2016 CPT Changes
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The document summarizes many of the changes to CPT and HCPCS codes for 2016, including additions of new codes for prolonged clinical staff services, esophagogastroduodenoscopy, biliary drainage procedures, nephrostomy procedures, paravertebral nerve blocks, and reflectance confocal microscopy imaging. It also notes deletions of codes in the urinary, vaccine, and drug categories and provides links for full lists of lab, drug, and PQRS code changes.
![Advanced Billing Consultants, Inc.
There are many changes to drug codes (Q and J). Complete
list can be found at: CMS Level II HCPCS Coding Decisions
for the 2015-2016 Coding Cycle [ZIP, 43KB]
Deleted: J7302
New:
J7297: Levonorgestrel-releasing intrauterine contraceptive
system, 52 mg, 3 year duration
J7298; 5 year duration
J1575: Injection, immune globulin/hyaluronidase, 100 mg
immunoglobulin
J0695: Injection, ceftolozane 50 mg and tazobactam 25 mg
Drug Codes](https://image.slidesharecdn.com/2016-cpt-changes-160218190207/85/2016-CPT-Changes-11-320.jpg)
2016 CPT Changes
- 1. January 1, 2016 2016 CPT Changes
- 2. Advanced Billing Consultants, Inc. This presentation was designed with the clients of Advanced Billing Consultants in mind. It is not all inclusive. Please refer to CPT and AMA for a complete listing of all deletions, additions, and revisions to the code sets. Disclaimer
- 3. Advanced Billing Consultants, Inc. New: 99415, 99416: prolonged clinical staff service direct pt contact w/ phys supervision; beyond 45 mins, plus each additional 30 mins (not counting the services done like PT/INR, ect.) E/M changes
- 4. Advanced Billing Consultants, Inc. New: 43210: Trans-oral approach for Esophagogastroduodenoscopy 47537: injection procedure for cholangiography, percutaneous through an existing access site 47532: same as 47537 but new access 47534: placement of biliary drainage catheter 47535: conversion of external biliary drainage catheter to internal-external biliary drainage catheter 47536: exchange of biliary drainage catheter 47537: removal of biliary drainage catheter 47538, 47539, 47540: placement of stent into a bile duct 47541: placement of access through the biliary tree to assist with an endoscopic biliary procedure 47542: balloon dilation of biliary ducts to allow for passage of stones (add on code) 47543: endoluminal biopsy of biliary tree (add on) 47544: removal of calculi/debris from biliary ducts or gallbladder, any method (add on code) 49185: sclerotherapy of a fluid collections, percutaneous Digestive System
- 5. Advanced Billing Consultants, Inc. Deleted: 50392, 50393, 50394, 50398 New 50430 injection procedure for antegrade nephrostogram and or ureterogram, new access 50431; existing access 50432: placement of nephrostomy catheter, percutaneous 50433; new access 50434: Convert nephrostomy catheter to nephroureteral catheter 50435: Exchange nephrostomy 50606: Endoluminal biopsy of ureter non-endoscopic (add on) 50693: placement of ureteral stent, percutaneous; pre-existing nephrostomy tract 50694; new acces, w/o separate nephrostomy catheter 50695; new acces, with separate nephrostomy catheter 50705: ureteral occlusion (add on) 50706: balloon dilation, ureteral stricture (add on) 54437: repair of traumatic corporeal tear (penis fracture) 54438: replantation, penis Urinary System
- 6. Advanced Billing Consultants, Inc. Deleted: 64412-64999 New: 64461: paravertebral block, thoracic 64462; second and any additional injection sites (add on) 64463; continuous infusion by catheter Nervous System
- 7. Advanced Billing Consultants, Inc. New 69209: removal impacted cerumen using irrigation/lavage, unilateral (when no instrument used- use 69210 if instrument is used.) Mod 50 allowed Auditory System
- 8. Advanced Billing Consultants, Inc. There are many changes to Lab codes, for complete list see: https://www.cms.gov/Medicare/Medicare-Fee-for-Service- Payment/ClinicalLabFeeSched/Downloads/CLFS-CY2016- Preliminary-Payment-Determinations.pdf Deleted: G0431, G0434 New G0477-G0483: drug screens Lab Codes
- 9. Advanced Billing Consultants, Inc. Deleted: 13 outdated vaccine codes New: 90625: cholera vaccine 90697: (DTap-IPV-Hib-HepB) 90620: Men B 2 dose 90621: MenB 3 dose Medicine: Vaccines
- 10. Advanced Billing Consultants, Inc. Deleted: 95973 (95972 revised to remove time element) New: 93050: arterial pressure waveform analysis (replaced 0311T) 96931-96936: reflectance confocal microscopy imaging of skin (RCM) Cardiovascular and Pulmonary
- 11. Advanced Billing Consultants, Inc. There are many changes to drug codes (Q and J). Complete list can be found at: CMS Level II HCPCS Coding Decisions for the 2015-2016 Coding Cycle [ZIP, 43KB] Deleted: J7302 New: J7297: Levonorgestrel-releasing intrauterine contraceptive system, 52 mg, 3 year duration J7298; 5 year duration J1575: Injection, immune globulin/hyaluronidase, 100 mg immunoglobulin J0695: Injection, ceftolozane 50 mg and tazobactam 25 mg Drug Codes
- 12. Advanced Billing Consultants, Inc. There are a lot of new PQRS reporting codes. The complete list can be found at: 2016 PQRS Measures List Reporting Codes (G-codes)
- 13. Advanced Billing Consultants, Inc. New 0381T: external heart rate recordings 0385T/0386T: more external heart rate recordings 0387T-0391T: permanent leadless pacemaker Category III codes
- 14. Advanced Billing Consultants, Inc. 30021 Tomas, Suite 250 Rancho Santa Margarita, CA 92688 Phone: 888-222-2125 Fax: 949-713-2931 info@advancedbillingconsultants.com