AANEM News Express

AANEM News Express

2015 CPT Code Changes Impacting NM and EDX Medicine

1/27/2015
 
This fall the American Medical Association (AMA) released the 2015 CPT code changes that went into effect January 1, 2015. There were some minor changes relevant to electrodiagnostic and neuromuscular medicine. AANEM’s 2015 Online Coding Guide (available for purchase here) has been updated to reflect these changes, additional coding tips, and frequently asked questions.
  • Urodynamics: The AMA/Specialty Society RVS Update Committee (RUC) identified codes 51784 and 51792 as being reported together 75% or more of the time. It was determined that these codes should NOT be reported together, and an exclusionary parenthetical note was added to clarify this.
  • Introduction/Injection of Anesthetic Agent: Parenthetical notes have been added and revised within the paravertebral spinal nerve injection codes (64490-64495) to clarify the intended use for these codes.
  • Chemodenervation: The destruction of neurolytic agent guidelines have been revised to instruct users to report one unit for injection of each additional extremity.
  • Electromyography: Revisions to the 95887 (Needle electromyography, non-extremity) guidelines clarify that this code is intended to be reported once per anatomic site, identifying a list of the various anatomic sites. The guidelines also instructs that 95887 can be used to report for a unilateral study of the cranial nerve innervated muscles and may be reported twice if performed bilaterally. The guidelines further explain that when a study of the cervical paraspinal muscle(s), or the lumbar paraspinal muscle(s) is performed with no corresponding limb study (95885 or 95886) on the same day, it is appropriate to report code 95887. Parenthetical notes were added after code 95887 directing users to the appropriate codes for various other electromyography procedures.
In addition to these CPT updates, CMS announced four new HCPCS modifiers, effective January 1, 2015, that are designed to be more descriptive subsets of modifier -59 (Distinct Procedural Service):
  • XE:  Separate Encounter: a service that is distinct because it occurred during a separate encounter.
  • XS:  Separate Structure: a service that is distinct because it was performed on a separate organ/structure.
  • XP:  Separate Practitioner: a service that is distinct because it was performed by a different practitioner.
  • XU:  Unusual Non-Overlapping: the use of a service that is distinct because it does not overlap usual components of the main service
These modifiers may be selectively required instead of modifier -59 when billing for Medicare patients, although CMS will still recognize -59 in many instances. Private payers will continue to utilize the -59 modifier.
 
In the Marketplace: 2015 Coding Guide


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