1 / 33

2005 CPT Coding Update

2005 CPT Coding Update. Steven A. Adams, CPC, CPC-H, COA. http://www.coderscentral.com/beauty.htm. 2005 Changes. More Than 350 Changes 1.5 Increase in Reimbursement. Avoiding trouble is largely a matter of knowing the rules & remembering your audience. CPT. What you did.

lieu
Download Presentation

2005 CPT Coding Update

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. 2005 CPT Coding Update Steven A. Adams, CPC, CPC-H, COA http://www.coderscentral.com/beauty.htm

  2. 2005 Changes More Than 350 Changes 1.5 Increase in Reimbursement

  3. Avoiding trouble is largely a matter of knowing the rules & remembering your audience.

  4. CPT What you did Here Are The Rules ICD-9 Why you did it

  5. Here’s Your Audience Criminal Justice Field Accountants Biologists “Most individuals do not have training in the health care field.” CMS and OIG

  6. 2005 RVU Update & Reimbursements Deductible, Venipuncture and Injection Changes New Codes for Debridement of Skin New Vaginal Repair Codes Coding for Endometrial Cryoablation and Essure Two new Codes for Fetal Doppler Studies New Malignancy Code New Category III Codes Topics

  7. Payment Reform Continues The lovely thing about being 40 is that you can appreciate 25 year old men more. Colleen McCullough

  8. Worthless Information?

  9. Atlanta, Georgia Rest of Georgia

  10. Sample OBGYN Reimbursements

  11. Effective 5/23/2005 Medicare Will Begin A: NPI

  12. Deductible, Venipuncture and Injection Changes Whatever women do they must do twice as well as men to be thought half as good. Luckily, this is not difficult. Charlotte Whitton

  13. Effective 1/1/05 Medicare Deductible is: $110

  14. Effective 1/1/05 Medicare No Longer Accepts G0001

  15. Effective 1/1/05 Medicare No Longer Accepts 90782

  16. New Medicare Injection Codes

  17. New Codes for Debridement • I love women, They’re the best thing ever created. If they want to be like men and come down to our level, that’s fine. • Mel Gibson

  18. 11004 - Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; external genitalia and perineum Debridement 11004 - $1154 11006 - $1450 11005 - $1572 11008 - $1460 11005 - abdominal wall, with or without fascial closure 11006 - external genitalia, perineum and abdominal wall, with or without fascial closure +11008 - Removal of prosthetic material or mesh, abdominal wall for necrotizing soft tissue infection

  19. New Vaginal Repair Codes My husband and I didn’t sign a pre-nuptial agreement. We signed a mutual suicide pact. Rosanne Barr

  20. 57282 - Sacrospinous ligament fixation for prolapse of vagina Colpopexy, vaginal; extra-peritoneal approach  57283 - Colpopexy, vaginal intra-peritoneal approach Repair Codes 57282 - $964 57283 - $1382 • +57267 - Insertion of mesh or other prosthesis for repair of pelvic floor defect, each site, vaginal approach - use with 45560, 57240-57265 57267 - $580

  21. Endometrial Cryoablation and Essure My wife and I were happy for ten years. Then we met. Rodney Dangerfield

  22. 58356 - Endometrial cryoablation with ultrasonic guidance, including endometrial curettage, when performed Cryoablation 0009T 58356 - $760 Do not report with: 58100 - Endometrial sampling (separate procedure) 58120 - Diagnostic D & C (non-obstetrical) 58340 - Catheterization for SIS 76700 - Ultrasound, abdominal B-scan 76856 - Ultrasound, pelvic limited

  23. 58565 - Hysteroscopy, surgical with bilateral fallopian tube cannulation to induce occlusion by placement of permanent implants Essure 58565 - $950 Do not report with: 58555 - Diagnostic Hysteroscopy (separate procedure) 57800 - Dilation of cervical canal (non-obstetrical) If unilateral, append -52

  24. Fetal Doppler Studies The 50-50-90 rule as it applies to women: Anytime you have a 50-50 chance of getting something right with a woman, there’s a 90% probability you’ll get it wrong. Andy Rooney

  25. 76820 - Doppler velocimetry, fetal; umbilical artery  76821 - Doppler, velocimetry, fetal; middle cerebral artery Doppler Studies 76820 - $194 76821 - $216 76820/26 - $54 76821/26 - $76 76827 - $212 76827/26 - $62 76827 - Doppler echocardiography, fetal, cardiovascular system, pulsed wave and/or continuous wave with spectral display; complete

  26. Malignancy In life, it’s not who you know that’s important, it’s how your wife found out. Joey Adams

  27. Malignancy Code 58956 - $2718 • 58956 - Bilateral salpingo-oopherectomy with total omentectomy, total abdominal hysterectomy for malignancy Do not report with: 49255 - Omentectomy 58150 - TAH 58180 - Supracervical abdominal hysterectomy 58262 - Vaginal Hysterectomy with removal of tubes 58263 - Vaginal hysterectomy with removal of tubes/ovaries and enterocele 58550 - Laparoscopy, with vaginal hysterectomy 58661 - Laparoscopy with removal of adnexal structures 58700 - Salpingectomy 58720 - Salpingo-oophorectomy 58900 - Biopsy of ovary 58925 - Ovarian cystectomy 58940 - Oophorectomy

  28. Category III Code Additions Men are like dogs because they keep coming back. Ladies are like cats, because if you yell at a cat just one time…they’re gone. Lenny Bruce

  29. Category III Codes 0071T • 0071T - Focused ultrasound ablation of uterine leiomyomata, including MR guidance; total leiomyomata volume less than 200 cc of tissue 0072T • 0072T - Focused ultrasound ablation of uterine leiomyomata, including MR guidance; total leiomyomata volume greater than 200 cc of tissue

  30. Resources coderscentral.com cms.gov lmrp.net gamedicare.com oig.hhs.gov/publications/workplan.html cms.hhs.gov/providerupdate/whatsnew.asp cms.hhs.gov/physicians/cciedits/default.asp medville.com

  31. 2005 RVU Update & Reimbursements Deductible, Venipuncture and Injection Changes New Codes for Debridement of Skin New Vaginal Repair Codes Coding for Endometrial Cryoablation and Essure Two new Codes for Fetal Doppler Studies New Malignancy Code New Category III Codes Topics

  32. Remember: That little barking dog chasing your car down the street actually thinks he’s chasing you out of his neighborhood. Steven Adams

  33. Questions?

More Related