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- One Year Out—What Do Anesthesiologists Need to Know About ICD-10-CM Conversion?
- One Year Out—What Do Anesthesiologists Need to Know About ICD-10-CM Conversion?
- Anesthesia Practices Prepare for the Health Insurance Exchanges
- Will the Medicare Physician Value-Based Payment Modifier Affect Your Anesthesia Group?
- Before the Shoe Drops: Anesthesiologists Can Help Hospitals Prevent Certain Hospital-Acquired Infections
- What Anesthesiologists Should Know About Third Party Payer Performance
- CERT Errors of Interest to Anesthesiologists and Pain Medicine Providers: Will the New A/B Contractor CERT Task Force Make a Difference?
- Will Medicare Publish Information on Payments to Anesthesiologists and Other Physicians?
- Legislative Replacement for SGR is on the Horizon for Anesthesiologists and other Physicians
- Drug Manufacturers' Payments to Anesthesiologists are Now Reportable Under the Sunshine Act
- Revisiting Readmissions as a Quality Metric for Hospitals and Anesthesiologists
- Will the Health Insurance Exchanges Mean More Patients for Anesthesiologists?
- New PQRS Reporting Requirements in the Proposed 2014 Medicare Fee Schedule Rule—Limited Impact on Anesthesia
- Looking at Bundled Payments from an Anesthesiology Perspective
- Preventable Hospital Readmissions—Opportunities for Anesthesiologists
- Do the Payers Understand Nerve Blocks for Post-Anesthesia Pain?
- Lessons from Bundled Payment Initiatives for Anesthesiologists
- Anesthesia Group Communications and the Attorney-Client Privilege
- Update on the SGR for Anesthesiologists and Pain Physicians
- Is Your Hospital Ripe for a Merger or Acquisition? What Anesthesiologists Need to Know Now
- When is an Anesthesiologist “Immediately Available?”
- Anesthesiologist Compensation
- Insights for Anesthesiologists: Participating in Hospitals’ New Strategies
- Anesthesiologists and Pain Physicians: Make Sure You are Enrolled in PECOS Now
- Hospitals May Pay for Anesthesia and Pain Medicine EHRs without Violating the Self-Referral or Anti-Kickback Laws
- Proposed “Medical Necessity” Restrictions on Post-Anesthesia Pain Blocks
- PQRS, the Value-Based Payment Modifier and Large Anesthesia Groups
- PQRS Refresher for Anesthesiologists, CRNAs and Pain Physicians
- ACOs, Antitrust and Anesthesiologists
- New Ways for Anesthesiologists to Add Value to the Management of their O.R.s
- Do ACOs Matter to Anesthesiologists and Pain Physicians Yet?
- How Safe Are Anesthesia Practices From a RAC Attack?
- The Sun Shines on Payments from Drug Companies to Anesthesiologists and other Physicians
- What Anesthesiologists and Pain Physicians Should Know about Health Insurance Exchanges
- The Company Model Presents Risks for Anesthesiologists and for ASCs
- Update Your Anesthesia Compliance Program: The Final HIPAA Privacy, Security and Breach Notification Rules Are Here
- Medicare Locality Conversion Factors for Anesthesia Services Through 2013
- 2013 CPT Coding Changes Pain Management and Anesthesia
- What Anesthesiologists Should Know About Health Insurance Exchanges
- Rental Networks, Claims Repricers and Anesthesia Practices
- Anesthesia Managed Care Contract Rates
- Giving Thanks for Anesthesiologists
- The Fiscal Cliff and What it Means to Anesthesiologists
- Final Fee Schedule Rule for 2013 Cuts Conversion Factors, Allows Payment to Nurse Anesthetists for Chronic Pain Services
- Anesthesiologists and Payment for Acute Pain Services
- Sedation by Non-Anesthesia Providers
- The SGR and Anesthesiology — It’s That Time of Year Again
- Anesthesia Business Consultants to Aid Anesthesiologists in Securing the Benefits of Meaningful Use through Complete EHR with F1RSTUse
- Compensating Anesthesiologists for Attending Group Meetings
- The OIG Targets “Personally Performed” Anesthesiologist Services
- A Warning for Anesthesiologists and Pain Physicians about Increased Billings through Better Technology
- Value-Based Purchasing for Hospitals Starts Now—and for Anesthesiologists, in 2015
- Anesthesiologists’ Role in Helping Surgery Centers Meet Their Quality Reporting Requirements
- Protect the Privacy and Security of Your Anesthesia Patients’ Electronic HIPAA Information
- New Hardship Exception for Anesthesiologists to Avoid the EHR Penalty
- Effective Hospital-Anesthesia Group Contracting: Understanding the Relationships Between Finance, Operations and Compliance
- When Negotiations with Carriers Force Anesthesiologists to Go Out of Network
- Anesthesiologists’ Investments in ASCs
- Proposed Changes for Anesthesiologists and Pain Physicians Who Report Measures to the PQRS
- Payment and Quality Changes Affecting Anesthesiologists in the 2013 Proposed Fee Schedule Rule
- What Anesthesia Practices Should Do With Unclaimed Funds Belonging to Patients
- After the Supreme Court Decision: Anesthesiologists Must Proceed With a Perioperative Care Model
- What Does Medicare’s 3-Day Payment Rule Mean for Anesthesia and Pain Practices?
- Tips for Anesthesia Practices to Get the Surgeons to the OR on Time
- OIG to Anesthesia Practices: Think Again Before You Pay Your ASC for the “Franchise”
- Latest Government Fraud Reports and How They Affect Anesthesiologists and Pain Physicians
- As an Anesthesiologist, What Should I Do About Meaningful Use if I am a Medicaid Provider?
- Collecting Payments from Anesthesia and Pain Medicine Patients
- Anesthesiology Plays a Role in Coordinating Management of Knee Replacement Patients, Contributing to Better Outcomes
- What the Proposed 60-Day Overpayment Refund Rule Means for Anesthesia Practices
- A New Quality Tool for Anesthesia Departments
- Managing Compensation for Anesthesiologists, CRNAs and AAs
- Medicare ACOs Are Blooming (With or Without Anesthesiologists)
- The Affordable Care Act, the Supreme Court and Anesthesiologists – Just the Facts, Please
- ICD-10 Delay Will Benefit Anesthesia and Pain Medicine Practices
- Medicare Updates of Interest to Anesthesiologists and Pain Physicians
- Practice Management Companies’ Acquisitions of Anesthesia Practices
- What Anesthesiologists Should Know about Medicare Prepayment Reviews
- Performance Based Compensation: Benchmarking, Monitoring and Improving Quality
- Performance-Based Compensation in Contracts between Hospitals and Anesthesia Groups: Measures
- Demystifying “Meaningful Use” for Anesthesiologists
- The Anesthesia Conversion Factor and the Medicare Fee Schedule, 20 Years Later
- Postoperative Pain Management Procedures Can Still Be Reported Separately from the Anesthesia Service
- Hospital Value-Based Purchasing Program: An Introduction for Anesthesiologists
- 2011 Medicare Rates for Anesthesia and Other Services Extended Through February
- Texas Statute Requires Anesthesia Informed Consent
- Results of Survey Regarding a Network of Anesthesia Practices
- PQRS 2012 for Anesthesiologists and Pain Specialists
- Anesthesia and the Version 5010 Standard
- How Will the Affordable Care Act Affect Anesthesiologists After the Supreme Court Rules?
- Information Technology, Patient Safety and Anesthesia Practice
- Be Careful With What You Say About One Another
- Do the Finalized ACO Regulations Help Anesthesiologists?
- A Major Change to the Perioperative/Anesthesia IT Integration Landscape
- 1 Anesthesia Group + 1 Anesthesia Group > 2 Anesthesia Groups
- Federal Budget Proposals and Medicare Payments for Anesthesia Services
- E-Prescribing by Anesthesiologists and Pain Physicians: Web Portal to Request Exemption is Up and Running
- HIPAA Privacy Rule Update for Anesthesiologists
- Electronic Prescribing: Anesthesiologists Will Soon Be Able to Request Their Exemptions
- The Medicare Bundled Payment Iniative and Anesthesia Services
- Anesthesia Providers: Plan to Revalidate Your Medicare Enrollment When Your Carrier Asks
- Medicare’s eRx and EHR Incentive Programs – Clearing Up the Confusion for Anesthesiologists
- Anesthesia and Social Media
- A Manual for all Anesthesiologists
- The IPAB Threat to Anesthesiologists and All Other Physicians
- Anesthesiology and the Proposed Rule for the 2012 Medicare Fee Schedule
- When is an Anesthesiologist's Signature Good Enough for Medicare?
- Health Plans Tighten the Belt – Around Anesthesiologists’ and Others’ Midsections
- Information from ASA on (1) Joint Commission Requirements and (2) Anesthesia Information Management
- Most Anesthesiologists Will Be Exempt from Medicare Electronic Prescribing Penalties ">
- Anesthesiologists' and CRNAs' Error Rates in Reporting PQRS Measures
- More Facet Joint Injection Pain
- Developing Leaders in Anesthesiology
- Anesthesiologists Visit Congress
- Compliance Update for Anesthesiologists
- Anesthesiologist and CRNA Participation Rates in the Physician Quality Reporting Initiative (PQRS), and New Compensation Data
- Preparing Your Anesthesia Practice for the 5010 Eletronic Transactions Standard
- ACO Proposed Rules–Will the Potential Waivers from Medicare Fraud Laws Benefit Anesthesiologists?
- Anesthesia Practice Cost and Revenue Data
- The Future As Seen From the Anesthesia Administration Assembly Conference
- What Should Anesthesiologists Know About the RACs?
2013 CPT CODING CHANGES PAIN MANAGEMENT AND ANESTHESIA
January 7, 2013
The 2013 CPT® Changes and Codebook are now available to health care providers. Overall, the 2013 changes include 186 new codes, 119 deleted codes, and 263 revised codes. In addition CPT revised 18 modifiers and updated 150 guidelines. The very good news for anesthesia and pain management providers is only a small handful of these changes directly impact the services they routinely provide. Following are general comments regarding the 2013 changes:
- No Anesthesia codes were deleted, revised, or added for 2013.
- Pain management providers should take note of the four revised codes and one new code in the nervous system section of CPT 2013. The majority of changes occur in the denervation subsection, where CPT revised codes 64612 and 64614 and added 64615 for bilateral chemodenervation of muscles innervated by the facial, trigeminal, cervical spinal and accessory nerves.
- CPT also changed the parenthetical note for code 76942, ultrasound guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation that now includes paravertebral facet joint injections using ultrasound.
- The Instructions for Use of the CPT Codebook introduced the term “Qualified Healthcare Professional” (QHP) and how it will be used throughout the CPT Codebook. The use of QHP is based on AMA CPT policy of neutrality with respect to identifying who may perform a procedure or service that is described in the CPT Codebook. It states:
Qualified Healthcare Professional (QHP)
A “physician or other qualified healthcare professional” is an individual who is qualified by education, training, licensure/regulation (when applicable), and facility privileging (when applicable) who performs a professional service within his/her scope of practice and independently reports that professional service.
These professionals are distinct from “clinical staff." A clinical staff member is a person who works under the supervision of a physician or other qualified healthcare professional and who is allowed by law, regulation and facility policy to perform or assist in the performance of a specified professional service, but who does not individually report that professional service.
Other policies may also affect who may report specific services.
The following changes are also noteworthy:
- CPT 2013 defines time for all time based codes (i.e., codes whose selection depends on the amount of time it takes to perform the service—not the anesthesia codes) and states that unless specific instructions to the contrary are contained in the code or code range instructions, “time is the face-to-face time with the patient.” Further, a unit of time is attained when the mid-point is passed. Finally, when another service is performed concurrently with a time-based service, the time associated with the concurrent service should not be included in the time used for reporting the time-based service.
- New codes for Complex Chronic Care Coordination Services (99487-99489) and for Transitional Care Management Services (99495 and 99496) were added. These codes have very specific documentation and reporting requirements. While CPT is neutral as to which providers may perform these services, it is unlikely they would be part of anesthesia or pain management ; however, any QHP may perform the services.
- We are aware of some pain management practices now offering behavioral health and psychotherapy services and want to bring to their attention that CPT 2013 includes a complete rewrite of the Medicine-Psychiatric Services section resulting in 11 new codes, 4 revised codes and 27 deletions.
- The Cardiovascular Surgery section includes new codes and guidelines for Aortic Valve, transcatheter aortic valve replacement, and diagnostic carotid angiography procedures. Medicine-Cardiovascular services section of CPT also underwent extensive revision in 2013.
The below table provides specific CPT code changes of interest to anesthesia and pain management.
|Revised text is in italics; Additions and Deletions for the same code range/set are listed together to see the difference in the old to the new codes.|
|Revised||76942||Ultrasonic guidance for needle placement, (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation||Do not report 76942 in conjunction with 27096, 32554, 32555, 32556, 32557, 37760, 37761,43232, 43237, 43242, 45341, 45342, 64479-64484, 64490-64495, 76975, )213T-0218T, 0228T-0231T, 0232T, 0249T, 0301T|
|Revised||64561||Percutaneous implantation of neurostimulator electrode array: sacral nerve (transforaminal placement), including image guidance, if performed|
|Revised||64612||Chemodenervation of muscle(s); muscle(s) innervated by facial nerve, unilateral (eg, for blepharospasm, hemifacial spasm||To report a bilateral procedure, use modifier 50.|
|Revised||64614||Chemodenervation of muscle(s); extremity and/or trunk muscle(s) (eg, for dystonia, cerebral palsy, multiple sclerosis||Report 64614 only once per session.|
|New||64615||Chemodenervation of muscle(s); muscle(s) innervated by facial, trigeminal, cervical spinal and accessory nerves, bilateral (eg, for chronic migraine)||Report 64615 only once per session.|
|Deleted||95900, 95903 and 95904||These nerve conduction tests codes have been deleted.|
|New||95907-95913||Nerve conduction tests studies new codes in 2013 are used to reflect number of studies performed, rather than each nerve, as the unit of service.||95907 is for 1-2 studies; 95908 is for 3-4 studies; 95909 is for 5-6 studies; 95910 is for 7-8 studies; 95911 is for 9-10 studies, 95912 is for 11-12 studies; 95913 is for 13 or more studies.|
|Deleted||+95920||Intraoperative neurophysiology has been deleted.|
|New||+95940||Continuous IONM in the OR one on one monitoring requiring personal attendance, each 15 minutes|
|New||+95941||Continuous IONM, from outside the OR (remote or nearby) or for monitoring of > 1 case while in the OR, per hour||CMS will not pay for CPT code +95941, but created a G code (G0453) to divide into 15 minutes increments for the undivided attention by the monitoring physician to one patient; NOTE: start/stop time must be documented to report properly.|
We hope that this summary will be useful. You might wish to keep it on hand until you and your coding staff become familiar with the 2013 changes.
With best wishes,
President and CEO