Coding Updates for General Surgery

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• Coding Updates for General Surgery

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Coding Updates for General Surgery
Multiple changes in the Current Procedural
Terminology (CPT) coding expected to impose in
2020. Following are the coding updates, which are
applicable to general surgery and similar
specialties for the year 2020. Coding Updates
for General Surgery General Surgery New Graft
Codes The code 20929, Tissue grafts, other (e.g.
fat, dermis, paratenon) has been misvalued,
identified by The American Medical Association
(AMA) Specialty Relative Value Scale (RVS) Update
Committee (RUC). The stakeholder societies find
out that the code 20929 depicted various types of
tissue graft which needed distinctive physician
work. For 2020, code 20926 will be altered by
five new codes (1576915774) in the Integumentary
System, Other Flaps and Grafts subsection. Breast
reduction Addition of new instructional
parentheticals to the direct reporting code
19300, Mastectomy for gynecomastia, breast tissue
removed for breast reduction for gynecomastia and
code 19318, Reduction mammaplasty, breast tissue
removed for breast reduction for other than
gynecomastia.
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Coding Updates for General Surgery
Breast guidelines The Excision and Incision
subheadings will be removed from the CPT
Integumentary System, Breast subsection.
Guidelines, which are earlier to the breast
biopsy codes have been changed widely, in
addition to proper instructions for image-guided
breast biopsy and reporting percutaneous,
reporting percutaneous, and open incisional
breast biopsy. Apart from this, the guidelines
which fall under the Breast, Introduction
subheading have been changed widely in order to
give straight instructions for reporting
percutaneous image-guided placement of breast
localization device(s). Instructions for
recording bilateral procedures correctly have
also been included. Furthermore, a new
introductory text added to the subsection Breast,
Mastectomy Procedures which defines and
distinguishes mastectomy procedures. Nipple- and
skin-sparing mastectomy Justification for coding
nipple- and skin-sparing mastectomy methodologies
was requested by the CPT Assistant Editorial
Board in the year 2017. After reviewing, the
stakeholder specialties find out that the code
19034, Mastectomy, subcutaneous, was misreported
for a mastectomy procedure. Moreover, the
procedure which was included in this code and
should be accurately reported was a nipple- or
skin-sparing technique. As far as subcutaneous
mastectomy is concerned, it is a process of
removing some breast tissues, which was
introduced in the 1960 and it is no longer
standard of care, hence, the code 19304 will be
omitted for the current year.
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Coding Updates for General Surgery
Chest wall procedures Stakeholder specialties
noticed that codes 19260, 19271, and 19272 that
define radical resection of a chest wall tumor
involving and/or including rib(s), were misplaced
in the Integumentary System, Breast subsection.
Therefore, these codes were numbered again as
2160121603 and moved to the Musculoskeletal
System, Neck (Soft Tissues), and Thorax
subsection. Cryoablation of malignant breast
tumors Cryoablation of malignant breast tumor(s)
will now be reported with a new code, 0581T,
Ablation, percutaneous, malignant breast
tumor(s), including imaging guidance when
executed unilaterally. Physicians should continue
to report cryoablation of fibroadenomas with
code 19105, Ablation, cryosurgical, of
fibroadenoma, including ultrasound guidance, each
fibroadenoma. The code 0581T contains any
imaging modality for guidance, on the other hand,
code 19105 only contains ultrasound guidance.
Additionally, code 0581T can be reported only one
time per breast treated no matter how many tumors
are ablated, on the other hand, code 19105 should
be reported for each fibroadenoma ablated.
Coverage policy and CPT Category III code
eligibility for payment is taken care of by the
separate third-party payer. Physicians should
with their local third-party payers for certain
reimbursement policies.
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Coding Updates for General Surgery
General Surgery Deletion of rarely used or
outmoded procedure codes Every year the AMA CPT
Editorial Panel segregates the code set for
codes, which are hardly or never utilized.
Manufacturers and stakeholder societies are
capable to give an explanation for maintaining
the code. Code 43401, Transection of esophagus
with repair, for esophageal varices, will be
eliminated for CPT 2020 because it is currently
not a standard practice. Apart from this, code
0377T, Anoscopy with directed submucosal
injection of bulking agent for fecal incontinence
is also deleted for CPT 2020, as no party has
shown an interest in keeping it.
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