Learn surgery CPT code changes in Gastroenterology (GI), Neurology, Ophthalmology and Urology specialties.
Current Procedural Terminology (CPT) 2015 update by American Medical Association (AMA) includes 276 new codes. There are a total of 129 revised codes and 137 deleted codes.
New Surgery CPT Codes were added to the Gastroenterology (Digestive System subsection), Neurology (Nervous System subsection), Ophthalmology (Eye and Ocular Adnexa subsections), Urology (Urinary System subsection), Musculoskeletal System and Cardiovascular System subsections.
Additional changes noted in the CPT Surgical Package Definition appear in the Surgical Guidelines to include the new language "or other qualified health care professional who performs the surgery" in the descriptor of provider of services.
We have already covered all Cardiology/ Cardiovascular CPT Code Changes in detail. In this post, we have highlighted the new, revised and deleted CPT codes for for Gastroenterology, Neurology, Ophthalmology and Urology in the following:
A new subheading for Endoscopy, Stomal was added this year. New notes provide guidance on coding when the intended procedure is unable to be completed. These notes also address the correct code assignment when reporting colonoscopy through a stoma. Ten new codes were added in this area: 44381, 44384, 44401-44408. They include codes for balloon dilation, placements of stents, ablation of tumors, mucosal resection, injection procedures, and decompression all conducted through a stoma.
Under the Endoscopy subheading additional notes and clarification was added for coding the extent of the procedure. A valuable new tool has been added in the form of a colonoscopy decision tree. Eight new codes were included this year. Two of the new codes replaced deleted codes.
Several of the new codes replaced deleted codes and added the terms “includes pre- and post-dilations and guide wire passage, when performed.” There are new codes for band ligations as well (45350, 45398).
Two new anoscopy codes—46601, 46607—were added to capture the use of high-resolution magnification (HRA).
Finishing up the new codes added in the Surgery Section, Digestive System Subsection in the Subheading of Other Procedures is a new code to represent Ablation of one or more liver tumor(s) by percutaneous cryoablation, 47383.
Current Procedural Terminology (CPT) 2015 update by American Medical Association (AMA) includes 276 new codes. There are a total of 129 revised codes and 137 deleted codes.
New Surgery CPT Codes were added to the Gastroenterology (Digestive System subsection), Neurology (Nervous System subsection), Ophthalmology (Eye and Ocular Adnexa subsections), Urology (Urinary System subsection), Musculoskeletal System and Cardiovascular System subsections.
Additional changes noted in the CPT Surgical Package Definition appear in the Surgical Guidelines to include the new language "or other qualified health care professional who performs the surgery" in the descriptor of provider of services.
We have already covered all Cardiology/ Cardiovascular CPT Code Changes in detail. In this post, we have highlighted the new, revised and deleted CPT codes for for Gastroenterology, Neurology, Ophthalmology and Urology in the following:
Gastroenterology (GI) Surgery CPT Codes Changes
New notes were added to Endoscopy, Small Intestine, including a note advising, “When bleeding occurs as the result of an endoscopic procedure the control of the bleeding is not reported separately during the same operative session.”A new subheading for Endoscopy, Stomal was added this year. New notes provide guidance on coding when the intended procedure is unable to be completed. These notes also address the correct code assignment when reporting colonoscopy through a stoma. Ten new codes were added in this area: 44381, 44384, 44401-44408. They include codes for balloon dilation, placements of stents, ablation of tumors, mucosal resection, injection procedures, and decompression all conducted through a stoma.
Under the Endoscopy subheading additional notes and clarification was added for coding the extent of the procedure. A valuable new tool has been added in the form of a colonoscopy decision tree. Eight new codes were included this year. Two of the new codes replaced deleted codes.
Several of the new codes replaced deleted codes and added the terms “includes pre- and post-dilations and guide wire passage, when performed.” There are new codes for band ligations as well (45350, 45398).
Two new anoscopy codes—46601, 46607—were added to capture the use of high-resolution magnification (HRA).
Finishing up the new codes added in the Surgery Section, Digestive System Subsection in the Subheading of Other Procedures is a new code to represent Ablation of one or more liver tumor(s) by percutaneous cryoablation, 47383.
New CPT Codes for Esophagus (Endoscopic Procedure) | |
43180 | Esophagoscopy, rigid, transoral with diverticulectomy of hypopharynx or cervical esophagus (eg, Zenker’s diverticulum), with cricopharyngeal myotomy, includes use of telescope or operating microscope and repair, when performed |
New CPT Codes for Colonoscopy | |
45388 | Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed) |
45389 | Colonoscopy; with endoscopic stent placement (includes pre and post-dilation and guide wire passage, when performed) |
45390 | Colonoscopy; with endoscopic mucosal resection |
45393 | Colonoscopy; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed |
45398 | Colonoscopy; with band ligation(s) (eg, hemorrhoids) |
45399 | Unlisted procedure, colon |
New CPT Codes for Colonoscopy Via Stoma | |
44401 | Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre-and post-dilation and guide wire passage, when performed) |
44402 | Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre-and post-dilation and guide wire passage, when performed); with endoscopic stent placement (including pre and post-dilation and guide wire passage, when performed) |
44403 | Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre-and post-dilation and guide wire passage, when performed); with endoscopic mucosal resection |
44404 | Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre-and post-dilation and guide wire passage, when performed); with endoscopic mucosal resection with directed submucosal injection(s), any substance |
44405 | Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre-and post-dilation and guide wire passage, when performed); with transendoscopic balloon dilation |
44406 | Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre-and post-dilation and guide wire passage, when performed); with endoscopic ultrasound examination, limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjacent structures |
44407 | Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre-and post-dilation and guide wire passage, when performed); with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjacent structures |
44408 | Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre-and post-dilation and guide wire passage, when performed); with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed |
New CPT Codes for Sigmoidoscopy | |
45346 | Sigmoidoscopy, flexible;with ablation of tumor(s), polyp(s), or otherlesion(s) (includes pre- and post-dilation and guide wire passage, when performed) |
45347 | Sigmoidoscopy; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed) |
45349 | Sigmoidoscopy; with endoscopic mucosal resection |
45350 | Sigmoidoscopy; with band ligation(s) (eg, hemorrhoids) |
New CPT Codes for Anoscopy | |
46601 | Anoscopy; diagnostic, with high-resolution magnification (HRA) (eg, colposcope, operating microscope) and chemical agent enhancement, including collection of specimen(s) by brushing or washing, when performed |
46607 | Anoscopy; with high-resolution magnification (HRA) (eg, colposcope, operating microscope) and chemical agent enhancement, with biopsy, single or multiple |
New CPT Codes for Small Intestine (Endoscopic Procedure) | |
44381 | Ileoscopy, through stoma; with transendoscopic balloon dilation |
44384 | Ileoscopy, through stoma; with transendoscopic balloon dilation; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed) |
New CPT Codes for Ablation Liver Tumors | |
47383 | Ablation, 1 or more liver tumor(s), percutaneous, cryoablation |
Revised CPT Codes for Esophagoscopy (Endoscopic Procedure) | |
43194 | Esophagoscopy, rigid, transoral; with removal of foreign body(s |
43197 | Esophagoscopy, flexible, transnasal; diagnostic, including collection of specimen(s) by brushing or washing when performed (separate procedure) |
43215 | Esophagoscopy; with removal of foreign body(s) |
43216 | Esophagoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps. |
43247 | Esophagogastroduodenoscopy, flexible, transoral; with removal of foreign body(s) |
43250 | Esophagogastroduodenoscopy, flexible, transoral; with removal of foreign body(s); with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps. |
Revised CPT Codes for Small Intestine Endoscopy | |
44360 | Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) |
44363 | Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure); with removal of foreign body(s) |
44380 | Ileoscopy, through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) |
44385 | Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) |
44386 | Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure); with biopsy, single or multiple |
44799 | Unlisted procedure, small intestine |
Revised CPT Codes for Colonoscopy Via Stoma | |
44388 | Colonoscopy through stoma; diagnostic,including collection of specimen(s) by brushing or washing, when performed (separate procedure) |
44390 | Colonoscopy through stoma; diagnostic,including collection of specimen(s) by brushing or washing, when performed (separate procedure); with removal of foreign body(s) |
44391 | Colonoscopy through stoma; diagnostic,including collection of specimen(s) by brushing or washing, when performed (separate procedure); with control of bleeding, any method |
44392 | Colonoscopy through stoma; diagnostic,including collection of specimen(s) by brushing or washing, when performed (separate procedure); with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps |
Revised CPT Codes for Sigmoidoscopy | |
45330 | Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) |
45332 | Sigmoidoscopy; with removal of foreign body(s) |
45333 | Sigmoidoscopy; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps |
45334 | Sigmoidoscopy; with control of bleeding, any method |
45337 | Sigmoidoscopy; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed |
45340 | Sigmoidoscopy; with transendoscopic balloon, dilation |
Revised CPT Codes for Anoscopy | |
46600 | Anoscopy; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) |
Deleted Code for Gastroenterology (GI) | |
43350 | Esophagostomy, fistulization of esophagus, external; abdominal approach |
42508 | Parotid duct diversion, bilateral (Wilke type procedure); with excision of 1 submandibular gland |
44383 | Ileoscopy, through stoma; with transendoscopic stent placement (includes predilation) |
44393 | Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique |
44397 | Colonoscopy through stoma; with transendoscopic stent placement (includes predilation) |
45339 | Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique |
45345 | Sigmoidoscopy; with transendoscopic stent placement (includes predilation) |
45355 | Colonoscopy, rigid or flexible, transabdominal via colotomy, single or multiple |
45383 | Colonoscopy, flexible, proximal to splenic flexure; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique |
45387 | Colonoscopy; with transendoscopic stent placement (includes predilation) |
45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) |
45379 | Colonoscopy; with removal of foreign body(s) |
45380 | Colonoscopy; with biopsy, single or multiple |
45381 | Colonoscopy; with directed submucosal injection(s), any substance |
45382 | Colonoscopy; with control of bleeding, any method |
45384 | Colonoscopy; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps |
45385 | Colonoscopy; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique |
45386 | Colonoscopy; with transendoscopic balloon, dilation |
45391 | Colonoscopy; with endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and cecum, and adjacent structures |
45392 | Colonoscopy; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and cecum, and adjacent structures |
Neurology/Neuro Surgery CPT Codes Changes
The Spine and Spinal Cord subheading, Injection, Drainage, or Aspiration Category includes the addition of four new codes:- 62302, Myelography via lumbar injection, coded according to the spinal region, cervical
- 62303, Thoracic
- 62304, Lumbosacral
- 62305, Two or more regions
New Neurology CPT Codes | |
62302 | Myelography via lumbar injection, including radiological supervision and interpretation; cervical |
62303 | Myelography via lumbar injection, including radiological supervision and interpretation; thoracic |
62304 | Myelography via lumbar injection, including radiological supervision and interpretation; lumbosacral |
62305 | Myelography via lumbar injection, including radiological supervision and interpretation; 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical) |
64486 | Transversus abdominis plane (TAP) block( abdominal plane block, rectus sheath block) unilateral; by injection(s) (includes imaging guidance, when performed) |
64487 | Myelography via lumbar injection, including radiological supervision and interpretation; by continuous infusion(s) (includes imaging guidance, when performed) |
64488 | Myelography via lumbar injection, including radiological supervision and interpretation; bilateral |
64489 | Myelography via lumbar injection, including radiological supervision and interpretation; by continuous infusions (includes imaging guidance, when performed) |
Revised Neurology CPT Codes | |
61055 | Cisternal or lateral cervical (C1-C2) puncture; with injection of medication or other substance for diagnosis or treatment |
62284 | Injection procedure for myelography and/or computed tomography, lumbar (other than C1-C2 and posterior fossa) |
Deleted Neurology CPT Codes | |
61334 | Exploration of orbit (transcranial approach); with removal of foreign body |
61440 | Craniotomy for section of tentorium cerebelli (separate procedure) |
61470 | Craniectomy, suboccipital; for medullary tractotomy |
61490 | Craniotomy for lobotomy, including cingulotomy |
61542 | Craniotomy with elevation of bone flap; for total hemispherectomy |
61609 | Transection or ligation, carotid artery in cavernous sinus; without repair (List separately in addition to code for primary procedure) |
61875 | Craniectomy for implantation of neurostimulator electrodes, cerebellar; subcortical |
62116 | Reduction of craniomegalic skull (eg, treated hydrocephalus); with simple cranioplasty |
64752 | Transection or avulsion of; vagus nerve (vagotomy), transthoracic |
64761 | Transection or avulsion of; pudendal nerve |
64870 | Anastomosis; facial-phrenic |
Eye/ Ophthalmology Surgery CPT Codes Changes
Eye/ Ophthalmology changes include Eye and Ocular Adnexa Subsection Changes. Anterior Sclera subheading, Aqueous Shunt Category includes a new code for aqueous shunt to extraocular plate reservoir, 66179, and a revision code, 66184.New Ophthalmology CPT Codes | |
66179 | Aqueous shunt to extraocular equatorial plate reservoir, external approach; without graft |
66184 | Revision of aqueous shunt to extraocular equatorial plate reservoir; without graft | Revised Ophthalmology CPT Codes |
66180 | Aqueous shunt to extraocular equatorial plate reservoir, external approach;with graft |
66185 | Revision of aqueous shunt to extraocular equatorial plate reservoir with graft |
67399 | Unlisted procedure, extraocular muscle |
Deleted Ophthalmology CPT Codes | |
66165 | Fistulization of sclera for glaucoma; iridencleisis or iridotasis |
69400 | Eustachian tube inflation, transnasal; with catheterization |
69401 | Eustachian tube inflation, transnasal; without catheterization |
69405 | Eustachian tube catheterization, transtympanic |
Urology Surgery CPT Codes Changes
Two new codes were added in the Vesical Neck and Prostate subheading. Cystourethroscopy with insertion of transprostatic implant single, 52441, and each additional, 52442:- 52441 Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; single implant
- 52442 Each additional permanent adjustable transprostatic implant
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