CPT® is based on the America Medical Association’s Physicians’ Current Procedural Terminology (CPT)® coding system, which is copyrighted and owned by the physician organization. CPT® is the nation’s official, HIPAA, compliant code set for procedures and services provided by physicians, ambulatory surgical centers, and hospital outpatient services, as well as laboratories, imaging centers, physical therapy clinics, urgent care centers and others.

2010 CPT CODING CHANGES:

Evaluation and Management: The E/M Guidelines at the beginning of the Evaluation and Management chapter were updated to expand the definition of Concurrent Care to include "Transfer of Care." The new definition reminds users to not use consultation codes when a transfer of care occurs, unless such transfer happens after the initial consultation evaluation.

Language within the nursing facility codes changed to remove the language "with the patient and/or family or caregiver" and replace it with "at the bedside and on the patient's facility floor or unit." The new text matches text within other facility E/M codes.

Surgery: The Special Report description in the Surgery Guidelines was shortened and the additional report items list has been removed. Additionally, the adjacent tissue transfer's code number has been changed and there is now an add on code for each additional 30 sq cm's transferred over 60 sq cm.

Soft tissue excision codes now include sizes and additional codes for radical resection of a tumor (eg malignant neoplasm) were expanded to include all existing soft tissue excision locations. Note that many of these codes are resquenced, which means they are not in the typical order of small to large, minor to major or proximal to distal. For example, code 28039 -Excision, tumor, soft tissue of foot or toe, subcutaneous, 1.5 cm or greater, appears before 28043 - Excision, tumor, soft tissue of foot or toe, subcutaneous; less than 1.5 cm. The AMA is no longer renumbering codes to make room for new codes within each section. Instead, the symbol # will be used to denote a code has been resequenced.

Resequencing Codes

Although the change does not affect many codes, the new practice of .Resequencing. which begins with CPT 2010 is a totally new concept. In order to respond to the increasing need for additional new codes due to the ever growing needs of physicians and payers, the AMA has found that adherence to the traditional numbering convention that inherently forces deletion and renumbering, compromises the long-term maintenance and integrity of CPT codes.

Resequencing allows related concepts to be placed in a numerical sequence regardless of the availability of numbers for sequential numerical placement. Thus, this process utilizes the content within the code descriptor to determine the appropriate placement in CPT.

There are new codes for laparoscopic paraesophageal hernia repair, including fundoplasty with and without implantation of mesh (43281-43282); laparoscopic longitudinal gastrectomy (i.e. sleeve gastrectomy) performed as a gastric restrictive (weight loss) procedure (43775); and transanal approach to excision of a rectal tumor, partial or full thickness (45171-45172). Complex cystogram codes were expanded to include urethral pressure profile studies and voiding pressure studies (51727-51729).

Bronchoscopy: The bronchoscopy codes were modified to include the text "including fluoroscopic guidance, when performed;" which had been in the section header (31622-31656). Hemorrhoidectomy codes were changed from simple, complex or extensive to single column/group or 2 or more column/groups (46250-46262 and 46945-46946). Similarly, the language was changed in the surgical treatment of anal fistula codes, replacing "complex or multiple" and replacing it with locations (46275-46280).

H1N1: New codes for H1N1 include: 90470 for the administration of the vaccine, and 90663 for the vaccine.

This title updates: Quarterly