CPT® Update: 92070 Doesnâ??t Allay to Therapeutic Contacts Anymore

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Novel codes 92071 and 92072 are to be used for lens prescriptions for keratoconus and OSD.

Even though you can't bill Medicare for consistent refractive lenses, savvy ophthalmology coders are aware of the fact that you can anticipate reimbursement for contact lens prescriptions for treating keratoconus (ICD-9 codes 371.60-371.62) as well as ocular surface disorders (OSDs) for example corneal abrasions or dry eye. On the other hand, what coders at present know is changing in 2012, with the removal of one familiar code and the introduction of two novel medical CPT codes. Read on this expert insight on accurate medical Supercoder coding.

92070 no more: The medical CPT 2012 manual scrubs the ophthalmology coder's standby meant for therapeutic contact lenses, 92070 (Fitting of contact lens for treating disease, including supply of lens). As an alternative, you'll find two novel codes:

92071 (Fitting of contact lens for treatment of ocular surface disease)

92072 (Fitting of contact lens for treatment of keratoconus, initial fitting).

Notes in the medical CPT® manual warn you against reporting 92071 with 92072. For the supply of lenses, which was included in the code previous to 2012, CPT® recommends reporting 99070 (Supplies and materials [except spectacles], provided by the physician over and above those usually included with the office visit or other services rendered [list drugs, trays, supplies, or other materials provided), or another suitable supply code.

A note associated with novel code 92072 instructs coders to report an apt 92002-92014 (E/M or General Ophthalmological Services) code for following listed fittings of keratoconic lenses.

Difference in Ophthalmologist's Work Means Difference in RVUs

Why the change? Ophthalmologists were earlier using 92070 to report two very dissimilar kinds of service. Upon assessment of this service, the specialty societies approved that there are two distinct uses for medical CPT® code 92070 that have significantly dissimilar levels of work.

The medical CPT® Editorial Panel decided and removed CPT® code 92070 and then created two novel medical CPT codes (92071 and 92072) to differentiate reporting fitting of contact lens meant for management of ocular surface disease and fitting of contact lens for supervision of keratoconus.

To echo the fact that managing contact lens of keratoconus involves more work for ophthalmologists than treatment of OSD, Medicare has allocated more work RVUs to 92072 (1.97 work RVUs) as compared to 92071 (0.61 work RVUs). The work RVUs for 92071 are alike the work RVUs assigned to 92070 in 2011, sans a small number of adjustments in pre- as well as post-service time.

CPT® : Ascertain Whether A Patient is New With CPT®'s Newest E/M Tweaks

Get acquainted with new thoracoscopy CPT 2012 codes.

It's a long-standing debate--once an established patient visits your practice in order to see a new physician, then should you report a novel patient office visit code? CPT® 2012 tries to make clear when that's possible with a revision to the "New and Established Patient" segment of the CPT® manual. Read this article for accurate medical coding and know what the new CPT 2012 codes are.

The rules: At present, Supercoder CPT® points out that a "new patient" refers to a patient who has not received any professional services, for instance an E/M or another face-to-face service from the physician or physician group practice -- in the similar physician specialty -- in the past three years.

Clarification: CPT® 2012 takes that definition a step ahead, now maintain that a new patient is one who has not obtained any professional services provided by physician or any other physician of the exact similar specialty and subspecialty who is from the same group practice, in the past three years. The parts of the description that are new for 2012 are underlined.

What this means to you: In case your practice employs a variety of subspecialists, CPT® now clarifies that claims for patients who see dissimilar doctors with diverse subspecialties can be billed using a new patient code (such as 99201-99205)

Example: A cardiology practice makes use of a general cardiologist and an electrophysiologist (EP), and then both physicians are categorized as these different specialties with their payers. The cardiologist refers a patient to the EP for consideration of an implantable cardiodefibrillator. In this condition, the visit with the EP must qualify as a new patient visit, supposing the payer accepts these CPT® rules.

CMS Offers Surprise 0-Day Global to New Thoracoscopy CPT2012 Codes

Not only did CPT® 2012 modifies the heading of its "Thoracoscopy" part to cover the term "VATS" (video-assisted thoracic surgery), it also introduced three new diagnostic thoracoscopy CPT 2012 codes (32607, 32608, 32609)

It's an interesting fact that these new CPT 2012 codes were allocated fewer global days than even the CPT® Advisory Committee recommended.

You must keep in mind that Diagnostic thoracoscopies (32607-32609 ) actually have zero-day globals. In fact it's there in a recommendation to modify those to ten-day globals which would reveal the time the patient spends in the hospital which could be up to ten days, but that has not up till now changed. Consequently, physicians can independently report E/M services that they offer to patients all through the related hospital stay, apart from the real day of the procedure itself.