CODING & REIMBURSEMENT

New Year's coding to know

By Suzanne Corcoran

Welcome to the new year! You'll find a number of code changes pertinent to ophthalmology in 2014; let's get started.

New codes:

66183 Insertion of anterior segment aqueous drainage device, without extra-ocular reservoir; external approach.

This replaces the Category III code, 0192T, which is deleted in 2014. Now that there is a Level 1 code, the Medicare Physician Fee Schedule will establish RVUs and a payment rate. When there was only a Category III code, no values were assigned.

0329T Monitoring of intraocular pressure for 24 hours or longer, unilateral or bilateral, with interpretation and report.

0330T Tear film imaging, unilateral or bilateral, with interpretation and report.

0333T Visual evoked potential, screening of visual acuity, automated.

Revised codes:

65778 Placement of amniotic membrane on the ocular surface; without sutures.

65779 Placement of amniotic membrane on the ocular surface; single layer sutured.

Previously, the description of these codes included the phrase, “for wound healing” and 65778 was defined as “self-retaining”.

CPT code 65780, Ocular surface reconstruction; amniotic membrane transplantation, multiple layers now includes the parenthetical notation “(For placement of amniotic membrane without reconstruction using no sutures or single layer suture technique, see 65778, 65779)”. This change should alleviate some confusion about when to use this code.

Complex wound repair codes were changed. CPT code 13150 (Repair, complex, eyelids, nose, ears and/or lips; 1.0cm or less) was deleted. CPT now instructs the use of the simple (12011) or intermediate (12051) repair codes for 1.0 cm or less. Other revised 1315x series codes are:

13151 Repair, complex, eyelids, nose, ears and/ or lips; 1.1 cm to 2.5 cm.

13152 Repair, complex, eyelids, nose, ears and/ or lips; 2.6 cm to 7.5 cm.

+13153 each additional 5 cm or less (list separately in addition to code for primary procedure).

Add-on code +15777 (Implantation of biologic implant (eg, acellular dermal matrix) for soft tissue reinforcement (ie, breast, trunk) now has supplemental parenthetical instructions to use CPT code 17999 for implantation of biologic implants for soft tissue reinforcement in tissues other than breast or trunk. In the past, some advocated using 15777 for oculoplastic surgery with xenograft.

Deleted codes:

13150 Repair, complex, eyelids, nose, ears and/or lips; 1.0cm or less.

0192T Insertion of anterior segment aqueous drainage device, without extraocular reservoir, external approach (replaced with a new Level I code).

0124T Conjunctival incision with posterior extrascleral placement of pharmacological agent.