Summary
For 2014, the four new codes (99446-99449) for interprofessional telephone/Internet assessment and management services have been added to the E/M section. Use these codes without the need for face-to-face contact with the consultant. Code 99446 is defined as an interprofessional telephone/Internet assessment and management service provided by a consultative physician, including a verbal and written report to the patient’s treating/requesting physician or other qualified health care professional, and involves 5 to 10 minutes of medical consultative discussion and review. Related codes include 99447 (11 to 20 minutes of medical consultative discussion and review); 99448 (21 to 30 minutes of medical consultative discussion and review); 99449 (31 minutes or more of medical consultative discussion and review). In Integumentary section, CPT code 10030 has been added to report image-guided drainage of a fluid collection using a catheter. There are six new codes in the Integumentary section for breast biopsy with imaging guidance, and breast localization device placement with imaging guidance (codes 19081 - 19086). The localization device has been bundled into the biopsy codes and there are add-on codes for each additional lesion. For digestive system, three new codes (49405-49407) for Image-guided fluid collection drainage by catheter (abscess, hematoma, seroma, cyst) including visceral organs, e.g., kidney, liver, spleen, lung, etc., peritoneal or retroperitoneal and transvaginal or transrectal. With the addition of these new codes, the old code 58823 has been eliminated.
Original Article
CPT / HCPCS Changes for 2014
The Current Procedural Terminology, Fourth Edition, (CPT-4) code set for 2014 includes a few updates of interest to ob-gyns. As in previous years, extensive new instructions and guidelines have been added to the CPT manual to help clarify coding in a variety of situations. CPT continues to modify code descriptions, instructions, and guidelines to increase provider neutrality language. This new guidance is in addition to new, revised and deleted CPT codes for 2014. These changes take effect January 1, 2014.
HIPAA requires insurers to accept new procedure codes beginning on January 1st.
The American Medical Association CPT Editorial Panel approved these changes for 2014. GUIDELINES
Appendix C
The clinical examples in Appendix C have been updated to clarify guidance to providers on identifying and reporting the most appropriate Evaluation and Management codes from the Office or Other Outpatient Services, Hospital Inpatient Services, Consultations, Critical Care, Prolonged Services and Care Plan Oversight sections of CPT. NEW, REVISED, AND DELETED CODES
Evaluation and Management
Interprofessional Telephone/Internet Assessment and Management Service
For 2014, CPT has introduced new codes for non-face-to-face interprofessional telephone/Internet Consultations. It is uncertain at this time whether payers will reimburse for these codes.
99446

Interprofessional telephone/internet assessment and management service provided by a consultative physician including a verbal and written report to the patient’s treating /requesting physician or other qualified healthcare professional; 5-10 minutes of medical consultative discussion and review.
99447

11-20 minutes of medical consultative discussion and review
99448

21-30 minutes of medical consultative discussion and review
99449

31 minutes or more of medical consultative discussion and review
Complex Chronic Care Coordination and Transitional Care Management
Introductory guidelines have been extensively updated to provide clarifying guidance and reporting instructions for both Complex Chronic Care Coordination and Transitional Care Management codes.
Integumentary System
Introduction and Removal
New code 10030 (Image guided fluid collection drainage by catheter (e.g. abscess, hematoma, seroma, lymphocele, cyst, soft tissue (e.g., extremity,