2013 CPT CODING UPDATE!CPT® is a registered trademark of the American Medical Association.

CPT® 2013 code changes announced; new codes reflect care advancements

Allow physicians to report advancements in healthcare services Molecular Tests Care Coordination

SINGLE LARGEST EXPANSION 186 New Codes Added 119 Outdated Codes Deleted 263 Another Revised Codes

SINGLE LARGEST EXPANSION Result of:

Significant advancements in medical understanding and testing for Molecular Disease Including Human Genome Project

The 2013 codes include 116 for molecular pathology!

New Codes Will Enhance.. Reporting of innovative diagnostic tools Improve Health Outcomes Reduce Long-Term Care Cost Additional Updates

Reflect Practice Changes and Improvements in Cardiology Neurologic Testing Psychiatry

"Medical knowledge is constantly advancing, and as steward of CPT, the AMA invests extensive resources each year to keep the code set current with contemporary medical science and technology," AMA President Jeremy A. Lazarus, MD

When is the code set updated?

The code set is updated annually with direct input from the health care community: Practicing Physicians Allied Health Professionals Advisors from more than 100 medical specialty

societies

Such input has allowed the code set to better support the reporting needs of physicians and other professionals in emerging models of care, including patient-centered medical homes and accountable care organizations.

Click here for the 2013 CPT code changes "Tapping into the clinical expertise of

the health care community produces the practical enhancements that CPT needs to reflect the coding demands of the modern health care system," Dr. Lazarus said.

A few CPT 2013 CPT codes..

0309T

Arthrodesis, pre-sacral interbody technique, including disc space preparation, discectomy,with posterior instrumentation, with image guidance, includes bone graft, when performed,lumbar, L4-L5 interspace (List separately in addition to code for primary procedure

0310T

Motor function mapping using non-invasive navigated transcranial magnetic stimulation(nTMS) for therapeutic treatment planning, upper and lower extremity

0311TNon-invasive calculation and analysis of central arterial pressure waveforms withinterpretation and report

0312T

Vagus nerve blocking therapy (morbid obesity); laparoscopic implantation of neurostimulator electrode array, anterior and posterior vagal trunks adjacent to esophagogastric junction(EGJ), with implantation of pulse generator, includes programming

0313T

Vagus nerve blocking therapy (morbid obesity); laparoscopic revision or replacement of vagaltrunk neurostimulator electrode array, including connection to existing pulse generator

0314T

Vagus nerve blocking therapy (morbid obesity); laparoscopic removal of vagal trunkneurostimulator electrode array and pulse generator

0315T

Vagus nerve blocking therapy (morbid obesity); removal of pulse generator agus nerve blocking therapy (morbid obesity); removal of pulse generator 

0316TVagus nerve blocking therapy (morbid obesity); replacement of pulse generator

0317T

Vagus nerve blocking therapy (morbid obesity); neurostimulator pulse generator electronicanalysis, includes reprogramming when performed

0318TImplantation of catheter-delivered prosthetic aortic heart valve, open thoracic approach, (eg,transapical, other than transaortic)

0319TImplantation of catheter-delivered prosthetic aortic heart valve, open thoracic approach, (eg,transapical, other than transaortic

0320T Insertion of subcutaneous defibrillator electrode

0321TInsertion of subcutaneous implantable defibrillator pulse generator only with existingsubcutaneous electrode

0322TRemoval of subcutaneous implantable defibrillator pulse generator only

0323T

Removal of subcutaneous implantable defibrillator pulse generator with replacement of subcutaneous implantable defibrillator pulse generator only

0324T Removal of subcutaneous defibrillator electrode

0325TRepositioning of subcutaneous implantable defibrillator electrode and/or pulse generator

0326T

Electrophysiologic evaluation of subcutaneous implantable defibrillator (includes defibrillationthreshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmiatermination, and programming or reprogramming of sensing or therapeutic parameters

0327T

Interrogation device evaluation (in person) with analysis, review and report, includesconnection, recording and disconnection per patient encounter; implantable subcutaneouslead defibrillator system

0328T

Programming device evaluation (in person) with iterative adjustment of the implantable deviceto test the function of the device and select optimal permanent programmed values withanalysis; implantable subcutaneous lead defibrillator system

0580F Multidisciplinary care plan developed or updated (DSP)

0581FPatient transferred directly from anesthetizing location to critical care unit (Peri2)

0582FPatient not transferred directly from anesthetizing location to critical care unit (Peri2)

0583F Transfer of care checklist used (Peri2)

0584F Transfer of care checklist not used (Peri2)

Did we say a few?

1500FSymptoms and signs of distal symmetric polyneuropathy reviewed and documented (DSP)

1501F Not initial evaluation for condition (DSP

1502FPatient queried about pain and pain interference with function using a valid and reliableinstrument (DSP

1503FPatient queried about symptoms of respiratory insufficiency (DSP)

1504F Patient has respiratory insufficiency (DSP

22586

Arthrodesis, pre-sacral interbody technique, including disc space preparation, discectomy,with posterior instrumentation, with image guidance, includes bone graft when performed, L5-S1 interspace

23473Revision of total shoulder arthroplasty, including allograft when performed; humeral or glenoidcomponent

23474Revision of total shoulder arthroplasty, including allograft when performed; humeral andglenoid component

24370Revision of total elbow arthroplasty, including allograft when performed; humeral or ulnar component

24371Revision of total elbow arthroplasty, including allograft when performed; humeral and ulnar component

31647

Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloonocclusion, when performed, assessment of air leak, airway sizing, and insertion of bronchialvalve(s), initial lobe

31648

Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; withremoval of bronchial valve(s), initial lobe

31649

Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; withremoval of bronchial valve(s), each additional lobe (List separately in addition to code for primary procedure)

31651

Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloonocclusion, when performed, assessment of air leak, airway sizing, and insertion of bronchialvalve(s), each additional lobe (List separately in addition to code for primary procedure[s]

31660

Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; withbronchial thermoplasty, 1 lobe

31661Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; withbronchial thermoplasty, 2 or more lobes

32554 Thoracentesis, needle or catheter, aspiration of the pleural space; without imaging guidance

32555 Thoracentesis, needle or catheter, aspiration of the pleural space; with imaging guidance

32556 Pleural drainage, percutaneous, with insertion of indwelling catheter; without imagingguidance

32557 Pleural drainage, percutaneous, with insertion of indwelling catheter; with imaging guidance

32701Thoracic target(s) delineation for stereotactic body radiation therapy (SRS/SBRT), (photon or particle beam), entire course of treatment

33361 Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; percutaneousfemoral artery approach

33362 Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; open femoralartery approach

33363 Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; open axillaryartery approach

33364 Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; open iliac arteryapproach

33365Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; transaorticapproach (eg, median sternotomy, mediastinotomy)

33367

Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; cardiopulmonarybypass support with percutaneous peripheral arterial and venous cannulation (eg, femoralvessels) (List separately in addition to code for primary procedure)

33368

Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; cardiopulmonarybypass support with open peripheral arterial and venous cannulation (eg, femoral, iliac,axillary vessels) (List separately in addition to code for primary procedure)

33369

Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; cardiopulmonarybypass support with central arterial and venous cannulation (eg, aorta, right atrium,pulmonary artery) (List separately in addition to code for primary procedure)

33990Insertion of ventricular assist device, percutaneous including radiological supervision andinterpretation; arterial access only

33991

Insertion of ventricular assist device, percutaneous including radiological supervision andinterpretation; both arterial and venous access, with transseptal puncture

33992 Removal of percutaneous ventricular assist device at separate and distinct session frominsertion

33993Repositioning of percutaneous ventricular assist device with imaging guidance at separateand distinct session from insertion

36221

Non-selective catheter placement, thoracic aorta, with angiography of the extracranial carotid,vertebral, and/or intracranial vessels, unilateral or bilateral, and all associated radiologicalsupervision and interpretation, includes angiography of the cervicocerebral arch, whenperformed

36222

Selective catheter placement, common carotid or innominate artery, unilateral, any approach,with angiography of the ipsilateral extracranial carotid circulation and all associatedradiological supervision and interpretation, includes angiography of the cervicocerebral arch,when performed

36223

Selective catheter placement, common carotid or innominate artery, unilateral, any approach,with angiography of the ipsilateral intracranial carotid circulation and all associatedradiological supervision and interpretation, includes angiography of the extracranial carotidand cervicocerebral arch, when performed

36224

Selective catheter placement, internal carotid artery, unilateral, with angiography of theipsilateral intracranial carotid circulation and all associated radiological supervision andinterpretation, includes angiography of the extracranial carotid and cervicocerebral arch,when performed

36225

Selective catheter placement, subclavian or innominate artery, unilateral, with angiography of the ipsilateral vertebral circulation and all associated radiological supervision andinterpretation, includes angiography of the cervicocerebral arch, when performed

36226

Selective catheter placement, vertebral artery, unilateral, with angiography of the ipsilateralvertebral circulation and all associated radiological supervision and interpretation, includesangiography of the cervicocerebral arch, when performed

36227

Selective catheter placement, external carotid artery, unilateral, with angiography of theipsilateral external carotid circulation and all associated radiological supervision andinterpretation (List separately in addition to code for primary procedure)

36228

Selective catheter placement, each intracranial branch of the internal carotid or vertebralarteries, unilateral, with angiography of the selected vessel circulation and all associatedradiological supervision and interpretation (eg, middle cerebral artery, posterior inferior cerebellar artery) (List separately in addition to code for primary procedure)

37197

Transcatheter retrieval, percutaneous, of intravascular foreign body (eg, fractured venous or arterial catheter), includes radiological supervision and interpretation, and imaging guidance(ultrasound or fluoroscopy), when performed

37211Transcatheter therapy, arterial infusion for thrombolysis other than coronary, any method,including radiological supervision and interpretation, initial treatment day

37212Transcatheter therapy, venous infusion for thrombolysis, any method, including radiologicalsupervision and interpretation, initial treatment day

37213

Transcatheter therapy, arterial or venous infusion for thrombolysis other than coronary, anymethod, including radiological supervision and interpretation, continued treatment onsubsequent day during course of thrombolytic therapy, including follow-up catheter contrastinjection, position change, or exchange, when performed;

37214

Transcatheter therapy, arterial or venous infusion for thrombolysis other than coronary, anymethod, including radiological supervision and interpretation, continued treatment onsubsequent day during course of thrombolytic therapy, including follow-up catheter contrastinjection, position change, or exchange, when performed; cessation of thrombolysis includingremoval of catheter and vessel closure by any method

3752F

Electrodiagnostic studies for distal symmetric polyneuropathy not conducted (or requested),documented, or reviewed within 6 months of initial evaluation for condition (DSP)

3753F

Patient has clear clinical symptoms and signs that are highly suggestive of neuropathy ANDcannot be attributed to another condition, AND has an obvious cause for the neuropathy(DSP)

3754F Screening tests for diabetes mellitus reviewed, requested, or ordered (DSP)

3755F Cognitive and behavioral impairment screening performed (DSP)

3756F Patient has pseudobulbar affect, sialorrhea, or ALS related symptoms (DSP)

3757F Patient does not have pseudobulbar affect, sialorrhea, or ALS related symptoms (DSP)

3758F Patient referred for pulmonary function testing or peak cough expiratory flow (DSP)

Take effect January 1, 2013..3759F Patient screened for dysphagia, weight loss, and

impaired nutrition, and results documented(DSP)

3760F Patient exhibits dysphagia, weight loss, or impaired nutrition (DSP)

3761F Patient does not exhibit dysphagia, weight loss, or impaired nutrition (DSP)

3762F Patient is dysarthric (DSP)

3763F Patient is not dysarthric (DSP)

38243 Hematopoietic progenitor cell (HPC); HPC boost

43206 Esophagoscopy, rigid or flexible; with optical endomicroscopy

43252Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenumand/or jejunum as appropriate; with optical endomicroscopy

44705 Preparation of fecal microbiota for instillation, including assessment of donor specimen

4540F Disease modifying pharmacotherapy discussed (DSP)

4541F Patient offered treatment for pseudobulbar affect, sialorrhea, or ALS related symptoms (DSP)

4550F Options for noninvasive respiratory support discussed with patient (DSP)

4551F Nutritional support offered (DSP)

4552F Patient offered referral to a speech language pathologist (DSP)

4553F Patient offered assistance in planning for end of life issues (DSP)

4554F Patient received inhalational anesthetic agent (Peri2)

4555F Patient did not receive inhalational anesthetic agent (Peri2)

4556F Patient exhibits 3 or more risk factors for post-operative nausea and vomiting (Peri2)

4557F Patient does not exhibit 3 or more risk factors for post-operative nausea and vomiting (Peri2)

4558FPatient received at least 2 prophylactic pharmacologic anti-emetic agents of different classespreoperatively and intraoperatively (Peri2)

4559F

 At least 1 body temperature measurement equal to or greater than 35.5 degrees Celsius (or 95.9 degrees Fahrenheit) recorded within the 30 minutes immediately before or the 15minutes immediately after anesthesia end time (Peri2)

4560F  Anesthesia technique did not involve general or neuraxial anesthesia (Peri2)

4561F Patient has a coronary artery stent (Peri2)

4562F Patient does not have a coronary artery stent (Peri2)

4563F Patient received aspirin within 24 hours prior to anesthesia start time (Peri2)

52287 Cystourethroscopy, with injection(s) for chemodenervation of the bladder 

64615Chemodenervation of muscle(s); muscle(s) innervated by facial, trigeminal, cervical spinaland accessory nerves, bilateral (eg, for chronic migraine)

78012Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation,suppression, or discharge, when performed)

c

78013 Thyroid imaging (including vascular flow, when performed);

78014

Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s)quantitative measurement(s) (including stimulation, suppression, or discharge, whenperformed)

78071 Parathyroid planar imaging (including subtraction, when performed); with tomographic(SPECT)

78072

Parathyroid planar imaging (including subtraction, when performed); with tomographic(SPECT), and concurrently acquired computed tomography (CT) for anatomical localization

81161DMD (dystrophin) (eg, Duchenne/Becker muscular dystrophy) deletion analysis, andduplication analysis, if performed

81201 APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis [FAP], attenuatedFAP) gene analysis; full gene sequence

81202 APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis [FAP], attenuatedFAP) gene analysis; known familial variants

81203 APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis [FAP], attenuatedFAP) gene analysis; duplication/deletion variants

81235

EGFR (epidermal growth factor receptor) (eg, non-small cell lung cancer) gene analysis,common variants (eg, exon 19 LREA deletion, L858R, T790M, G719A, G719S, L861Q)

81252GJB2 (gap junction protein, beta 2, 26kDa; connexin 26) (eg, nonsyndromic hearing loss)gene analysis; full gene sequence

81253GJB2 (gap junction protein, beta 2, 26kDa; connexin 26) (eg, nonsyndromic hearing loss)gene analysis; known familial variants

81254

GJB6 (gap junction protein, beta 6, 30kDa, connexin 30) (eg, nonsyndromic hearing loss)gene analysis, common variants (eg, 309kb [del(GJB6-D13S1830)] and 232kb [del(GJB6-D13S1854)])

81321PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; full sequence analysis

81322PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; known familial variant

81323PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; duplication/deletion variant

81324

PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy withliability to pressure palsies) gene analysis; duplication/deletion analysis

81325PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy withliability to pressure palsies) gene analysis; full sequence analysis

81326PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy withliability to pressure palsies) gene analysis; known familial variant

81479 Unlisted molecular pathology procedure

81500Oncology (ovarian), biochemical assays of two proteins (CA-125 and HE4), utilizing serum,with menopausal status, algorithm reported as a risk score

81503

Oncology (ovarian), biochemical assays of five proteins (CA-125, apolipoprotein A1, beta-2microglobulin, transferrin and pre-albumin), utilizing serum, algorithm reported as a risk score

81506

Endocrinology (type 2 diabetes), biochemical assays of seven analytes (glucose, HbA1c,insulin, hs-CRP, adiponectin, ferritin, interleukin 2-receptor alpha), utilizing serum or plasma,algorithm reporting a risk score

81508Fetal congenital abnormalities, biochemical assays of two proteins (PAPP-A, hCG [anyform]), utilizing maternal serum, algorithm reported as a risk score

81509Fetal congenital abnormalities, biochemical assays of three proteins (PAPP-A, hCG [anyform], DIA), utilizing maternal serum, algorithm reported as a risk score

81510Fetal congenital abnormalities, biochemical assays of three analytes (AFP, uE3, hCG [anyform]), utilizing maternal serum, algorithm reported as a risk score

81511

Fetal congenital abnormalities, biochemical assays of four analytes (AFP, uE3, hCG [anyform], DIA) utilizing maternal serum, algorithm reported as a risk score (may includeadditional results from previous biochemical testing)

81512

Fetal congenital abnormalities, biochemical assays of five analytes (AFP, uE3, total hCG,hyperglycosylated hCG, DIA) utilizing maternal serum, algorithm reported as a risk score

81599 Unlisted multianalyte assay with algorithmic analysis

82777 Galectin-3

86152Cell enumeration using immunologic selection and identification in fluid specimen (eg,circulating tumor cells in blood);

86153

Cell enumeration using immunologic selection and identification in fluid specimen (eg,circulating tumor cells in blood); physician interpretation and report, when required

86711  Antibody; JC (John Cunningham) virus

86828

 Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I and Class II HLA antigens

86829

 Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I or Class II HLA antigens

86830

 Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); antibody identification by qualitative panel using completeHLA phenotypes, HLA Class I

86831

 Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); antibody identification by qualitative panel using completeHLA phenotypes, HLA Class II

86832

 Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); high definition qualitative panel for identification of antibodyspecificities (eg, individual antigen per bead methodology), HLA Class I

86833

 Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); high definition qualitative panel for identification of antibodyspecificities (eg, individual antigen per bead methodology), HLA Class II

86834

 Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class I

86835 Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class II

87631

Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus,influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytialvirus, rhinovirus), multiplex reverse transcription and amplified probe technique, multipletypes or subtypes, 3-5 targets

87632

Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus,influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytialvirus, rhinovirus), multiplex reverse transcription and amplified probe technique, multipletypes or subtypes, 6-11 targets

87633

Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus,influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytialvirus, rhinovirus), multiplex reverse transcription and amplified probe technique, multipletypes or subtypes, 12-25 targets

87910 Infectious agent genotype analysis by nucleic acid (DNA or RNA); cytomegalovirus

87912 Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis B virus

88375 Optical endomicroscopic image(s), interpretation and report, real-time or referred, eachendoscopic session

90653 Influenza vaccine, inactivated, subunit, adjuvanted, for intramuscular use

90672 Influenza virus vaccine, quadrivalent, live, for intranasal use

90685Influenza virus vaccine, quadrivalent, split virus, preservative free, when administered tochildren 6-35 months of age, for intramuscular use

90686Influenza virus vaccine, quadrivalent, split virus, preservative free, when administered toindividuals 3 years of age and older, for intramuscular use

90687 Influenza virus vaccine, quadrivalent, split virus, when administered to children 6-35 monthsof age, for intramuscular use

90688Influenza virus vaccine, quadrivalent, split virus, when administered to individuals 3 years of age and older, for intramuscular use

90739 Hepatitis B vaccine, adult dosage (2 dose schedule), for intramuscular use

90785 Interactive complexity (List separately in addition to the code for primary procedure)

90791 Psychiatric diagnostic evaluation

90792 Psychiatric diagnostic evaluation with medical services

90832 Psychotherapy, 30 minutes with patient and/or family member 

90833

Psychotherapy, 30 minutes with patient and/or family member when performed with anevaluation and management service (List separately in addition to the code for primaryprocedure)

90834 Psychotherapy, 45 minutes with patient and/or family member 

90836

Psychotherapy, 45 minutes with patient and/or family member when performed with anevaluation and management service (List separately in addition to the code for primaryprocedure)

90837 Psychotherapy, 60 minutes with patient and/or family member 

90838

Psychotherapy, 60 minutes with patient and/or family member when performed with anevaluation and management service (List separately in addition to the code for primaryprocedure)

90839 Psychotherapy for crisis; first 60 minutes

90840 Psychotherapy for crisis; each additional 30 minutes (List separately in addition to code for primary service)

90863

Pharmacologic management, including prescription and review of medication, whenperformed with psychotherapy services (List separately in addition to the code for primaryprocedure)

91112Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule,with interpretation and report

92920 Percutaneous transluminal coronary angioplasty; single major coronary artery or branch

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92921Percutaneous transluminal coronary angioplasty; each additional branch of a major coronaryartery (List separately in addition to code for primary procedure)

92924Percutaneous transluminal coronary atherectomy, with coronary angioplasty when performed;single major coronary artery or branch

92925Percutaneous transluminal coronary atherectomy, with coronary angioplasty when performed;each additional branch of a major coronary artery (List separately in addition to code for primary procedure)

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