Updates of Interest to Pain Management and Anesthesia Professionals
Only a handful of the many coding updates for 2013 have an impact on pain management or anesthesia services. CPT 2013 defines time as “face-to-face time” with patients for all time-based codes, except that specific instructions or instructions are given in the code. These codes do not include anesthesia codes. The reference refers to codes whose selection was based on how long it takes to complete the service. The passing of the midpoint is a unit of time. If another service is performed simultaneously with a time-based services, the time for reporting that service must not include the time related to the concurrent service.
CPT also introduced the term Qualified Healthcare Professional and gave instructions on its use in the CPT Codebook. A QHP can be defined as an individual who has been trained, licensed/regulated, educated, and privileged (when applicable), who performs professional services within the scope of their practice and reports on that service independently. It is important to distinguish between clinical staff and qualified healthcare professionals. Clinical staff are those who work under the direction of a doctor or another qualified healthcare professional. They can perform or assist with the performance of a professional service as permitted by law, regulation, and facility policy, but they cannot report it individually Group Anesthesia Company.
No revisions, deletions or additions of anesthesia codes have been made for 2013.
These coding changes, revisions, and deletions are important for pain management professionals.
Coordination Services for Complex Chronic Care: New Codes
- 99487 Complex care coordination services; 1 hour per month of clinical staff time directed and managed by a physician, or another qualified health care professional.
- 99488 Complex care coordination services; 1 hour of clinical staff time directed per physician or other qualified healthcare professional, with one face to face visit, per calendar year
- 99489 Complex chronic coordination services; each additional 30-minutes of clinical staff time directed and managed by a physician, or other qualified health professional, per calendar year (List separately to code for primary procedure).
The new codes allow physicians, other qualified healthcare professionals, and clinical staff to bill their time in coordinating medical specialties and services necessary to manage complex patient conditions, daily activities, and psychosocial needs. They include all non face-to-face care coordination services, and may include one face-to-face office/outpatient/home/domiciliary evaluation and management visit associated with the care plan for the patient’s chronic conditions.
Important to remember is that these codes cannot be reported more than once per calendar month. These codes cannot be reported together with the E/M and Medicine sections excluded codes in the same calendar month. They must be able to understand the guidelines for the use of the new codes Anesthesia.
These codes are considered bundled services by Medicare for 2013, and they will not be reimbursed. The CMS states that the codes represent services that are well bundled with the services they relate and can’t be paid separately. Temporarily, the status indicator B has been given to the codes 99487–99488 and 99489. This indicates that payments for covered services are always included in other services. CMS plans to look at codes for complex care coordination services in its overall strategy to support primary and secondary care. CMS will also examine ways to promote primary care in a fee for service payment system.
Notes on the Nervous System Section
- Neurostimulators, Peripheral Nerve Section: CPT code 64561 has been revised to indicate that the code also includes image guidance and should not be reported separately. The code description reads “percutaneous implant of neurostimulator electrode array; Sacral nerve, including image guidance, if applicable.”
- Destruction by Neurolytic agent (e.g. Destruction by Neurolytic Agent (e.g. The addition of parentheticals indicates the coding for specific chemodenervation processes. The chemodenervation agent must also be reported separately.
Revised codes:
- 64612 Chemodenervation (of muscle(s); muscle(s), innervated facial nerve unilateral (eg, for Blepharospasm; hemifacial spasm); to report a bilateral procedure use modifier 50.
- 64614 Chemodenervation (muscle(s), extremity, and/or trunk) Dystonia, cerebral palsy, multiple Sclerosis (report only one time per session).
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