 81215-81217. There will also be new codes, 81163-81167.

Here are your most likely replacements for the deletions:

  • CPT® 2018 codes 81211 (full sequence analysis and common duplication/deletion variants in BRCA1) and 81213 (uncommon duplication/deletion variants) will most likely cross to revised code 81162 (full sequence analysis and full duplication/deletion analysis), new code 81163 (full sequence analysis), and new code 81164 (full duplication/deletion analysis)
  • CPT® 2018 code 81214 (BRCA1 full sequence analysis and common duplication/deletion variants) will most likely cross to new codes 81165 (BRCA1 full sequence analysis) and 81166 (BRCA1 full duplication/deletion analysis).

Step Away From Electroretinography Code 92275

The single 2018 electroretinography code 92275 is also on the soon-to-be-gone list. In its place there will be three new codes. You’ll use 92273 (full field), 92274 (multifocal), and Category III code 0509T (pattern).

Study Neurostimulator 959XX Changes

Codes 95974, 95975, 95978, and 95979 cover implanted neurostimulator pulse generator system electronic analysis and programming in 2018. In 2019, that mouthful is moving:

  • In place of cranial codes 95974 and 95975 (both complex), you’ll have new codes 95976 (simple) and 95977 (complex)
  • Instead of deep-brain codes 95978 (first hour) and 95979 (each additional 30 minutes), expect to use new codes 95983 (first 15 minutes) and 95984 (each additional 15 minutes).

What About You?

Are you starting to get a handle on the AMA CPT® 2019 code changes that will affect you? What’s your favorite way to prepare?

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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