2006 CPT codes - 4 of 7

The medicine section of CPT has numerous additions in 2006.

The 2006 American Medical Association (AMA) Current Procedural Terminology (CPT) code set includes a number of important changes for audiologists and speech-language pathologists. These additions and revisions are the culmination of two years of work by the ASHA Health Care Economics Committee and ASHA's advisors to the AMA CPT Editorial Panel

The new codes created a need for revision of the descriptors of two long-standing codes: 92506 and 92507. Reference to aural rehabilitation in both of those procedures is  Deleted  for 2006.

CPT code 92506 will read: "Evaluation of speech, language, voice, communication, and/or auditory processing.

CPT code 92507 will read: "Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual" will be the new 

Another audiology code was revised for 2006. Audiologists had reported problems with 92568, "Acoustic reflex testing," and 92569, "Acoustic reflex decay." Third party payers denied reimbursement for 92569 stating that is was bundled in 92568. The payers were not persuaded that they were incorrect when contacted by the audiologists or ASHA.

The 2006 CPT should resolve the payers' misinterpretation because of the new and more specific descriptor for 92568, "Acoustic reflex testing; threshold."

There is a change of note for speech-language pathologists who evaluate and treat patients with voice disorders. CPT 92520 will more specifically describe what is involved with laryngeal function studies.

The descriptor for 2006 will read "Laryngeal function studies (i.e., aerodynamic testing and acoustic testing)." Please note the "i.e." is not an "e.g." so that 92520 is restricted to reporting either aerodynamic testing or acoustic testing.

CPT 92506 will read, "Evaluation of speech, language, voice, communication, and/or auditory processing. "Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual" will be the new 92507.

Medicine - Respiratory Therapists (989xx - 

New codes in the patient education area may be useful for respiratory therapists providing patient education. 

Education and Training for Patient Self-Management - Respiratory therapy

"The purpose of these codes is to teach self-management of a patient's illness or disease, or delay disease comorbidity."

The curriculum used in patient education must be recognized by a physician society or by a non-physician healthcare professional society/association, such as the AARC.

Moderate (Conscious) Sedation Codes

Conscious Sedation Codes have been Replaced with six new codes. In 2006 it is now referred to as "Moderate Sedation."

The following are included with Conscious Sedation:

1. Patient assessment

2. IV Access

3. Admin of medication

4. Maintenance of sedation

5. Monitoring of Oxygen saturation, heart rate and BP.

6. Recovery 

Be sure to locate the Moderate Sedation Guidelines and highlight these items. The coder needs to highlight and understand what "intraservice time" means. This is especially important for those planning to take a certification. There is usually at least one question on the exam on "intraservice time" most typically, anesthesia services.

The old codes, 99141 and 99142 are deleted, and we now have six codes organized by provider and age.

Note: Some of the old Infusion CPT codes correspond to more than one G-code. Also, there are codes that will allow physicians to bill for services that previously did not have a code or were bundled into other services. 

Infusions

Infusions that were previously reported under CPT code 90780 (non-chemotherapy infusion, 1st hour) will be billed under one of three G-codes. The first hour of a hydration infusion will be billed under G0345. The first hour of infusion of a non-chemotherapy drug other than hydration will be billed under G0347.

The first hour of infusion of anti-neoplastic agents provided for treatment of non-cancer diagnoses or substances such as monoclonal antibody agents and other biologic response modifiers will be billed under G0359.

A monoclonal antibody is any of a class of antibodies produced in the laboratory by identical offspring of a hybridoma -- a cell hybrid in which a tumor cell forms one of the original source cells.

Monoclonal_Antibodies Link

List of therapeutic monoclonal antibodies

Empire Carrier Policy on monoclonal antibodies

The AMA has a downloadable file of the new and revised 2006 CPT codes, which go into effect January 1, 2006 available for purchase at https://catalog.ama-assn.org

feeschedule2006.htm

2006_CPT_codes.html

In 2003, the AMA's reimbursement committee determined that it was unable to assign professional work values to the current testing codes because they do not distinguish aspects of the service performed by a professional from those performed by a technician or computer. In response, the APA Practice Organization successfully sought the 2006 testing and assessment codes, which make such a distinction.

Psychological Testing. Code 96100 will be DELETED and replaced by three new codes.

Code 96115 has been replaced by one code below:

Under the new codes effective in 2006, psychologists will continue to bill for the entire testing and assessment service, including when a technician or computer has administered the test. Any professional work value presumably would capture the extent of the professional's direct involvement (i.e., whether the psychologist actually administers the test or just provides the interpretation and report).

Medicine Special Services

 Vaccines

 
Vaccines

Duodenal motility (manometric) study 91022
This procedure describes the placement of a motility probe into the duodenum with its tip distal to the ligament of Treitz. Motility changes are then measured in both fasting and fed states, and with and without prokinetic agents. 

This code is distinct from the existing CPT code 91020 describing gastric motility. Use 43235 if an endoscopy is performed for tube placement, and if fluoroscopy is performed, 76000 should also be coded.

Medicine Special Services

 Test 4

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