Errata and Technical Corrections – CPT® 2014 Date: November 26, 2013 The information that follows is sourced to either a publication errata or a technical correction by the CPT Editorial Panel. An errata (denoted as E) for the current edition of the CPT code set will publish information that was approved by the CPT Editorial Panel and inadvertently excluded from the current code set. Technical corrections (denoted as T) are clarifications of original Panel intent for the current code structure. All items below are errata if they are not designated as a technical correction in the right hand column. The order of the entries on this document is by code order. Additionally, each entry shows the date of publication to this document. The links immediately following are provided as a guide to the most recently added items. The effective date for each item is January 1, 2014. Updates to this document are made as issues surface requiring clarification. Users are encouraged to sign up on theCPT listserv to receive email notification as updates are posted to the AMA website. Most recent entries added to Errata and Technical Corrections - CPT® 2014 Revise the “eg” in code 81405 Revise codes 64644, 64645, and 64647 1 CPT is a registered trademark of the American Medical Association Copyright 2012-2013, American Medical Association, all rights reserved Last Updated: 11-26-13 La Errata and Technical Corrections Front Matter Introduction Instructions for Use of the CPT Codebook Date posted to Site Posted 11/11/13 E Throughout the CPT code set the use of terms such as “physician,” “qualified health care professional,” or “individual” is not intended to indicate that other entities may not report the service. In selected instances, specific instructions may define a service as limited to professionals or limited to other entities (eg, hospital or home health agency). Revise the instructions for use of the CPT codebook guidelines to include missing content “define a service as limited to professionals or limited to other entities (eg, hospital or home health agency).” Surgery Musculoskeletal System General Introduction or Removal 20661 Posted 11/21/13 E Application of halo, including removal; cranial CPT Assistant Nov 97:14, Aug 12:14 Revise the CPT Assistant citation for code 20661. Surgery Hemic and Lymphatic Systems General Transplantation and Post-Transplantation Cellular Infusions Hematopoietic cell transplantation (HCT) refers to the infusion of hematopoietic progenitor … HCT may be autologous (when the HPC donor and recipient are the same person) or allogeneic (when the HPC donor and recipient are not the same person). Code 38241 is used to report any autologous transplant while 38240 is used to report an allogeneic transplant. In some cases allogeneic transplants involve more than one donor and cells from each donor are infused sequentially whereby one unit of 38240 is reported for each donor infused. Code 38242 is used to report a donor lymphocyte infusion. Code 38243 is used to report a HPC boost from the original allogeneic HPC donor. A lymphocyte infusion or HPC boost can occur days, months or even years after the initial hematopoietic cell transplant. The lymphocyte infusion is used to treat relapse, infection, or post-transplant lymphoproliferative syndrome. HPC boost represents an infusion of hematopoietic progenitor cells from the original donor that is being used to treat a relapse or post-transplant cytopenia(s). Codes 38240, 38242, and 38243 should not be reported together on the same date of service. Posted 11/11/13 T Effective 10/14/13 If a separately identifiable evaluation and management service is performed on the same date… 38240 38241 # 38243 Hematopoietic progenitor cell (HPC); allogeneic transplantation per donor autologous transplantation HPC boost Revise the transplantation and post-transplantation cellular infusion guidelines by removing the inaccurate statement that HPC boost is used for treatment of relapse, infection, or posttransplant lymphoproliferative syndrome 2 CPT is a registered trademark of the American Medical Association Copyright 2012-2013, American Medical Association, all rights reserved Last Updated: 11-26-13 La Errata and Technical Corrections Date posted to Site Surgery Digestive System Esophagus Endoscopy Posted 11/11/13 E ▲43235 ▲43238 Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s), esophagus (includes endoscopic ultrasound examination limited to the esophagus, stomach or duodenum, and adjacent structures) Revise code 43238 removing reference to the term “esophagus”. Surgery Female Genital System Cervix Uteri Posted 11/11/13 E (For cervicography, use Category III code 0003T) Delete parenthetical note referencing deleted code 0003T. Surgery Nervous System Extracranial Nerves, Peripheral Nerves, and Autonomic Nervous System Destruction by Neurolytic Agent (eg, Chemical, Thermal, Electrical or Radiofrequency), Chemodenervation 64620 Posted Posted 11/21/13 E09/11/12 E Destruction by neurolytic agent, Intercostal nerve (Imaging guidance [fluoroscopy or CT] are inclusive components of 64633-64636) Revise the transposed code included in the parenthetical note following 64620. 3 CPT is a registered trademark of the American Medical Association Copyright 2012-2013, American Medical Association, all rights reserved Last Updated: 11-26-13 La Errata and Technical Corrections Date posted to Site Surgery Nervous System Destruction by Neurolytic Agent (eg, Chemical, Thermal, Electrical or Radiofrequency), Chemodenervation Posted 11/11/13 T Report 64642, 64643, 64644, 64645 once per extremity. Codes 64642, 64643, 64644, 64645 can be reported together up to a combined total of four units of service per patient when all four extremities are injected. Report only one base code (64642 or 64644) per session. Report one or more units of additional extremity code(s) (64643 or 64645) for each additional extremity injected. Report 64646 or 64647 for chemodenervation of muscles of the trunk. Effective 10/14/13 Trunk muscles include the erector spinae and paraspinal muscles, rectus abdominus and obliques. All other somatic muscles are extremity muscles, head muscles, or neck muscles. (For chemodenervation guided by needle electromyography or muscle electrical stimulation, see 95873, 95874. Do not report more than one guidance code for each corresponding chemodenervation of extremity or trunk code) (Do not report modifier 50 in conjunction with 64642, 64643, 64644, 64645, 64646, 64647) 64642 Chemodenervation of one extremity; 1-4 muscle(s) Revise the guidelines preceding code 64642 to limit injections to reporting of one unit for injection of each additional extremity. Surgery Nervous System Destruction by Neurolytic Agent (eg, Chemical, Thermal, Electrical or Radiofrequency), Chemodenervation 64644 64645 64646 64647 Posted 11/26/13 E Chemodenervation of one extremity; 5 or more muscles each additional extremity, 5 or more muscles (List separately in addition to code for primary procedure) Chemodenervation of trunk muscle(s); 1-5 muscle(s) 6 or more muscles Revise codes 64644, 64645 and 64647 by removing the parenthetical included in the term muscles, as the (s) only makes sense in code 64646 as all the others are always plural. 4 CPT is a registered trademark of the American Medical Association Copyright 2012-2013, American Medical Association, all rights reserved Last Updated: 11-26-13 La Errata and Technical Corrections Date posted to Site Pathology and Laboratory Molecular Pathology Tier 2 Molecular Pathology Procedures Posted 11/26/13 E ▲81405 Molecular pathology procedure, Level 6 (eg, analysis of 6-10 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 11-25 exons, regionally targeted cytogenomic array analysis), regionally targeted cytogenomic array analysis ABCD1 (ATP-binding cassette, sub-family D [ALD], member 1) (eg, adrenoleukodystrophy), full gene sequence Revise code 81405 with specification that example of the regionally targeted cytogenomic array analysis is intended to be a part of the “eg” reference within the parentheses. Medicine Cardiovascular Cardiography Posted 11/11/13 E Codes 93040-93042 are appropriate when an order for the test is triggered by an event, the rhythm strip is used to help diagnose the presence or absence of an arrhythmia, and a report is generated. There must be a specific order for an electrocardiogram or rhythm strip followed by a separate, signed, written, and retrievable report. It is not appropriate to use these codes for reviewing the telemetry monitor strips taken from a monitoring system. The need for an electrocardiogram or rhythm strip should be supported by documentation in the patient medical record. (For echocardiography, see 93303-93350) (For electrocardiogram, 64 leads or greater, with graphic presentation and analysis, see 0178T0180T use 93799) 93000 Electrocardiogram, routine ECG… Delete reference to code 93799 from the parenthetical note preceding 93000 and replace with codes 0178T-0180T. 5 CPT is a registered trademark of the American Medical Association Copyright 2012-2013, American Medical Association, all rights reserved Last Updated: 11-26-13 La Errata and Technical Corrections Date posted to Site Medicine Cardiovascular Cardiac Catheterization 93454 Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; 93461 with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) with bypass graft angiography 93462 Left heart catheterization by transseptal puncture through intact septum or by transapical puncture (List separately in addition to code for primary procedure) (Use 93462 in conjunction with 93452, 93453, 93458- 93461, 93653, 93654) (Do not report 93462 in conjunction with 93656) 93463 Pharmacologic agent administration (eg, inhaled nitric oxide, intravenous infusion of nitroprusside, dobutamine, milrinone, or other agent) including assessing hemodynamic measurements before, during, after and repeat pharmacologic agent administration, when performed (List separately in addition to code for primary procedure) (Use 93463 in conjunction with 93451-93453, 93456-93461, 93530, 93531, 93532, 93533, 93563, 93564, 93580, 93581) (Report 93463 only once per catheterization procedure) (Do not report 93463 for pharmacologic agent administration in conjunction with coronary interventional procedure codes 92920-92944, 92975, 92977) Posted 11/11/13 T Effective 10/14/13 Revise the parenthetical cross-reference following code 93463 to include the congenital cardiac catheterization codes 93530-93533 and delete codes 93563, 93564. Category III (0256T has been deleted. To report, see 33361, 33362, 33363, 33364) Posted 11/11/13 E (0257T has been deleted. To report, see 33365, 33366) ►(0258T has been deleted. To report, see 33365, 33366)◄ (0259T has been deleted. To report, see 33365, 33367, 33368, 33369) The deleted parenthetical notes for codes 0256T, 0257T, and 0259T should not be in green text with bowties as they were deleted in 2013. 6 CPT is a registered trademark of the American Medical Association Copyright 2012-2013, American Medical Association, all rights reserved Last Updated: 11-26-13 La Errata and Technical Corrections Date posted to Site Medium Descriptors Posted 11/11/13 E 43238 EGD intrmural US needle aspirate/biopsy esophags 43239 EGD transoral biopsy single/multiple 43240 EGD transoral transmural drainage pseudocyst 43241 EGD intraluminal tube/catheter insertion 43242 EGD intrmural needle aspir/biop altered anatomy 43243 EGD injection sclerosis esophgl/gastric varices 43244 EGD band ligation esophgeal/gastric varices 43245 EGD dilation gastric/duodenal stricture 43246 EGD percutaneous placement gastrostomy tube 43247 EGD flexible foreign body removal 43248 EGD insert guide wire dilator passage esophagus 43249 EGD balloon dilation esophagus <30 mm diam 43250 EGD flex removal lesion hot bx/bipolar cautery 43251 EGD removal tumor polyp/other lesion snare tech 43252 EGD flex transoral w/optical endomicroscopy 43253 EGD US guided transmural injxn/fiducial marker 43254 EGD transoral endoscopic mucosal resection 43255 EGD transoral control bleeding any method 43257 EGD deliver thermal energy sphnctr/cardia GERD 43259 EGD US exam surgical alter stom duodenum/jejunum 43266 EGD endoscopic stent placement w/wire& dilation 43270 EGD ablate tumor polyp/lesion w/dilation& wire Revise codes 43238-43259, 43266, and 43270 to reflect “EGD” not EDG. 7 CPT is a registered trademark of the American Medical Association Copyright 2012-2013, American Medical Association, all rights reserved Last Updated: 11-26-13 La Errata and Technical Corrections Date posted to Site Short Descriptor Posted 11/11/13 E 43752 NASAL/OROGASTRIC W/TUBE PLMT Revise short descriptor for code 43752 to reflect “tube plmt”. Medium Descriptor 60605 Exc carotid body tumor w exc carotid artery Posted 11/19/13 E Revise medium descriptor for code 60605. Medium Descriptor 64645 Chemodenervation 1 extremity ea addl 5/> muscles Posted 11/11/13 E Revise medium descriptor for code 64645 to reflect “5/>”. Medium Descriptor 64821 Sympathectomy radial artery Posted 11/21/13 E Revise medium descriptor for code 64821 to reflect “radial”. Medium Descriptor 75805 Lymphangiography pelvic/abdominal unilat rs&i Posted 11/21/13 E Revise medium descriptor for code 75805. Medium Descriptor 96119 Neuropsyc tstg w/prof I&R admn by tech pr hr Posted 11/11/13 E Revise medium descriptor for code 96119 to reflect “Neuro”. Category II Patient History Medium and Short Descriptor Posted 11/11/13 E 1040F DSM-5 criteria for major depressive disorder documented at the initial evaluation (MDD, MDD 1 ADOL) 1040F Dsm-5 criteria mdd docd at the initial eval 1040F DSM-5 INFO MDD DOCD Revise code descriptor, medium, and short descriptor for code 1040F to reflect “5”. Index Mastoidectomy Posted 11/21/13 E With Skull Base Surgery… 61590, 61591, 61597 Revise transposed code 61591. 8 CPT is a registered trademark of the American Medical Association Copyright 2012-2013, American Medical Association, all rights reserved Last Updated: 11-26-13 La E-mail notifications Sign up to receive e-mail notification when changes are posted to the AMA Web site for CPT Announcements, Category II codes, Category III codes, Vaccine codes, Errata and Panel Agenda Proposals and Subsequent Actions. You may also receive notice when registration opens for the CPT Editorial Panel meeting. 30 CPT is a registered trademark of the American Medical Association Copyright 2012-2013, American Medical Association, all rights reserved
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