Orthopedic Billing Specialist to Take Care of CPT Code Changes Made to Orthopedic Surgery Billing in 2013

This year’s CPT Manual has spelt out extensive coding changes and revisions to orthopedic surgical codes.  In all, there are 500 code changes to the Category I codes, including 251 revisions, 151 new codes and 100 deletions. Moreover, there has been significant overhauling of nerve conduction studies, some revisions to the radiology section, and E/M changes. The extent of these coding changes and revisions, having already taken effect from January 1, 2013, has begun to impact orthopedic reimbursements in a big way. As a result, orthopedic practices may have inherited an ominous task of migrating to   a higher order in orthopedic surgical coding. Given the CPT Manual’s full list of revisions, deletions, and additions to have been effected for 2013, orthopedic practices would require to be conversant with the guidelines for the following coding sections:

  • Spine CPT Errata, whereinchange has been added to the spine bone grafts (20930–20938), instrumentation (22840–22844, 22848, 22845–22847), and intervertebral device (22851) CPT codes.
  • Bone marrow aspirate, wherein explanation has been added to bone graft codes (20930–20938) related to bone marrow aspiration. Henceforth, Category III code 0232T should be used when bone marrow aspiration is performed for platelet-rich stem cell.
  • Cervical Spinal Arthrodesis, which is now required to be coded as per the new guidelines issued to CPT codes 22554, 22585, 63075, and 63076
  • Cast application, which now includesguideline changes made to “Application and Strapping” section addressing the application of the first cast, its removal, coding by the individual who performs the initial service, and restorative management.
  • Hip arthroscopy, under whichCPT code 29916 (Arthroscopic labral repair of a torn labrum) is now considered inherent to CPT codes 29915, 29862, and 29863.
  • Chemodenervation, in which a new guideline change is introduced for CPT code 64614 used in  Chemodenervation of muscle(s); extremity and/or trunk muscle(s)
  • Intraoperative nerve monitoring is now included in the primary surgical service and is not separately reportable.
  • New CPT codes applicable to procedures for spine, shoulder arthroplasty, elbow arthroplasty, nerve conduction, extracorporeal shock wave: wound healing, etc.

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While these are some of the notable changes and guidelines to have been effected for orthopedic surgical coding since the beginning of 2013, orthopedic practices may need to follow these action steps to be fully compliant with the changes and revisions:

  • Analyze the 2013 CPT Manual in its entirety to understand the guideline changes found throughout it. Specifically focus on the E&M changes and new codes that may have applicability to your practice.
  • Revise charge capture tools, electronic health record (EHR) lists and short lists or favorites, if charge capture is performed within the EHR.
  • Enroll with an accredited orthopedic surgical coding course.

Medicalbillersandcoders.com – which has always stood by the physician community during times of medical billing and coding crisis – has arranged for networking with the right resources (orthopedic coding specialists) to maneuver through this major surgical orthopedic coding changes and revisions. The competence and experience of our select pool of surgical Orthopedic Billing specialists should help you minimize the impact of this coding change and revision while ensuring appreciable increase in orthopedic reimbursements.

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