For the Week of September 26, 2016

Can the hospital code for placement of a temporary pacemaker (33210) at the same session as a coronary intervention?

Code 33210 is designated as a “separate procedure,” and, as such, it cannot be assigned when it is performed as part of another procedure. If a temporary pacemaker is placed for monitoring of an emergency department patient until a decision concerning the appropriate treatment is made, the hospital could assign a code for the temporary pacemaker since it would be considered a separate session.

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I know that the CPT codes for presumptive drug class screening have changed for 2017 but what about the level II codes G0480–G0483?

The Centers for Medicare & Medicaid Services (CMS) listed level II codes G0480–G0483 (now used for definitive testing) under “reconsideration requests” in the document it distributed for the annual Clinical Laboratory Fee Schedule (CLFS) public meeting held on July 18, 2016. It’s not yet certain what the outcome will be for these codes.

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What codes should hospital outpatient departments use to bill for the topical application of mitomycin during or following ophthalmic surgery?

Hospital outpatient departments should should not bill HCPCS code J9280 (injection, mitomycin, 5 mg) for the topical application of mitomycin. Instead, they should assign the following codes:

• For use of mitomycin with the trade name Mitosol®, report J7315—mitomycin, ophthalmic, 0.2 mg.
• For use of any other topical mitomycin, report J7999—compounded drug, not otherwise classified.

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What code would be appropriate to report for an inguinal hernia ultrasound?

According to Clinical Examples in Radiology (Summer 2015), code 76882 (ultrasound, extremity, nonvascular, real-time with image documentation; limited, anatomic specific) would be reported for an ultrasound used to image or evaluate for an inguinal hernia. Clinical Examples in Radiology is co-published by the American Medical Association and the American College of Radiology.

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Last week you gave examples of chest manipulations but not the codes. Can you provide?

The following codes would be assigned:

94667 Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function; initial demonstration and/or evaluation
94668 Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function; subsequent

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What is the BPCI initiative?

The Bundled Payments for Care Improvement (BPCI) initiative is comprised of four broadly defined models of care, which link payments for the multiple services beneficiaries receive during an episode of care. Under the initiative, organizations enter into payment arrangements that include financial and performance accountability for episodes of care. These models may lead to higher quality and more coordinated care at a lower cost to Medicare.

For more details on this, go to https://innovation.cms.gov/initiatives/bundled-payments/.

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