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                               2012  CPT  Coding  Changes  –  Part  II  
  
Quick  Look  Summary:    
  
                Additional  2012  Changes  for:  
                   o Complete  L-­‐S  spine  x-­‐rays,  including  bending  views  
                   o L-­‐S  spine  x-­‐rays,  bending  views  only  
                   o Vertebroplasty  
                   o Conscious  Sedation  bundling  into  Liver  and  Lung  Biopsies,  as  well  as  Catheter  
                          placements  into  the  aorta  and  abdominal,  pelvic,  or  lower  extremity  artery  
                          branches  

In  addition  to  the  new  bundling  CPT  coding  changes  that  are  effective  in  January  that  were  previously  
outlined,  (CTA  Abdomen  and  Pelvis  bundling,  Nuc  Med  changes  for  HIDA  scans  and  Pulmonary  imaging  
codes,  as  well  as  the  renal  angiography  and  IVC  filter  changes),  there  were  a  few  more  instructional  
changes  in  CPT  for  2012  that  pertain  to  the  Radiology  book  of  business.  

Though  the  actual  CPT  code  for  the  “Complete”  L-­‐S  spine  x-­‐ray,  including  bending  views  has  not  changed  
the  requirements  for  assigning  CPT  code  72114  has.    In  2012,  there  must  be  a  minimum  of  6  views  imaged  to  
allow  assigning  this  code.    If  bending  views  are  the  only  views  imaged,  in  2012  coders  no  longer  need  4  
views  documented  as  the  AMA/CPT  has  reduced  the  required  number  of  views  to  2  or  3  views  to  properly  
assign  CPT  code  72120.    Specifying  the  actual  views  being  interpreted  (AP,  Lateral,  flexion,  extension,  LPO,  
RPO,  left  and  right  bending  views,  etc.)  better  assists  the  coder  when  assigning  codes  from  the  spine  x-­‐ray  
section  of  CPT.    The  guidelines  for  assigning  codes  72100  (L-­‐S  spine,  2  or  3  views)  and  72110  (L-­‐S  spine,  
minimum  of  4  views)  have  not  changed.  

The  AMA  has  also  changed  the  reporting  rules  for  Vertebroplasty  procedures  to  no  longer  allow  
separate  reporting  of  bone  biopsies  when  performed  at  the  same  level  as  the  Vertebroplasty.    (Bone  
biopsies  have  never  been  separately  reportable  with  Kyphoplasty  procedures.)    Remember,  if  the  
physician  performs  a  bone  biopsy  at  a  level  not  addressed  by  the  Vertebroplasty,  the  coder  may  report  
the  biopsy  separately  by  appending  a  -­‐59  modifier.  

Other  changes  that  will  affect  reimbursement  in  2012  include  the  determination  that  conscious  sedation  
is  inherent  in  both  the  Liver  biopsy  (47000)  and  Lung  biopsy  (32405)  codes.    Conscious  sedation  was  
also  included  in  the  non-­‐selective  catheter  insertion  into  the  aorta  (36200)  and  selective  catheter  
insertions  into  the  abdominal,  pelvic,  or  lower  extremity  arterial  branches  (36200,  36245,  36246,  
36247  &  36248)  for  2012.    Bundling  edits  will  no  longer  allow  separate  reporting  of  CPT  codes  99144  and  
99145  with  these  procedures.    This  change  has  a  potential  average  loss  of  $40  for  the  first  30  minutes  
and  $25  for  each  subsequent  15  minutes  that  conscious  sedation  is  utilized.  

  


Tgalan                                                                                                                                                                                                      -­‐  1  -­‐                                                                                                                                                                                  2012  Coding  Changes,  Part  II  
HIS  South  –  Radiology  Division                                                                                                                                                                                                                                                                                                                                                  December  14,  2011  

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2012 CPT Coding Change Part II

  • 1.       2012  CPT  Coding  Changes  –  Part  II     Quick  Look  Summary:       Additional  2012  Changes  for:   o Complete  L-­‐S  spine  x-­‐rays,  including  bending  views   o L-­‐S  spine  x-­‐rays,  bending  views  only   o Vertebroplasty   o Conscious  Sedation  bundling  into  Liver  and  Lung  Biopsies,  as  well  as  Catheter   placements  into  the  aorta  and  abdominal,  pelvic,  or  lower  extremity  artery   branches   In  addition  to  the  new  bundling  CPT  coding  changes  that  are  effective  in  January  that  were  previously   outlined,  (CTA  Abdomen  and  Pelvis  bundling,  Nuc  Med  changes  for  HIDA  scans  and  Pulmonary  imaging   codes,  as  well  as  the  renal  angiography  and  IVC  filter  changes),  there  were  a  few  more  instructional   changes  in  CPT  for  2012  that  pertain  to  the  Radiology  book  of  business.   Though  the  actual  CPT  code  for  the  “Complete”  L-­‐S  spine  x-­‐ray,  including  bending  views  has  not  changed   the  requirements  for  assigning  CPT  code  72114  has.    In  2012,  there  must  be  a  minimum  of  6  views  imaged  to   allow  assigning  this  code.    If  bending  views  are  the  only  views  imaged,  in  2012  coders  no  longer  need  4   views  documented  as  the  AMA/CPT  has  reduced  the  required  number  of  views  to  2  or  3  views  to  properly   assign  CPT  code  72120.    Specifying  the  actual  views  being  interpreted  (AP,  Lateral,  flexion,  extension,  LPO,   RPO,  left  and  right  bending  views,  etc.)  better  assists  the  coder  when  assigning  codes  from  the  spine  x-­‐ray   section  of  CPT.    The  guidelines  for  assigning  codes  72100  (L-­‐S  spine,  2  or  3  views)  and  72110  (L-­‐S  spine,   minimum  of  4  views)  have  not  changed.   The  AMA  has  also  changed  the  reporting  rules  for  Vertebroplasty  procedures  to  no  longer  allow   separate  reporting  of  bone  biopsies  when  performed  at  the  same  level  as  the  Vertebroplasty.    (Bone   biopsies  have  never  been  separately  reportable  with  Kyphoplasty  procedures.)    Remember,  if  the   physician  performs  a  bone  biopsy  at  a  level  not  addressed  by  the  Vertebroplasty,  the  coder  may  report   the  biopsy  separately  by  appending  a  -­‐59  modifier.   Other  changes  that  will  affect  reimbursement  in  2012  include  the  determination  that  conscious  sedation   is  inherent  in  both  the  Liver  biopsy  (47000)  and  Lung  biopsy  (32405)  codes.    Conscious  sedation  was   also  included  in  the  non-­‐selective  catheter  insertion  into  the  aorta  (36200)  and  selective  catheter   insertions  into  the  abdominal,  pelvic,  or  lower  extremity  arterial  branches  (36200,  36245,  36246,   36247  &  36248)  for  2012.    Bundling  edits  will  no  longer  allow  separate  reporting  of  CPT  codes  99144  and   99145  with  these  procedures.    This  change  has  a  potential  average  loss  of  $40  for  the  first  30  minutes   and  $25  for  each  subsequent  15  minutes  that  conscious  sedation  is  utilized.     Tgalan                                                                                                                                                                                                      -­‐  1  -­‐                                                                                                                                                                                  2012  Coding  Changes,  Part  II   HIS  South  –  Radiology  Division                                                                                                                                                                                                                                                                                                                                                  December  14,  2011