2010 CPT® for CdilCardiology

2010 CPT? Updates

f Cardiology

for

C di l

Presented by:

Betty Johnson, CPC, CPC\I, CPC\H,

CDERC, CCS\P, PCS, CCP, RMC, CIC

CMS

THE RUC PROCESS

? The RUC, Specialty Society Relative Value Scale Update

Committee, is an independent group that makes

recommendations to CMS

? It is an expert panel comprised of 29 members

? Is supported by an Advisory Committee of 100 specialty

societies and health care professional organizations

? CMS has adopted 95% of its work value recommendations

BJ&A 2009. ALL RIGHTS RESERVED.

2

CMS

? In 2006 the Medicare Payment Advisory Commission

(MedPAC) sited concerns over the RUC

RUCss ability to identify

overvalued services, so a Five\Year Review Identification

Workgroup was created (the Workgroup). In 2008 it was

approved for the Workgroup to conduct reviews on an

ongoing basis.

? The Workgroup and CMS have identified over 600 services to

date

BJ&A 2009. ALL RIGHTS RESERVED.

3

CMS

? The screens that have been used to date are:

Site of Service Anomalies

High Volume Growth

CMS Fastest Growing Procedures

High IWPUT

Services Surveyed by One Specialty and Now Performed by a Different

Specialty

C Harvard Valued

C Codes Inherently Performed Together

C

C

C

C

C

BJ&A 2009. ALL RIGHTS RESERVED.

4

CMS

? Out of the more than 600 services identified by the

Workgroup, 413 codes have completed the review process.

C

C

C

C

C

Work and PE Maintained C 130

Work Increased C 29

Work Decreased C 125

Direct Practice Expense Reviewed C 105

Deleted from CPT \ 24

BJ&A 2009. ALL RIGHTS RESERVED.

5

CPT C THE MANUAL

RENUMBER OR RESEQUENCE?

? Terminology v.

v Numbers

? Traditionally when new codes were added within a grouping,

if there was not room in the sequence, the existing codes

were deleted, renumbered, and added to a section including

the new services

? Labor intensive on many fronts (encounter forms, claims

software, etc.) & running out of numbers

BJ&A 2010. ALL RIGHTS

RESERVED.

6

CPT C THE MANUAL

? New concept of resequencing

? Terminology\based instead of numerically based

? Less affect in electronic format

page

g 110

? Look at p

? Appendix N (p 585 of CPT? Professional Edition)

BJ&A 2010. ALL RIGHTS

RESERVED.

7

CPT MANUAL

? Anatomy templates moved to corresponding section of CPT

for ease of use

? Table of contents at the beginning of each section: not as

replacement for alphabetic index, but as an addition

? NO modifier additions or deletions

BJ&A 2009. ALL RIGHTS RESERVED.

8

CPT\THORACIC

INTRODUCTION AND REMOVAL C P156

32552 Removal of indwelling tunneled pleural catheter

with cuff

?32553 Placement of interstitial device(s) for radiation

therapy guidance (eg, fiducial markers, dosimeter),

percutaneous, intra-thoracic, single or multiple

BJ&A 2009. ALL RIGHTS RESERVED.

9

CPT\THORACIC

? Tunneled pleural catheters used to be placed primarily for

malignant pleural effusions at the end of a patient

patientss life. Use

has been expanded and the catheter is used for many other

reasons now. Removing the catheter following resolution of

the pleural effusion improves quality of life for the patient by

removing the possibility of infection.

? Code 32550 does not include payment for the incisions and

dissection required to remove the device , therefore the new

code 32552 was created.

BJ&A 2009. ALL RIGHTS RESERVED.

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