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Highlights of 2010 CPT Changes

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For 2010, there are 219 new CPT codes, 141 that have been revised and 63 that were deleted.  A high-level summary follows:

  • The Surgery Section had the most codes added, deleted and revised.  Category II Codes were second with the most changes.
  • Evaluation and Management Guidelines" now include definitions of Transfer of Care (care of the patient is completely relinquished to a second physician) and Concurrent Care (the provision of similar services to the same patient by more than one physician on the same day).
  • General consultation guideline revisions include a definition for a consultation, "a type of evaluation and management service provided by a physician at the request of another physician or appropriate source to either recommend care for a specific condition/problem or to determine whether to accept responsibility for ongoing management of a patient's entire care or care of a specific condition or problem.
  • In the E/M Section, the add-on status was removed from "Prolonged Services Without Direct (Face-to-Face) Patient Contact codes to allow reporting on a different date that the primary service to which it is related.
    • A notable change is introduction of 27 "Resequenced" codes and the addition of a "#" symbol to indicate that a code is out of sequence.
      Resequencing allows new codes to be visually placed with existing codes regardless of the numeric sequence. CPT felt this supported the integrity of the data inherent in codes and descriptors by eliminating the disruptions that occur by re-numbering. This allows for adding new codes when no code numbers are available in sequence for placement of the new codes into the section.
    • Appendix N was added to assist coders in locating out-of-sequence codes in a numeric system. Appendix M was revised to become a permanent crosswalk of previously deleted and renumbered codes for continuity of information inherent to the previous code numbers.
  • Forty-one new musculoskeletal codes and 54 revised codes allow more specific reporting of soft-tissue tumor removals.  New guidelines also direct coders to report complex repairs separately.
  • A Bronchoscopy Section revision clarifies that fluoroscopic guidance not to be reported separately with codes 31622-31646.
  • Multiple changes to the Urodynamics Study Section allow reporting of combinations of services typically provided together.
  • Facet Injection 64470-64476 were deleted.  Codes 64490-64495 were added for specifying the location and level of these procedures.
  • Radiology codes were added for CT and CTA of the heart, and for myocardial perfusion and cardiac blood pool imaging studies.
  • New pathology/laboratory codes give labs more specific means to report certain tests such as 86305 - ovarian cancer marker.

References:  AMA CPT 2010, CPT Changes:  An Insider's View 2010, and Overview of Changes for CPT 2010 - Marie Mindeman, Director CPT Coding and Regulatory Affairs.