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2019

What CPT code replaced 10022?

 
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By:Jacqueline Thelian, CPC, CPC-I, CHCA

CPT code 10022 Fine needle aspiration; with imaging guidance was replaced in 2019 with the following range of CPT codes 10005-10012.

CPT 2019 includes a new subsection of CPT codes for Fine Needle Aspiration (FNA) Biopsy as these codes now include imaging guidance as part of the procedure. The subsection includes the following codes, including the nine new codes, all of which are reported by type of imaging modality and per lesion.  

  • 10021 Fine needle aspiration biopsy, without imaging guidance; first lesion (not a new code)

  • +10004 each additional lesion (List separately in addition to code for primary procedure)

  • 10005 Fine needle aspiration biopsy, including ultrasound guidance; first lesion

  • +10006 each additional lesion (List separately in addition to code for primary procedure)

  • 10007 Fine needle aspiration biopsy, including fluoroscopic guidance; first lesion

  • +10008 each additional lesion (List separately in addition to code for primary procedure)

  • 10009 Fine needle aspiration biopsy, including CT guidance; first lesion

  • +10010 each additional lesion (List separately in addition to code for primary procedure)

  • 10011 Fine needle aspiration biopsy, including MR guidance; first lesion

  • +10012 each additional lesion (List separately in addition to code for primary procedure)

When more than one FNA biopsy is performed on separate lesions at the same session, same day, same imaging modality, use the appropriate imaging modality add on code for the second and any subsequent lesions. For example: 

10005 Fine needle aspiration biopsy, including ultrasound guidance; first lesion

+10006 each additional lesion (List separately in addition to code for primary procedure)

When FNA biopsies are performed on separate lesions, same session, same day, using different imaging modalities 

Report the corresponding primary code with modifier 59 for each additional imaging modality and the  corresponding add on codes for subsequent lesions sampled. Regardless  if the lesions are ipsilateral or contralateral to each other, and/or whether they are in the same or different organ/structures. For example:

10007 Fine needle aspiration biopsy, including fluoroscopic guidance; first lesion

10005 -59 Fine needle aspiration biopsy, including ultrasound guidance; first lesion

+10006 each additional lesion (List separately in addition to code for primary procedure)

In this example three lesions are biopsied, one by fluoroscopy and two by ultrasound. Modifier 59 is appended to the second fine needle aspiration code (10005)  by ultrasound and  CPT code 10006 is reported to capture the second fine needle aspiration  by ultrasound.


 Source:

  • 2019 Current Procedural Terminology (CPT) 

Do I Still Need Progress Reports?

 
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By:Jacqueline Thelian, CPC, CPC-I, CHCA

As per the Centers for Medicare and Medicaid Services (CMS) effective for dates of service on and after January 1, 2019 the reporting of HCPCS G Codes for Functional reporting and the severity modifiers are no longer required. 

This change had no impact on the requirement to document Progress Reports.  The CMS Local Coverage Determinations (LCD) state “Progress reports shall be written by a clinician at least once every 10 treatment days. A progress report is not a separately billable service.” 

It is important to keep in mind progress reports are oftentimes the  key document in physical therapy audits to provide the medical necessity for the services rendered. 

For further information  please go to the following CMS sites:  CMS All Fee For Services Providers Page https://www.cms.gov/Center/Provider-Type/all-fee-for-service-providers-center.html


The Clock is Ticking for Quality Payment Program (QPP) Data Submission

 
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By:Jacqueline Thelian, CPC, CPC-I, CHCA

It’s that time again. The QPP data submission site is open now until April 2, 2019, 8pm.

If you are part of an Accountable Care Organization (ACO) or Alternative Payment Model (APM) who will submit quality measures on your behalf remember you are most likely  responsible to report your Promoting Interoperability.  It is advised to check with you ACO/APM, many of which encourage the providers/group to report this on their own.

For an eligible clinicians or groups reporting on their own or to report their Promoting Interoperability, go to the QPP Data Submission System https://qpp.cms.gov/login and you can login using either your Enterprise Identity Management (EIDM) credentials or the new HCQIS Authorization Roles and Profile (HARP).

It is recommended you sign in during the submission period which will allow you to review the entered data before the final submission.

If you are an EC reporting via administrative claims, your reporting was included in all your claims.


 Source:

Home Visits, Now on Cruise Ships and Campgrounds!

 
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By:Jacqueline Thelian, CPC, CPC-I, CHCA

(99347 – 99350)

Yes, it is true CMS  updated the definition of home to include, temporary lodging and short term accommodations. The change includes places such as, hotels, hostels, campgrounds, and cruise ships.

Other changes to the home visit include:

  • Only requiring documentation of an interval history since the previous visit

  • Eliminating requirements to re-document information from practice staff or patient

  • Removing the need to justify home visits in place of office visits