Latest crop of Category IIIs allow reporting of heart, foot and wound therapies

by: Laura Evans, CPC Jul 3, 2018

A sinus tarsi foot implant designed to correct gait; extracorporeal shockwave wound care treatment; and a wireless cardiac stimulator for biventricular pacing are some of the new CPT Category III codes released by the AMA July 1 that will be available for reporting in January.

CPT Category III codes, which end in the letter “T,” are temporary codes that describe new technology procedures or diagnostic tests that may or may not yet have FDA approval. In addition, many payers also consider them investigational and experimental and therefore non-covered.

Despite that, CPT rules state that when a specific Category III code is available to describe a service, you should report that and not a CPT Category I code. The idea is to collect as much data as possible on the procedures. Category III codes with enough momentum often become Category I codes after a year or two. Codes that are not reported often are deleted after five years.

The newly updated list also includes codes issued in January that are available for reporting as of July 1. Those include transcatheter placement of stent graft(s) in the femoral-popliteal artery, macular pigment optical density measurement and a new imaging test of the meibomian glands and pulse-echo bone density measurement.

All the new codes are to be included in the 2019 CPT manual.

To comment, login here.

Login

User Name:
Password:
Remember me Forgot password
Welcome to the new Part B News Online. If you are a returning user having trouble logging in, please click here.