December 1, 2008

What’s New in 2009?
By Greg Schnitzer, RN, CCS, CCS-P, CPC, CPC-H, RCC, CHC
Radiology Today
Vol. 9 No. 24 P. 56

Each year, the American Medical Association revises its CPT codes as new ones are added to reflect new medical procedures that have been developed. Some old codes are also deleted as procedures fall into disfavor or become obsolete, and some code descriptions are revised to clarify the intent and proper use of the code.

Of course, 2009 is no exception. Effective January 1, there are a few radiology-related CPT changes. Close to 100 codes underwent a slight change to their descriptions. Throughout the CPT code set, numbers that appeared in the text of the codes’ descriptions are now replaced by numerals rather than the number spelled out. For example, note the following change:

• 2008 version: 71020 — Radiologic examination, chest, two [emphasis added] views, frontal and lateral

• New 2009 version: 71020 — Radiologic examination, chest, 2 [emphasis added] views, frontal and lateral

So, not counting the codes that simply have had numbers changed from words to numerals, what other changes are there for radiology-related codes? Well, there are just a few, such as the following:

74270 is being revised slightly:

• 2008 version: 74270 — Radiologic examination, colon; barium enema, with or without KUB

• New 2009 version: 74270 — Radiologic examination, colon; contrast (eg, barium) enema, with or without KUB

• What it means: Beginning in January, a barium enema is only an example of contrast that may be used in the colon. Other kinds of contrast are now included by the 74270 code description.

Remote afterloading high-intensity brachytherapy codes have been deleted and replaced with new ones. Four codes are being deleted and will be replaced by three new codes:

Four 2008 codes that will be deleted:

• 77781 — Remote afterloading high intensity brachytherapy; 1-4 source positions or catheters

• 77782 — 5-8 source positions or catheters

• 77783 — 9-12 source positions or catheters

• 77784 — over 12 source positions or catheters

Three new 2009 codes that are now added:

• 77785 — Remote afterloading high dose rate radionuclide brachytherapy, 1 channel

• 77786 — 2-12 channels

• 77787 — more than 12 channels

There’s a new code (78808) for injection procedures for radiopharmaceutical localization, Injection procedure for radiopharmaceutical localization by nonimaging probe study, intravenous (eg, parathyroidadenoma). This code also has the following clarifying parenthetical comment: (For sentinel lymph node identification, use 38792).

Two automated data codes are now deleted:

• 78890 — Generation of automated data: interactive process involving nuclear physician and/or allied health professional personnel; simple manipulations and interpretation, not to exceed 30 minutes

• 78891 — complex manipulations and interpretation, exceeding 30 minutes

As always, all the additions, deletions, and revisions can be found in Appendix B of the newest version of the CPT code book. Additionally, each year the American Medical Association publishes a book called CPT Changes: An Insider’s View. This book not only offers a complete summary of all the CPT additions, deletions, and revisions for the coming year, but it also provides the medical association’s rationale behind each coding change and provides an illustrative use case to demonstrate how each new code would be used in actual practice.

— Greg Schnitzer, RN, CCS, CCS-P, CPC, CPC-H, RCC, CHC, is a coding quality expert for CodeRyte, Inc.