As new and more effective treatment options are created and evaluated, AMA must update the CPT® Manual to add and revise codes that allow providers to accurately report the work they performed. The 2015 updates include more than 500 changes, including more than 250 new codes that impact nearly every section. In the 2015 CPT Manual, only the integumentary and respiratory system sections remain unchanged.
Because CMS has not created any national ED E/M guidelines, providers must create their own criteria for each visit level. CMS has developed a list of 11 criteria that it uses when auditing facility E/M criteria.
Consider this scenario: A physician orders three hours of hydration as well as a one-hour therapeutic antibiotic infusion for a patient. A nurse documents the hydration start time as 10 a.m. and the antibiotic start time as 11 a.m. Neither provider documents a stop time. What should coders report?
While many of the code changes in the 2014 CPT® Manual surgical sections involve bundling together common procedures, the major changes in the Radiology and Laboratory sections involve updates for newly recognized technologies and drugs.
As CMS pushes the OPPS from a fee-for-service program toward more of a true prospective payment system, financial impact analysis of changes, departmental budgeting, and forecasting has become more complicated each year.
In total, the AMA added 60 new codes throughout the surgery section of the 2012 CPT® Manual , 18 of which appear in the cardiovascular and respiratory system subsections. The AMA also revised 86 codes and deleted 48 codes in the surgery section.
In November 2011, the FDA approved transcatheter aortic valve replacement (TAVR) to treat aortic valve stenosis for those patients who are not candidates for traditional open-heart surgery. This procedure is also referred to as a transcatheter aortic valve implantation (TAVI).
