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Coding Q&A 

29 days ago

Summary of proposed 2019 CPT changes for IR

By Stephanie Dybul, MBA, RT  e-IRQ exclusive

SIR will help your practice prepare for all 2019 coding changes in detail in the annual Interventional Radiology Coding Update. Below is a summary of the proposed changes for 2019.

Peripherally inserted central catheter (PICC)

Two new peripherally inserted central venous catheter (PICC) codes will be created that bundle placement of a PICC and all associated radiological supervision and interpretation (RS&I). CPT codes 36568 and 36569 will remain as codes to be used when a PICC is placed without imaging guidance. The central venous access procedure guidelines will be updated to include the saphenous vein as an example of an entry site for a PICC and to clarify the instructions for reporting imaging guidance used for centrally inserted central venous catheters.

Vascular injection procedures

For 2019, the parenthetical notes under the vascular injection procedures will be revised. Due to the low volume of utilization, fluoroscopy code 76001 is deleted to reflect current clinical practice. With the deletion of code 76001, the parentheticals of a number of CPT codes will be revised.

Gastrostomy tube replacement without imaging guidance

CPT code 43760 will be deleted and two new codes will be available to report simple versus complex replacement of a percutaneous gastrostomy tube performed without imaging or endoscopic guidance. When fluoroscopic guidance is used in replacing a gastrostomy tube, CPT code 49450 will remain.

Dilation of urinary tract

Two new codes will be created to report dilation of the urinary tract in preparation for endourologic procedures and CPT code 50395 will be deleted. The new codes will include all associated RS&I as well as postprocedure tube placement, when performed.

Fine needle aspiration codes

A new subheading and subsection titled “Fine needle aspiration [FNA] biopsy” will be added, and new guidelines will be added to the new subsection. Several parenthetical notes will be added or revised throughout the CPT code set to accommodate these changes. Code 10021 will be revised; code 10022 deleted and nine new Category I codes will be created. The new code set bundles the procedure and the RS&I by imaging modality.

Please consult the CPT® 2019 Professional Edition codebook accompanying introductory language describing the codes and reporting instructions  for these changes.

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