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THE CPT CODE set has undergone extensive revisions for 2013, with codes, guidelines, and modifiers being revamped and updated. HIM coding professionals should download and review the CPT 2013 errata on the AMA website before starting to use the new codes. This download can be accessed at www.amaassn.org, and a complete list of new and revised codes can be found in "Appendix B" of the CPT manual.
General Revisions
Dozens of codes, coding guidelines, and modifiers were revised to eliminate the word "physician" or add the words "other qualified health care professional." This reflects that in some circumstances it may be appropriate for professionals besides physicians to report the service.
The introduction states that the CPT code set "is also used by other entities to report outpatient services," but in some cases "specific instructions may define a service as limited to professionals or limited to other entities (i.e., hospital or home health agency)."
The section of the introduction on time was revised to clarify facility reporting of services that extend into a second calendar date.
Evaluation and Management Codes
The evaluation and management (E/M) codes were extensively revised to include other qualified healthcare professionals. For example, these changes affect all of the codes for office and outpatient visits (99201-99215).
The E/M guidelines were revised to indicate that when an advanced practice nurse or physician assistant is working with a physician, he or she is considered to be the exact same specialty and subspecialty as the physician.
New codes were established for complex chronic care coordination services rendered to high-risk patients in a noninstitutional setting (99487-99489) and for transitional care management at the time a patient transitions from a facility to a community setting (99495-99496). Additionally, new codes 99485-99486 were created for supervision of interfacility transport of critically ill or critically injured pediatric patients 24 months of age or younger.
Surgery Changes
In the integumentary section, the code for island pedicle flap (15740) was revised to require identification and dissection of "an anatomically named axial vessel."
In the Musculoskeletal section, new code 22586 was created for L5-S1 arthrodesis by presacral interbody technique. New codes were also added for revision of total shoulder arthroplasty (23473-23474) and total elbow arthroplasty (24370-24371).
In the respiratory section, new codes were...