Part 1: 17 Changes Coming Your Way in CPT® 2017

CPT 2017 update

A look at the CPT® 2017 pre-production file reveals that if you can get a grip on conscious sedation changes, you’ll master a massive chunk of the updates in one fell swoop. But the devil is in the details, as the saying goes. This rundown of the expected changes will help you decide where to focus the preparations for your specialty.

In Part 1, you’ll see numbers 1 to 6, taking you from conscious sedation to uterine fibroid ablation. Check back in for Part 2 in the next post, which will range from spinal injections to larval therapy!

Keep in mind: This overview is based on the not-yet-final list of CPT® updates, so there could be changes before the code set becomes final and before you start using the codes for dates of service Jan. 1, 2017, and later. This summary highlights changes from the Category I updates.

1. Clue In to the Conscious Sedation Revolution

Expect CPT® 2017 to remove the conscious sedation symbol from the more than 400 codes that currently carry the mark. That mark meant that you should not report moderate/conscious sedation in addition to the procedure code. You also can anticipate the deletion of the current moderate sedation codes. You’ll replace the old codes with new ones that apply in 15-minute increments instead of the 30 minutes used in the 2016 codes.

Tip: Gastroenterology coders should check out this American Gastroenterological Association document discussing the changes and the likely implementation of a HCPCS code specific to gastrointestinal endoscopic services (excluding biliary procedures) to reflect the work and costs specific to that specialty.

The document also explains that the changes are occurring because CMS has seen an increase in anesthesia billed separately from endoscopic procedures. That meant the resource cost for conscious sedation was included in the surgical code reimbursement, but the surgeon wasn’t incurring that cost.

2.  Break Old Bone Coding Habits

Spine: Spine coders should prepare to replace biomechanical device insertion code 22851 with new code options. Watch for three new add-on codes for biomechanical device insertion, plus four more new codes related to stabilization device insertion.

Pelvic ring: If you code for pelvic ring fractures, expect to see a couple of new options for closed treatment.

Bunion: Foot surgery coders will have changes to their bunion CPT® codes to learn along with the new ICD-10 2017 codes M21.61- (Bunion) and M21.62- (Bunionette). Unlike ICD-10, CPT® doesn’t seem to mind keeping hallux valgus and bunion in the same code.

3. Forget Fiberoptic, Add Age for Larynx Services

Coding for larynx procedures will look a little different in 2017, with “fiberoptic” removed from laryngoscopy codes and the addition of new laryngoplasty codes, including stenosis codes that differ based on patient age.

4. Make Room for Multiple Cardiovascular Surgery Changes

Heart: Percutaneous left atrial appendage closure (LAAC) will move from Cat. III to Cat. I. And you’ll have two new options for open aortic valvuloplasty.

Angioplasty: Plan to move your search for visceral, aortic, brachiocephalic, and venous balloon angioplasty to new code options that lump open and percutaneous procedures together. The new codes include radiological supervision and interpretation, so expect to say so long to the related radiology codes.

Dialysis circuit: The 2017 code set plans to delete dialysis AV shunt imaging and intervention codes 36147 and 36148, but you’ll have nine new codes specific to dialysis vascular services.

Newborn transfusion: Watch for a new code specific to partial exchange transfusion in a newborn. You’ll use the code when the procedure requires expert skill.

Endovenous ablation: You’ll see some changes to endovenous ablation codes, most notably new options for mechanochemical ablation.

Tip: See number 13 in Part 2 for cardiovascular medicine section changes.

5. Don’t Miss Esophageal Sphincter Augmentation Additions

If you’ve been hoping for new code options for esophageal sphincter augmentation device placement and removal, CPT® 2017 answers your wish with a new code for each.

6. See Cat. I for Uterine Fibroid Ablation in 2017

Laparoscopic uterine fibroid ablation got the vote of approval and moved from Cat. III to Cat. I.

How About You?

Which changes are you interested in learning more about?

See you soon for Part 2 of the CPT® 2017 overview!


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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