2015 CPT Updates

2015 CPT Changes
Prepared by Advanced Billing Consultants
Copyright 2014 | Advanced Billing Consultants, Inc.

More Selective Modifiers to 59:
The –X{EPSU} modifiers
 XE: Separate Encounter (patient treated twice)
 XS: Separate structure (two different types of lesions)
 XP: Separate Practitioner (2 different providers on same
day
 XU: Unusual non-overlapping service (2 unrelated
procedures)

E&M Changes
 99481 and 99482 replaced by 99184

Chronic Care Management
 New code: 99490- chronic care management services, at
least 20 minutes of clinical staff time directed by a
physician or other qualified health care professional,
per calendar month, with the following required
elements:
 multiple (two or more) chronic conditions expected to last
at least 12 months, or until the death of the patient,
 Chronic conditions place the patient at significant risk of
death, acute exacerbation/decompensation, or functional
decline,
 Comprehensive care plan established, implemented,
revised or monitored

Complex Chronic Care
Management
 Deleted: 99488
 Add on: 99489 to 99487
 Each additional 30 minutes of clinical staff time

Advanced Care Planning
 Face to face encounter, not requiring the patient
 New codes: 99497 for first 30 mins and 99498 for each
additional 30 mins

Anesthesia
 Deleted: 00452, 00622, 00634

Surgical Package
 The definition is clarified to indicate the History and
Physical are included in the procedure

Arthrocentesis
 Revised: 20600, 20605, 20610- without ultrasound
guidance
 New:
 20604: small joint with ultrasound guidance
 20606: intermediate joint or bursa with ultrasound
guidance
 20611: major joint or bursa with ultrasound guidance

Ablation of Bone Tumors
 Revise: 20982 include the adjacent soft tissue
 New: 20983
 Ablation therapy for reduction or eradication of 1 or more
bone tumors including adjacent soft tissue when involved
by tumor extension, percutaneous, including imaging
guidance when performed; cryoablation

Open Treatment of Rib
Fractures
 Deleted: 21800, 21810, 0245T, 0246T, 0247T, 0248T
 New open treatment of rib fracture(s):
 21811: 1-3 ribs
 21812: 4-6 ribs
 21813: 7 or more ribs

Percutaneous Vertebroplasty
 Deleted: 22520, 22521, 22522
 New: Percutaneous vertebroplasty
 22510: cervivothoracic
 22511: lumbrosacral
 22512: each additional cervivothoracic or lumbosacral
vertebral body

Percutaneous Vertebral
Augmentation
 Deleted: 22523, 22524, 22525
 New: Percutaneous vertebral augmentation, 1 vertebral
body
 22513: thoracic
 22514: lumbar
 22515: each additional thoracic or lumbar vertebral body

Total Disc Arthroplasty
 Revised: 22856 is now the parent code for 22858
 New:
 22858: second level, cervical
 0375T: cervical, three or more levels (not an add on to
22856)

Arthrodesis of Sacroiliac Joint
 Revised: 27280 to indicate open procedure
 New:
 27279: arthrodesis, sacroiliac joint, percutaneous or
minimally invasive, with image guidance, includes
obtaining bone graft when performed, and placement of
transfixing device (mod 50 allowed)

Musculoskeletal
 Deleted: 29020, 29025, 29715
 Revised: 27370 to indicate the injection is performed
for contrast

Pacemaker or Implantable
Defibrillator
 Deleted: 0322T, 0323T, 0324T, 0326T, 0327T
 New:
 33270: insertion or replacement of permanent subcutaneous
implantable defibrillator system, with subcutaneous electrode,
including defibrillation threshold evaluation, induction of
arrhythmia, evaluation of sensing for arrhythmia termination,
and programming or reprogramming of sensing or therapeutic
parameters, when performed
 33271: insertion of subcutaneous implantable defibrillator
electrode
 33272: removal of subcutaneous implantable defibrillator
electrode
 33273: repositioning of previously implanted subcutaneous
implantable defibrillator electrode

Cardiovascular
 Deleted: 33472, 36469, 36822
 New:
 34839: Physician planning of a patient-specific fenestrated
visceral aortic endograft requiring a minimum of 90
minutes of physician time

ECMO or ECLS
 Deleted: 33960, 33961, 36822
 New codes:
 33946: ECMO/ECLS provided by physician; imitation, veno-
venous
 33947: initiation, veno-arterial
 33948: daily management, each day, veno-venous
 33949: daily management, each day, veno-arterial

ECMO or ECLS Cont’d
CPT Technique Age Tunneling Status
Open
Percutaneou
s Thoracotomy Sternotomy
Birth-
5 6+ Insertion
Repositio
n Removal
33951 X X X
33952 X X X
33953 X X X
33954 X X X
33955 X X X X
33956 X X X X
33957 X X X
33958 X X X
33959 X X X
33962 X X X
33963 X X X X
33964 X X X X
33965 X X X
33966 X X X
33969 X X X
33984 X X X
33985 X X X X
33986 X X X XCopyright 2014 | Advanced Billing Consultants, Inc.

ECMO or ECLS Cont’d
 New add-on codes:
 33987: arterial exposure with creation of graft conduit to
facilitate arterial perfusion for ECMO/ECLS
 33988: Insertion of left heart vent by thoracic incision for
ECMO/ECLS
 33989: Removal of left heart vent by thoracic incision for
ECMO/ECLS

Transcatheter Procedures
 Revised: 37215, 37216, 37217
 New: 37218: Transcatheter placement of intravascular
stent(s), intrathoracic common carotid artery or
innominate artery, open or percutaneous antegrade
approach, including angioplasty, when performed, and
radiological supervision and interpretation

Endovascular
Rebascularization
 Revised: 37236, 37237

Digestive System
 Deleted: 42508

Esophagoscopy
 Revised: 43194, 43197, 43215, 43216, 43247, 43250
 Deleted: 43350
 New: 43180: esophagoscopy, rigid, transoral with
diverticulectomy of hypopharynx or cervical esophagus,
with cricopharyngeal myotomy, includes use of
telescope or operating microscope and repair, when
performed

Endoscopy
 CPT 2015 divided the endoscopy, small intestine and
stomal subsection into two separate sections which
results in many revisions and new codes
1. Small intestine endoscopy
2. Stomal endoscopy

Endoscopy, Small Intestine
 Revised: 44360, 44363

Endoscopy, Stomal
 Revised: 44380, 44385, 44386, 44388, 44390, 44391,
44392
 Deleted: 44383, 44393, 44397
 New:
 44381, 44384, 44401, 44402, 44403, 44404, 44405, 44406,
44407, 44408

Endoscopy
 Revised: 45330, 45332, 45333, 45334, 45337, 45378,
45379, 45380, 45381, 45382, 45384, 45385, 45386,
45391, 45392, 45340
 Deleted: 45355, 45383, 45387, 45339, 45345
 New: 45388, 45389, 45399, 45346, 45347, 45349, 45350,
45390, 45393, 45398

Digestive System: Colon
 New: 45399

Anus: Endoscopy
 Revised: 46600
 Deleted: 0226T, 0227T
 New: 46601, 46607

Liver
 New: 47383: Ablation, 1 or more liver tumor(s),
percutaneous, cryoblation

Urinary
 New: 52441: Cystourethroscopy, with insertion of
permanent adjustable transprostatic implant, single
inplant
 52442: Each additional permanent adjustable
transprostatic implant

Maternity Care and Delivery
 Introductory guidelines clarify the visit when pregnancy
is confirmed is not part of antepartum care

Nervous System
 Revised: 61055
 Deleted: 61334, 61440, 61470, 61490, 61542, 61609,
61875, 62116

Myelography
 Revised: 62284
 New: 62302, 62303, 62304, 62305

Transversus Abdominis Plane
Block
 New: 64486, 64487, 64488, 64489
 Deleted: 64752, 64761, 64870

Eye and Ocular Adnexa
 Deleted: 66165
 Revised: 66180, 66185, 67399
 New: 66179, 66184

Auditory System
 Deleted: 69400, 69401, 69405

Radiology
 Deleted: 72291, 72292, 74291, 76645, 76950
 New: 76641, 76642 (breast ultrasounds), 77061, 77062,
77063

Bone/Joint Studies
 Deleted: 77082
 New:
 77085: DXA with vertebral fracture assessment
 77086: vertebral fracture assessment only

Radiation Oncology
 Deleted: 77305, 77310, 77315, 77326, 77327, 77328
 New: 77306, 77307, 77316, 77317, 77318

Radiation Treatment Delivery
 Deleted: 77403, 77404, 77406, 77408, 77409, 77411,
77413, 77414, 77416, 77418, 77421
 Revised: 77401, 77402, 77407, 77412
 New: 77385, 77386, 77387

Drug Assay and Drug Testing
 All codes deleted and replaced with new codes
 Codes specify purpose of the test
 See CPT book for the presumptive drug class A and B
lists and the definitive drug classes

Molecular Pathology
 New codes: 81246, 81288, 81313
 Revised: 81245, 81402, 81403, 81404, 81405

MAAA
 New: 81519: oncology (breast), mRNA, gene expression
profiling by real-time RT-PCR of 21 genes, utilizing
formalin-fixed paraffin embedded tissue, algorithm
reported as recurrence score

Chemistry
 Revised: 82541, 82542, 82543, 82544, 84600
 Deleted: 82980, 83008, 83055, 83071, 83634
 New: 83006

Transfusion Medicine
 Revised: 86900, 86901, 86902, 86904, 86905, 86906

Microbiology
 Deleted: 87001, 87620, 87621, 87622
 Revised: 87501, 87502, 87503, 87631, 87632, 87633
 New: 87505, 87506, 87507, 87623, 87624, 87625, 87806

Surgical Pathology
 Deleted: 88343, 88349
 Revised: 88342, 88360, 88361, 88365, 88367, 88368
 New: 88341, 88344, 88364, 88366, 88373, 88374, 88369,
88377

Reproductive Medicine
Procedures
 New: 89337

Vaccines
 New HPV and Flu: 90651, 90630
 Revised: 90654, 90721, 90723, 90734

Gastroenterology
 New: 91200

Ophthalmology
 New: 92145

Implantable & Wearable
Cardiac Device Evaluations
 New: 93260, 96261
 Revised: 93282, 93283, 93284, 93287, 93289, 93295,
93296

Echocardiography
 New: 93355

Intracardiac Electrophysiological
Procedures/Studies
 New: 93644
 Revised: 93642

Noninvasive Physiologic
Studies & Procedures
 New: 93702

Cerebrovascular Arterial
Studies
 New: 93895

Neurostimulators, Analysis-
Programming
 Revised: 95972

Central Nervous System
Assessments/Tests
 Revised: 96110 (with scoring and documentation
 New: 96127: Brief emotional/behavior assessment, with
scoring and documentation per standardized instrument

Active Wound Care
Managment
 Revised: 97605, 97606: utilizing DME
 New: 97607, 97608: utilizing disposable, non-durable
medical equipment

Other Services and
Procedures
 New: 99188

Adaptive Behavior Assessment
 Mid year 2014 changes:
 New: 0659T, 0360T, 0360T, 0362T, 0363T, 0364T, 0365T,
0366T, 0367T, 0368T, 0369T, 0370T, 0371T, 0372T

Exposure Adaptive Behavior
Treatment
 Mid year 2014 changes:
 New: 0373T, 0374T

Value Based Payment Modifier
 Groups of 10 or more eligible professionals should make
sure they are participating in PQRS to avoid 2%
reduction in Medicare payments for 2016. This is based
on 2014 performance
 For more specific info:
http://www.cms.gov/Medicare/Medicare-Fee-for-
Service-
Payment/PhysicianFeedbackProgram/ValueBasedPaymen
tModifier.html

References
 AAPC. “2015 CPT Updates” (2014). Web 12 Dec 2014.
www.aapc.com
 American Medical Association. “ Changes. An Insiders
View.” (2014)

2015 CPT Updates

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