6 must-know coding updates in 2020

Angie Stewart for Becker’s Hospital Review

Becker’s ASC Review compiled a timeline of significant medical coding updates that have been proposed or implemented so far this year:

January 

CMS began paying for certain angioplasty and stenting procedures in ASCs on Jan. 1, under its 2020 Medicare Hospital Outpatient Prospective Payment System and ASC Payment System Final Rule. Here are the Current Procedural Terminology codes for three coronary intervention procedures and three associated add-on procedures that CMS added to the ASC Covered Procedure List for 2020:

• 92920: Percutaneous transluminal coronary angioplasty; single major coronary artery or branch
• 92921: Percutaneous transluminal coronary angioplasty; each additional branch of a major coronary artery (list separately in addition to code for primary procedure)
• 92928: Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch
• 92929: Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in addition to code for primary procedure)
• C9600: Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch
• C9601: Percutaneous transcatheter placement of drug-eluting intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in addition to code for primary procedure)

May

Early in the pandemic, Anesthesia Business Consultants’ coding teams captured a wide range of diagnoses used for COVID-19 patients and “COVID-like” patients whose virus status wasn’t definitively known, President and CEO Tony Mira said in a May 11 newsletter. Nineteen codes used for COVID-19 patients, in order of frequency for clients in ABC’s database:

• U07.1: COVID-19
• R06.03: Acute respiratory distress
• J96.90: Respiratory failure, unspecified whether with hypoxia or hypercapnia
• J96.00: Acute respiratory failure, unspecified whether with hypoxia or hypercapnia
• I46.9: Cardiac arrest, cause unspecified
• J96.01: Acute respiratory failure with hypoxia
• J98.8: Other specified respiratory disorders
• J98.9: Respiratory disorder, unspecified
• J96.91: Respiratory failure, unspecified with hypoxia
• R09.02: Hypoxemia
• B97.29: Other coronavirus as the cause of diseases classified elsewhere
• J95.859: Other complication of respirator (ventilator)
• R09.2: Respiratory arrest
• Z20.828: Contact with and (suspected) exposure to other viral communicable diseases
• R06.89: Other abnormalities of breathing
• J18.9: Pneumonia, unspecified organism
• J96.10: Chronic respiratory failure, unspecified whether with hypoxia or hypercapnia
• I50.9: Heart failure, unspecified
• R06.00: Dyspnea, unspecified

July

CMS published 11 CPT Category III codes that took effect July 1 in the ASC payment system. The agency also made updated payment rates available for download. The new codes are:

• 0594T
• 0596T
• 0597T
• 0598T
• 0600T
• 0601T
• 0614T
• 0616T
• 0617T
• 0618T
• 0619T

Click here for a description of each code.

August

CMS released the 2021 proposed payment rule for hospital outpatient departments and ASCs on Aug. 4. The agency proposed removing 300 musculoskeletal procedure codes from the inpatient-only list over a three-year period, including 67 spine codes for 2021.

CMS also indicated it would consider changing how procedures are added to the ASC-payable list. For 2021, the agency proposed including these 11 codes:

• 0266T
• 0268T
• 0404T
• 21365
• 27130
• 27412
• 57282
• 57283
• 57425
• C9764
• C9766

September 

The American Medical Association released the 2021 CPT code set on Sept. 1, giving healthcare organizations four months to prepare. If adopted as-is on Jan. 1, 2021, the code set will include 206 new codes, 54 deletions and 69 revisions, for a total of 329 editorial changes.

October

The CDC’s ICD-10-CM code update for fiscal year 2021 went into effect Oct. 1 with 57 new musculoskeletal codes. Effective through Sept. 30, 2021, the update entails 490 new, 47 revised and 58 invalidated codes, which were all outlined in the CDC’s proposed rule. Several of the new musculoskeletal codes are in the M24 category for other articular cartilage disorders, ligament disorders, pathological dislocation, recurrent dislocation, contracture and ankylosis.