Proposed Panel Agenda October 2014 CPT Editorial Panel Meeting

Transcription

1 Proposed Panel Agenda October 2014 CPT Editorial Panel Meeting The proposed agenda for the October 2014 CPT Editorial Panel meeting shows the code application names, code(s) affected, and a description of the request. The Code Numbers and Request Descriptions detailed in this document are extracted from Code Applications submitted for discussion at this meeting. Until such time as the CPT Editorial Panel acts on these requests, the information that appears in this Proposed Agenda is provided for informational purposes only, giving interested individuals the information to help determine whether or not to attend the meeting and provide comment on a given topic(s). Codes that contain an X (e.g., 1002X4, 234X2X, 0301XT) below are placeholder codes that are intended, through the first three digits, to give readers an idea of the proposed placement in the code set of the potential code changes. These codes are not used for claims reporting and will be removed and not retained when the final CPT Datafiles are distributed on August 31st of each year. To report the services for X codes listed on this form, please refer to the actual codes as they appear in the CPT Datafiles publication distributed on August 31 st of each year. Upon review of this agenda, if the reviewer believes that they will need to provide comment on an issue, they should send a request to Marie Mindeman to ask about the ability of obtaining a copy of the application and associated materials. A request for review of the agenda materials should contain the identity of the interested party seeking such and a brief summary of the basis for the request (e.g., associated vendor/ industry representative). AMA staff will advise any interested parties wishing to comment of relevant deadlines for provision of comments on the agenda. The applicant(s) who submitted the original code change application is automatically considered an interested party and will receive notice of any request for review submitted by another party. During the time between now and the Panel meeting, the agenda will, most likely, be modified to reflect changes additions, deletions or updates. Please check back frequently for the most up to date information. Outcomes on these actions will be found in the CPT Editorial Panel Summary of Actions for the October meeting which will be published on or about November 18, 2014, to the CPT home page of the AMA website. Tab # Name Code # Request-Description 6 ACIP Vaccine Abbreviations 906XX Revise vaccine code descriptors to include ACIP abbreviations 7 Open Treatment Rib Fracture without Fixation Delete to clarify reporting with current appropriate codes 1

2 8 Percutaneous Gastrocnemius Recession 299XX1 Add 299XX1 to report percutaneous surgical treatment of the gastrocnemius fascia for gait correction 9 Laryngoplasty 3158X 3158X Add 3158X1 3158X4; revise 31584, 31587, 31588; delete 21495, for accurate definition of the services currently performed 10 Endobronchial Ultrasound-EBUS Add 316X1, 316X2; revise to bundle the services of imaging with endobronchial biopsy 11 Transcatheter Pulmonary Valve Implantation 3347X1 0262T 12 Cerebral and Intracranial Endovascular Thrombectomy X1 6164X2 6164X IVUS Bundle X1 3725X Mediastinoscopy with Biopsy X1 15 Esophageal Sphincter Augmentation 4328X1 4328X2 16 Heterotopic Liver Allotransplantation Delete Drainage Instruction Edits Add 3347X1 and delete 0262T to report transcatheter insertion of pulmonary valve Add 6164X1 6164X3 to report the bundled services of thrombectomy infusion and imaging in cerebral vessels Add 3725X1, 3725X2; delete 37250, 37251, 75945, to report bundled imaging services of diagnostic non-coronary vessel ultrasound Add 3940X1; revise to clarify appropriate reporting of medianostomies and medianastinal masses Add 4328X1, 4328X2 to report insertion and removal of a small band on the esophageao sphincter for treatment of GERD Revise instructions for codes 49020, 49060, and to clarify reporting of drainage 2

3 18 Genitourinary Catheter Procedures Add 5039X1 5039X5, 506XX6, 5069X7 5069X10, 507XX11, 507XX12; Delete 50392, 50393, 50394, 50398, 74475, for reporting brush biopsy,ureteral dilation, ureteral embolization, nephroureteral stent, nephrostomy tube with ureteral stent placement, and balloon PTA of the ureter 19 Endoscopy Guidelines Urinary System Revision of existing guidelines to clarify reporting of endoscopy services for reporting evaluation of functional replacements of the native bladder 20 Penile Trauma Repair, Replantation 5443X1 5443X2 21 Injection Spinal Accessory Nerve Delete Intrastromal Corneal Ring Implantation 6577X 0099T 23 Scleral Buckling Retinal Detachment Repair Delete Add 5443X1 and 5443X2 to report traumatic corporal tear, and complete penile amputation. Delete 0099T and add 6577X for corneal ring implantation 24 Cerumen Removal 692XX Add 692XX to report lavage removal of cerumen 25 Laryngoscopy Radiological S&I Delete laryngoscopy radiological supervision and interpretation code Radiologic Exam Thoracolumbar Spine X1 7208X4 27 Radiologic Exam Hip and Pelvis X1 7350X3 7352X1 7352X3 7355X1 7355X2 28 Surface Radionuclide High Dose Rate Brachytherapy 7778X1 7778X2 Revise ; delete 72010, 72069, 72090; and add 7208X1 7208X4 with a standardized hierarchy and nomenclature for this code family Add 7350X1 7350X3 7352X 7352X3 7355X 7355X2 and delete 73500, 73510, 73520, 73530, 73540, to create bundled codes for hip and pelvis imaging services commonly reported together Add 7778X1 and 7778X2 to add new services for high dose rate radionuclide surface brachytherapy 29 Surface Electronic High Dose Rate Brachytherapy 0182T Add 01XXt to report high dose rate (HDR) Electronic Brachytherapy for treatment of skin lesions. 3

4 30 BRAF for Melanoma Revise Editorial Revise to include testing for melanoma and any V600 variant(s) 31 Molecular Pathology Updated HUGO Nomenclature Revise 81275, (ABL), (KRAS), (BRAF) to include updated full gene names approved by the HUGO Gene Nomenclature Committee 32 VKORC1 Revise Editorial Revise to allow reporting of a singular common variant or multiple common variants 33 Tier 2 KCNA5 for Atrial Fibrillation - WITHDRAWN Revise to include testing for KCNA5 to allow separate reporting of full gene sequence for this gene in the arrhythmia gene panel 34 Tier 2 KCNE1 for Genetic Heart Rhythm Disorders WITHDRAWN Revise to include testing for KCNE1 to allow separate reporting of full gene sequence for this gene in the arrhythmia gene panel 35 Tier 2 KCNE2 for Genetic Heart Rhythm Disorders - WITHDRAWN Revise to include testing for KCNE2 to allow separate reporting of full gene sequence for this gene in the arrhythmia gene panel 36 KRAS Tier 2 to Tier CEBPA for Acute Myeloid Leukemia Tier 2 to Tier ABL1 Tier 2 to Tier NRAS Tier 2 to Tier PDGFRA Tier 2 to Tier KIT Tier 2 to Tier Revise to remove KRAS from the list of tests reported with and add to report this test Revise to remove CEBPA from the list of tests reported with and add for acute myeloid leukemia Revise to remove ABL1 from the list of tests reported with and add to report this test Revise to remove NRAS from the list of tests reported with and add to report this test Revise to remove PDGFRA from the list of tests reported with and add to report this test Revise to remove KIT (c-kit) from the list of tests reported with and add for the KIT test for acute myeloid leukemia, melanoma 42 Tier 2 1p36, 5p15, 15q11 2 Deletion Analysis - WITHDRAWN Add deletion analysis of three analytes 1p36, 5p15, and 15q11 2 to code Tier 1 22q11.2 for DiGeorge Syndrome - WITHDRAWN 81XXX Add 81XXX 44 HIV-1 Ag with HIV-1-HIV-2 Antibodies - WITHDRAWN 87806X Add 87806X to report rapid single (differentiated) HIV-1/HIV-2 antibody and HIV-1 p24 antigen test results 4

5 45 Immunofluorescent Studies Add 8834X5 46 Meningococcal Serogroup B (4CMenB) Vaccine 9064XX1 Add 9064XX1 to report meningococcal serogroup b (4CMenB) vaccine for vaccine prevention of meningococcal disease 47 Meningococcal Serogroup B (MenB) Vaccine 9073X1 Add 9073X1 to report meningococcal serogroup b (MenB) vaccine for vaccine prevention of meningococcal disease 48 Recombinant Purified Influenza Hemagglutinin Vaccine - WITHDRAWN Revise to specify administration to patients 18 years and older 49 Vaccine Code Expedited Process Criteria 906XX1 Propose process for expedited vaccine approval 50 Cholera Vaccine Oral Route Revise WITHDRAWN Revise to specify oral route of administration for cholera vaccine for prevention of cholera disease 51 Adaptive Behavior Assessment Instruction Revisions Revise reporting instructions for adaptive behavior assessments 52 Wide Field Imaging Pediatric 922XX Add 922XX to report pediatric wide field imaging for management/monitoring of retinal disease 53 Special Otorhinolaryngologic Services Vestibular Caloric Irrigation X1 925X2 Revision of existing guidelines to clarify reporting of Special Otorhinolaryngologic Services Add 925X1, 925X2; delete current code to provide a more accurate method for reporting the total number of irrigations at one setting 55 Voice Prosthetic Device Parenthetical Notes Locate from Audiologic Function Tests subsection to Evaluative and Therapeutic Services subsection of Special Otorhinolaryngologic Services 56 Polysomnography Multi-Spectral Digital Skin Lesion Analysis 969XX 969YY Revise codes 95810, to include mandibular repositioning Add 969XX, 969YY to report pre-biopsy detection and status determination of melanoma or high-grade pigmented lesions 58 Computational Analysis of Cardiac Signals 0206T Extend Category III code 0206T pending completion of clinical trials 5

6 59 Multi-Frequency Bioelectrical Impedance Analysis 000XT Add 000XT to report segmental measurement of bioimpedance 60 Central Sleep Apnea Treatment Device Procedures - WITHDRAWN 03X1T 03X5T Add Category III codes 03X1T 03X5T to report transvenous implantation of electrodes 61 GES-SB-Colon Transit Imaging XXX1T XXX2T Add Category III codes XXX1T XXX2T to report gastric emptying and revise to differentiate the GES from the current radiologic exam 62 MAAA Admin Fetal Aneuploidy for Trisomy 21 or 18 00XM Add 000XM to report test for aneuploidy for trisomy 21 or MAAA Admin 4Kscore High Grade Prostate Cancer 00XXM1 Add 00XXM1 to report test to identify high grade prostate cancer 64 Explicit Electronic File Code Instructions Review of widespread proposed revisions of code instructions 65 Acupuncture HCPAC Seat ZZZ Request for addition of seat to HCPAC for representation by acupuncturists 66 Inhalation Treatment Revise to clarify intent of service 67 Distinct Procedural Service Modifier X1, X2, X3, X4 Request for deletion of modifier 59 and addition of four new modifiers to more granularly describe the conditions for distinct procedural services 68 The Joint CPT/RUC Moderate Sedation Workgroup To be announced Results of the discussions conducted by the Joint Moderate Sedation Workgroup (JMSW) (more detail after September 2014 RUC meeting). This item is intended as an Informational Item for the October 2014 CPT Editorial Panel consideration. 69 The Literature Requirements Review Workgroup Not applicable Results of the discussion conducted by the Literature Requirements Review Workgroup (LRRW). More detailed information will be submitted prior to CPT Editorial Panel meeting. This item is intended as an Informational Item for the October 2014 CPT Editorial Panel consideration. 70 LAB GRID 71 CPT Code Edits Review Consent Calendar 6