Part 3: Master Medicine Code Updates for CPT® 2020

EEG updates in CPT 2020

A lot of specialties will find relevant updates in the Medicine section of CPT® 2020, and we’ve pulled together the can’t-miss news for you here. Tip: If you report EEG, you will certainly want to read on.

Don’t forget: You’ll find the E/M and Surgery section updates in Part 1 and the Radiology and Path/Lab section updates in Part 2.

Look for Flu Code in Vaccines, Toxoids

The January CPT® update includes 90694 (Influenza virus vaccine, quadrivalent (aIIV4), inactivated, adjuvanted, preservative free, 0.5 mL dosage, for intramuscular use), which will carry the symbol indicating FDA approval is pending.

Check Time on New Biofeedback Codes

The new code set will replace 90911 for perineal muscles biofeedback training with two codes. You’ll use 90912 for the first 15 minutes and +90913 for each additional 15 minutes.

Be Ready for Ophthalmology Drawing Changes

For extended ophthalmoscopy, you’ll be using 92201 (with retinal drawing and scleral depression) and 92202 (with drawing of optic nerve or macula). The code set will delete related retinal drawing codes 92225 (initial) and 92226 (subsequent).

Target Two Areas in Special Otorhinolaryngologic Services

  • Posturography: The 2019 code set includes 92548 (Computerized dynamic posturography). But 2020 coding will be more specific. The descriptor for 92548 will add that the code applies to sensory organization testing. New code 92549 will apply when motor control and adaptation testing are also performed.
  • Auditory function: Auditory rehabilitation codes 92626 (first hour) and +92627 (each additional 15 minutes) will be revised to clarify they apply to “Evaluation of auditory function for surgically implanted device(s) candidacy or postoperative status of a surgically implanted device(s).”

Count on More Cardiovascular Revisions

  • Myocardial imaging: New add-on code +93356 will allow you to report myocardial strain imaging using speckle tracking-derived assessment alongside echocardiography codes 93303-93308, 93350, and 93351.
  • Blood pressure: Ambulatory blood pressure monitoring codes 93784-93790 will get an update from referencing magnetic tape and computer disk to “report-generating software, automated.” The codes will continue to apply to 24 hours or more of monitoring. The codes also have a new instruction pointing you to 2020 codes 99473 and 99474 for self-measured blood pressure monitoring.

Prepare for Pre-Op Noninvasive Vascular Diagnostic Studies

To code for a complete study of arterial inflow and venous outflow for vessel assessment before creation of hemodialysis access, you’ll have new duplex scan codes 93985 (bilateral) and 93986 (unilateral).

See a Small Change for Pulmonary

Code 94728 will remove the term impulse from the descriptor to become “Airway resistance by oscillometry.”

Expect EEG Makeover in Neurology and Neuromuscular Procedures

Neurology coders should be aware that electroencephalographic coding will see some big changes in 2020. They start with the revision of EEG extended monitoring code 95813, changing “greater than 1 hour” to “61-119 minutes.”

Next you will need to get a handle on a long list of new, out of sequence codes. In the code book, the new codes are after +95967, but the digits are 95700-95726.

First is 95700 for continuous recording EEG setup by an EEG technologist. The code includes, but doesn’t require, video and takedown.

Then you’ll find 95705-95716, which describe the technical component of services, according to the pages of must-read Special EEG Tests guidelines that accompany this code range. You’ll choose among the codes based on use of video, the EEG time (two to 12 hours or 12 to 26 hours), and whether there was no monitoring, intermittent monitoring and maintenance, or continuous monitoring and maintenance.

Codes 95717-95726 represent the professional component, with the code descriptors stating “physician or other qualified health care professional. Codes 95705-95716, described above, are performed “by EEG technologist.” Time and video use will again be crucial to your code choice. For instance, you’ll use 95726 for “Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary report, complete study; greater than 84 hours of EEG recording, with video (VEEG).”

Because you’ll have these new codes, CPT® 2020 deletes all-night EEG code 95827 and seizure localization codes 95950, 95951, 95953, and 95956.

Increase Code Options for Health Behavior Assessment and Intervention

The new code set deletes health and behavior codes 96150 (assessment) and 96151 (re-assessment) and combines them in single code 96156. The 2019 codes were for “each 15 minutes,” but the 2020 code does not list a time.

Health and behavior intervention coding will also see an update, with 96152-96155 replaced with these new codes. In each case, the first code is for the first 30 minutes and the add-on code is for each additional 15 minutes:

  • Individual: 96158, +96159
  • Group of two or more patients: 96164, +96165
  • Family, with patient present: 96167, +96168
  • Family, without patient present: 96170, +96171.

Start Counting Time for These Physical Medicine and Rehabilitation Codes

Therapeutic interventions focusing on cognitive function also will see a change. The 2020 code set will delete 97127 and replace it with 97129 (initial 15 minutes) and +97130 (each additional 15 minutes).

What About You?

Now that you’ve had the overview of CPT® 2020, how will you prepare for the changes that affect you?

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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