Solve the Mystery of the CPT® 2017 Urology Updates

solving the mystery of urology CPT 2017 updates

You’ve got to put on your detective hat and use your “little grey cells” to search out many of the CPT® 2017 changes for urology. If you don’t know where to look, you may miss what’s new. Dig into the details of these three changes.

1. Find the New Note Under 55700

If you concentrate your 2017 prep on just code changes, you’ll miss the update to an instruction under 55700 (Biopsy, prostate; needle or punch, single or multiple, any approach).

In CPT® 2016, you’ll find this note with 55700:

  • If imaging guidance is performed, use 76942.

In 2017, you’ll find a revised note:

  • If imaging guidance is performed, see 76942, 77002, 77012, 77021.

The change acknowledges the various kinds of guidance the physician may use and confirms that you may report the guidance in addition to the biopsy:

  • 76942, ultrasound guidance
  • 77002, fluoroscopic guidance
  • 77012, CT guidance
  • 77021, MR guidance.

2. Unveil the Cat. III Timeline

Forgetting to check Category III CPT® codes for changes could also lead you to miss some codes appearing in the print manual for the first time. Examples include:

  • 0421T, Transurethral waterjet ablation of prostate, including control of post-operative bleeding, including ultrasound guidance, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included when performed)
  • 0438T, Transperineal placement of biodegradable material, peri-prostatic (via needle), single or multiple, includes image guidance
  • +0443T, Real time spectral analysis of prostate tissue by fluorescence spectroscopy.

But remembering to check Cat. III isn’t the real detective work here. The real clues to understanding these codes are in the timeline for Cat. III.

Code 0421T was implemented Jan. 1, 2016, and 0438T and +0443T were implemented July 1, 2016. So you may be wondering why those codes are marked as new in the CPT® 2017 manual. The short version is that Cat. III codes are temporary codes for emerging technologies and services, so they have a semi-annual early release schedule. In other words, Cat. III codes come out on a schedule that differs from the annual CPT® update publication calendar, so not all implemented Cat. III codes make it into the manual by publication time. (But your online coding tools should update throughout the year.)

3. Put a Magnifying Glass to Moderate Sedation Changes

Many coders looking at the list of 2017 code changes were mystified by the number of codes marked as revised that had no apparent change to their descriptors. The answer was that the revision was the removal of the moderate sedation symbol, indicating you must report a moderate sedation code separately in 2017 to get paid for providing that service with the procedure.

Plenty of urology codes will be affected by this change, including codes for percutaneous renal biopsy and ablation, internally dwelling ureteral stent services, nephroureteral and nephrostomy catheter services, and others. So be sure to get to know the new rules for reporting moderate sedation to ensure you get every dollar your practice deserves in 2017.

What Do You Think?

Do you prefer a short list of CPT® changes or were you hoping for changes that didn’t happen? What do you think about the moderate sedation change?


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.


1 Comments For This Post

  1. jitendra Says:

    their has been a very big change in surgery codes in 2017 with the removal of moderate conscious sedation. Yes, we have to separatly code the new CPT codes for moderate sedation in 2017. Be alert now while using new or revised codes in 2017, to avoid unnecessary errors.

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