2. CPT® 2013 code changes
announced; new codes reflect
care advancements
Allowphysicians to report advancements in
healthcare services
Molecular Tests
Care Coordination
SINGLE LARGEST EXPANSION
186 New Codes Added
119 Outdated Codes Deleted
263 Another Revised Codes
3. SINGLE LARGEST EXPANSION
Result of:
Significant advancements in medical
understanding and testing for Molecular
Disease
Including Human Genome Project
The
2013 codes include 116 for molecular
pathology!
4. New Codes Will Enhance..
Reporting of innovative diagnostic tools
Improve Health Outcomes
Reduce Long-Term Care Cost
Additional Updates
Reflect Practice Changes and
Improvements in
Cardiology
Neurologic Testing
Psychiatry
5. "Medical knowledge is constantly
advancing, and as steward of CPT, the
AMA invests extensive resources each year
to keep the code set current with
contemporary medical science and
technology," AMA President Jeremy A.
Lazarus, MD
6. When is the code set
updated?
The code set is updated annually with direct
input from the health care community:
Practicing Physicians
Allied Health Professionals
Advisors from more than 100 medical specialty
societies
Such input has allowed the code set to better
support the reporting needs of physicians and
other professionals in emerging models of care,
including patient-centered medical homes and
accountable care organizations.
7. Click here for the 2013 CPT
code changes
"Tapping into the clinical expertise of the
health care community produces the
practical enhancements that CPT needs
to reflect the coding demands of the
modern health care system," Dr. Lazarus
said.
8. A few CPT 2013 CPT codes..
Arthrodesis, pre-sacral interbody technique, including disc space
preparation, discectomy,with posterior instrumentation, with image
guidance, includes bone graft, when performed,lumbar, L4-L5
interspace (List separately in addition to code for primary
0309T procedure
Motor function mapping using non-invasive navigated transcranial
magnetic stimulation(nTMS) for therapeutic treatment planning,
0310T upper and lower extremity
Non-invasive calculation and analysis of central arterial pressure
0311T waveforms withinterpretation and report
Vagus nerve blocking therapy (morbid obesity); laparoscopic
implantation of neurostimulator electrode array, anterior and
posterior vagal trunks adjacent to esophagogastric junction(EGJ),
0312T with implantation of pulse generator, includes programming
Vagus nerve blocking therapy (morbid obesity); laparoscopic
revision or replacement of vagaltrunk neurostimulator electrode
0313T array, including connection to existing pulse generator
9. Vagus nerve blocking therapy (morbid obesity); laparoscopic
removal of vagal trunkneurostimulator electrode array and pulse
0314T generator
Vagus nerve blocking therapy (morbid obesity); removal of pulse
generator agus nerve blocking therapy (morbid obesity); removal of
0315T pulse generator
Vagus nerve blocking therapy (morbid obesity); replacement of
0316T pulse generator
Vagus nerve blocking therapy (morbid obesity); neurostimulator pulse
generator electronicanalysis, includes reprogramming when
performed
0317T
Implantation of catheter-delivered prosthetic aortic heart valve,
0318T open thoracic approach, (eg,transapical, other than transaortic)
10. Implantation of catheter-delivered prosthetic aortic heart valve,
0319T open thoracic approach, (eg,transapical, other than transaortic
0320T Insertion of subcutaneous defibrillator electrode
Insertion of subcutaneous implantable defibrillator pulse generator
0321T only with existingsubcutaneous electrode
Removal of subcutaneous implantable defibrillator pulse generator
0322T only
Removal of subcutaneous implantable defibrillator pulse generator
with replacement of subcutaneous implantable defibrillator pulse
0323T generator only
11. 0324T Removal of subcutaneous defibrillator electrode
Repositioning of subcutaneous implantable defibrillator electrode
0325T and/or pulse generator
Electrophysiologic evaluation of subcutaneous implantable
defibrillator (includes defibrillationthreshold evaluation, induction of
arrhythmia, evaluation of sensing for arrhythmiatermination, and
programming or reprogramming of sensing or therapeutic
0326T parameters
Interrogation device evaluation (in person) with analysis, review and
report, includesconnection, recording and disconnection per
patient encounter; implantable subcutaneouslead defibrillator
0327T system
Programming device evaluation (in person) with iterative
adjustment of the implantable deviceto test the function of the
device and select optimal permanent programmed values
0328T withanalysis; implantable subcutaneous lead defibrillator system
12. 0580F Multidisciplinary care plan developed or updated (DSP)
Patient transferred directly from anesthetizing location to critical care
0581F unit (Peri2)
Patient not transferred directly from anesthetizing location to critical
0582F care unit (Peri2)
0583F Transfer of care checklist used (Peri2)
0584F Transfer of care checklist not used (Peri2)
13. Did we say a few?
Symptoms and signs of distal symmetric polyneuropathy reviewed
1500F and documented (DSP)
1501F Not initial evaluation for condition (DSP
Patient queried about pain and pain interference with function
1502F using a valid and reliableinstrument (DSP
1503F Patient queried about symptoms of respiratory insufficiency (DSP)
1504F Patient has respiratory insufficiency (DSP
14. Arthrodesis, pre-sacral interbody technique, including disc space
preparation, discectomy,with posterior instrumentation, with image
22586 guidance, includes bone graft when performed, L5-S1 interspace
Revision of total shoulder arthroplasty, including allograft when
23473 performed; humeral or glenoidcomponent
Revision of total shoulder arthroplasty, including allograft when
23474 performed; humeral andglenoid component
Revision of total elbow arthroplasty, including allograft when
24370 performed; humeral or ulnar component
Revision of total elbow arthroplasty, including allograft when
24371 performed; humeral and ulnar component
15. Bronchoscopy, rigid or flexible, including fluoroscopic
guidance, when performed; with balloonocclusion, when
performed, assessment of air leak, airway sizing, and
31647 insertion of bronchialvalve(s), initial lobe
Bronchoscopy, rigid or flexible, including fluoroscopic
guidance, when performed; withremoval of bronchial
31648 valve(s), initial lobe
Bronchoscopy, rigid or flexible, including fluoroscopic
guidance, when performed; withremoval of bronchial
valve(s), each additional lobe (List separately in addition to
31649 code for primary procedure)
Bronchoscopy, rigid or flexible, including fluoroscopic
guidance, when performed; with balloonocclusion, when
performed, assessment of air leak, airway sizing, and
insertion of bronchialvalve(s), each additional lobe (List
31651 separately in addition to code for primary procedure[s]
Bronchoscopy, rigid or flexible, including fluoroscopic
guidance, when performed; withbronchial thermoplasty, 1
31660 lobe
16. Bronchoscopy, rigid or flexible, including fluoroscopic
31661 guidance, when performed; withbronchial thermoplasty,
2 or more lobes
Thoracentesis, needle or catheter, aspiration of
32554
the pleural space; without imaging guidance
Thoracentesis, needle or catheter, aspiration of
32555
the pleural space; with imaging guidance
Pleural drainage, percutaneous, with insertion of
32556
indwelling catheter; without imagingguidance
Pleural drainage, percutaneous, with insertion of
32557
indwelling catheter; with imaging guidance
17. Thoracic target(s) delineation for stereotactic body
32701 radiation therapy (SRS/SBRT), (photon or particle beam),
entire course of treatment
Transcatheter aortic valve replacement (TAVR/TAVI) with
33361
prosthetic valve; percutaneousfemoral artery approach
Transcatheter aortic valve replacement (TAVR/TAVI) with
33362
prosthetic valve; open femoralartery approach
Transcatheter aortic valve replacement (TAVR/TAVI) with
33363
prosthetic valve; open axillaryartery approach
Transcatheter aortic valve replacement (TAVR/TAVI) with
33364
prosthetic valve; open iliac arteryapproach
18. Transcatheter aortic valve replacement (TAVR/TAVI) with
33365 prosthetic valve; transaorticapproach (eg, median
sternotomy, mediastinotomy)
Transcatheter aortic valve replacement (TAVR/TAVI) with
prosthetic valve; cardiopulmonarybypass support with
33367 percutaneous peripheral arterial and venous cannulation
(eg, femoralvessels) (List separately in addition to code
for primary procedure)
Transcatheter aortic valve replacement (TAVR/TAVI) with
prosthetic valve; cardiopulmonarybypass support with
33368 open peripheral arterial and venous cannulation (eg,
femoral, iliac,axillary vessels) (List separately in addition to
code for primary procedure)
Transcatheter aortic valve replacement (TAVR/TAVI) with
prosthetic valve; cardiopulmonarybypass support with
33369 central arterial and venous cannulation (eg, aorta, right
atrium,pulmonary artery) (List separately in addition
to code for primary procedure)
Insertion of ventricular assist device, percutaneous
33990 including radiological supervision andinterpretation;
arterial access only
Insertion of ventricular assist device, percutaneous
33991 including radiological supervision andinterpretation; both
arterial and venous access, with transseptal puncture
19. Removal of percutaneous ventricular assist device at
33992
separate and distinct session frominsertion
Repositioning of percutaneous ventricular assist device
33993 with imaging guidance at separateand distinct session
from insertion
Non-selective catheter placement, thoracic aorta, with
angiography of the extracranial carotid,vertebral, and/or
intracranial vessels, unilateral or bilateral, and all
36221
associated radiologicalsupervision and interpretation,
includes angiography of the cervicocerebral arch,
whenperformed
Selective catheter placement, common carotid or
innominate artery, unilateral, any approach,with
angiography of the ipsilateral extracranial carotid
36222
circulation and all associatedradiological supervision and
interpretation, includes angiography of the
cervicocerebral arch,when performed
Selective catheter placement, common carotid or
innominate artery, unilateral, any approach,with
angiography of the ipsilateral intracranial carotid
36223
circulation and all associatedradiological supervision and
interpretation, includes angiography of the extracranial
carotidand cervicocerebral arch, when performed
20. Selective catheter placement, internal carotid artery,
unilateral, with angiography of theipsilateral intracranial
carotid circulation and all associated radiological
36224
supervision andinterpretation, includes angiography of the
extracranial carotid and cervicocerebral arch,when
performed
Selective catheter placement, subclavian or innominate
artery, unilateral, with angiography of the ipsilateral
36225 vertebral circulation and all associated radiological
supervision andinterpretation, includes angiography of the
cervicocerebral arch, when performed
Selective catheter placement, vertebral artery, unilateral,
with angiography of the ipsilateralvertebral circulation and
36226 all associated radiological supervision and interpretation,
includesangiography of the cervicocerebral arch, when
performed
Selective catheter placement, external carotid artery,
unilateral, with angiography of theipsilateral external carotid
36227 circulation and all associated radiological supervision
andinterpretation (List separately in addition to code for
primary procedure)
Selective catheter placement, each intracranial branch of
the internal carotid or vertebralarteries, unilateral, with
angiography of the selected vessel circulation and all
36228
associatedradiological supervision and interpretation (eg,
middle cerebral artery, posterior inferior cerebellar artery)
(List separately in addition to code for primary procedure)
21. Transcatheter retrieval, percutaneous, of intravascular
foreign body (eg, fractured venous or arterial catheter),
37197 includes radiological supervision and interpretation, and
imaging guidance(ultrasound or fluoroscopy), when
performed
Transcatheter therapy, arterial infusion for thrombolysis
37211 other than coronary, any method,including radiological
supervision and interpretation, initial treatment day
Transcatheter therapy, venous infusion for thrombolysis, any
37212 method, including radiologicalsupervision and
interpretation, initial treatment day
Transcatheter therapy, arterial or venous infusion for
thrombolysis other than coronary, anymethod, including
radiological supervision and interpretation, continued
37213
treatment onsubsequent day during course of thrombolytic
therapy, including follow-up catheter contrastinjection,
position change, or exchange, when performed;
Transcatheter therapy, arterial or venous infusion for
thrombolysis other than coronary, anymethod, including
radiological supervision and interpretation, continued
treatment onsubsequent day during course of thrombolytic
37214
therapy, including follow-up catheter contrastinjection,
position change, or exchange, when performed; cessation
of thrombolysis includingremoval of catheter and vessel
closure by any method
22. Electrodiagnostic studies for distal symmetric
polyneuropathy not conducted (or
3752F
requested),documented, or reviewed within 6 months of
initial evaluation for condition (DSP)
Patient has clear clinical symptoms and signs that
are highly suggestive of neuropathy ANDcannot be
3753F
attributed to another condition, AND has an obvious
cause for the neuropathy(DSP)
Screening tests for diabetes mellitus reviewed, requested,
3754F
or ordered (DSP)
Cognitive and behavioral impairment screening
3755F
performed (DSP)
Patient has pseudobulbar affect, sialorrhea, or
3756F
ALS related symptoms (DSP)
Patient does not have pseudobulbar affect, sialorrhea, or
3757F
ALS related symptoms (DSP)
Patient referred for pulmonary function testing or peak
3758F
cough expiratory flow (DSP)
23. Take effect January 1, 2013..
Patient screened for dysphagia, weight loss, and
3759F
impaired nutrition, and results documented(DSP)
Patient exhibits dysphagia, weight loss, or impaired
3760F
nutrition (DSP)
Patient does not exhibit dysphagia, weight loss, or
3761F
impaired nutrition (DSP)
3762F Patient is dysarthric (DSP)
3763F Patient is not dysarthric (DSP)
38243 Hematopoietic progenitor cell (HPC); HPC boost
Esophagoscopy, rigid or flexible; with optical
43206
endomicroscopy
24. Upper gastrointestinal endoscopy including esophagus,
43252 stomach, and either the duodenumand/or jejunum as
appropriate; with optical endomicroscopy
Preparation of fecal microbiota for instillation,
44705
including assessment of donor specimen
4540F Disease modifying pharmacotherapy discussed (DSP)
Patient offered treatment for pseudobulbar affect,
4541F
sialorrhea, or ALS related symptoms (DSP)
Options for noninvasive respiratory support discussed with
4550F
patient (DSP)
4551F Nutritional support offered (DSP)
Patient offered referral to a speech language pathologist
4552F
(DSP)
25. Patient offered assistance in planning for end of life issues
4553F
(DSP)
4554F Patient received inhalational anesthetic agent (Peri2)
Patient did not receive inhalational anesthetic
4555F
agent (Peri2)
Patient exhibits 3 or more risk factors for post-operative
4556F
nausea and vomiting (Peri2)
Patient does not exhibit 3 or more risk factors for post-
4557F
operative nausea and vomiting (Peri2)
Patient received at least 2 prophylactic pharmacologic
4558F anti-emetic agents of different classespreoperatively and
intraoperatively (Peri2)
At least 1 body temperature measurement equal to or
greater than 35.5 degrees Celsius (or 95.9 degrees
4559F Fahrenheit) recorded within the 30 minutes immediately
before or the 15minutes immediately after anesthesia end
time (Peri2)
26. Anesthesia technique did not involve general or neuraxial
4560F
anesthesia (Peri2)
4561F Patient has a coronary artery stent (Peri2)
4562F Patient does not have a coronary artery stent (Peri2)
Patient received aspirin within 24 hours prior to anesthesia
4563F
start time (Peri2)
Cystourethroscopy, with injection(s) for chemodenervation
52287
of the bladder
Chemodenervation of muscle(s); muscle(s) innervated by
64615 facial, trigeminal, cervical spinaland accessory nerves,
bilateral (eg, for chronic migraine)
Thyroid uptake, single or multiple quantitative
78012 measurement(s) (including stimulation,suppression, or
discharge, when performed)
27. Thyroid imaging (including vascular flow, when
78013
performed);
Thyroid imaging (including vascular flow, when
performed); with single or multiple uptake(s)quantitative
78014
measurement(s) (including stimulation, suppression, or
c discharge, whenperformed)
Parathyroid planar imaging (including subtraction, when
78071
performed); with tomographic(SPECT)
Parathyroid planar imaging (including subtraction, when
performed); with tomographic(SPECT), and concurrently
78072
acquired computed tomography (CT) for anatomical
localization
DMD (dystrophin) (eg, Duchenne/Becker muscular
81161 dystrophy) deletion analysis, andduplication analysis, if
performed
APC (adenomatous polyposis coli) (eg, familial
81201 adenomatosis polyposis [FAP], attenuatedFAP) gene
analysis; full gene sequence
30. PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-
81325 Tooth, hereditary neuropathy withliability to pressure
palsies) gene analysis; full sequence analysis
PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-
81326 Tooth, hereditary neuropathy withliability to pressure
palsies) gene analysis; known familial variant
81479 Unlisted molecular pathology procedure
Oncology (ovarian), biochemical assays of two proteins
81500 (CA-125 and HE4), utilizing serum,with menopausal status,
algorithm reported as a risk score
Oncology (ovarian), biochemical assays of five proteins
(CA-125, apolipoprotein A1, beta-2microglobulin,
81503
transferrin and pre-albumin), utilizing serum, algorithm
reported as a risk score
Endocrinology (type 2 diabetes), biochemical assays of
seven analytes (glucose, HbA1c,insulin, hs-CRP,
81506
adiponectin, ferritin, interleukin 2-receptor alpha), utilizing
serum or plasma,algorithm reporting a risk score
31. Fetal congenital abnormalities, biochemical assays of two
81508 proteins (PAPP-A, hCG [anyform]), utilizing maternal serum,
algorithm reported as a risk score
Fetal congenital abnormalities, biochemical assays of
81509 three proteins (PAPP-A, hCG [anyform], DIA), utilizing
maternal serum, algorithm reported as a risk score
Fetal congenital abnormalities, biochemical assays of
81510 three analytes (AFP, uE3, hCG [anyform]), utilizing
maternal serum, algorithm reported as a risk score
Fetal congenital abnormalities, biochemical assays of four
analytes (AFP, uE3, hCG [anyform], DIA) utilizing maternal
81511 serum, algorithm reported as a risk score (may
includeadditional results from previous biochemical
testing)
Fetal congenital abnormalities, biochemical assays of five
analytes (AFP, uE3, total hCG,hyperglycosylated hCG,
81512
DIA) utilizing maternal serum, algorithm reported as a risk
score
81599 Unlisted multianalyte assay with algorithmic analysis
32. 82777 Galectin-3
Cell enumeration using immunologic selection and
86152 identification in fluid specimen (eg,circulating tumor cells in
blood);
Cell enumeration using immunologic selection and
86153 identification in fluid specimen (eg,circulating tumor cells in
blood); physician interpretation and report, when required
86711 Antibody; JC (John Cunningham) virus
Antibody to human leukocyte antigens (HLA), solid phase
assays (eg, microspheres or beads, ELISA, flow cytometry);
86828
qualitative assessment of the presence or absence
of antibody(ies) to HLA Class I and Class II HLA antigens
Antibody to human leukocyte antigens (HLA), solid phase
assays (eg, microspheres or beads, ELISA, Flow cytometry);
86829
qualitative assessment of the presence or absence
of antibody(ies) to HLA Class I or Class II HLA antigens
33. Antibody to human leukocyte antigens (HLA), solid phase
assays (eg, microspheres or beads, ELISA, Flow cytometry);
86830
antibody identification by qualitative panel using
completeHLA phenotypes, HLA Class I
Antibody to human leukocyte antigens (HLA), solid phase
assays (eg, microspheres or beads, ELISA, Flow cytometry);
86831
antibody identification by qualitative panel using
completeHLA phenotypes, HLA Class II
Antibody to human leukocyte antigens (HLA), solid phase
assays (eg, microspheres or beads, ELISA, Flow cytometry);
86832 high definition qualitative panel for identification of
antibodyspecificities (eg, individual antigen per
bead methodology), HLA Class I
Antibody to human leukocyte antigens (HLA), solid phase
assays (eg, microspheres or beads, ELISA, Flow cytometry);
86833 high definition qualitative panel for identification of
antibodyspecificities (eg, individual antigen per
bead methodology), HLA Class II
Antibody to human leukocyte antigens (HLA), solid phase
86834 assays (eg, microspheres or beads, ELISA, Flow cytometry);
semi-quantitative panel (eg, titer), HLA Class I
34. Antibody to human leukocyte antigens (HLA), solid phase assays (eg,
86835 microspheres or beads, ELISA, Flow cytometry); semi-quantitative
panel (eg, titer), HLA Class II
Infectious agent detection by nucleic acid (DNA or RNA); respiratory
virus (eg, adenovirus,influenza virus, coronavirus, metapneumovirus,
87631 parainfluenza virus, respiratory syncytialvirus, rhinovirus), multiplex
reverse transcription and amplified probe technique, multipletypes or
subtypes, 3-5 targets
Infectious agent detection by nucleic acid (DNA or RNA); respiratory
virus (eg, adenovirus,influenza virus, coronavirus, metapneumovirus,
87632 parainfluenza virus, respiratory syncytialvirus, rhinovirus), multiplex
reverse transcription and amplified probe technique, multipletypes or
subtypes, 6-11 targets
Infectious agent detection by nucleic acid (DNA or RNA); respiratory
virus (eg, adenovirus,influenza virus, coronavirus, metapneumovirus,
87633 parainfluenza virus, respiratory syncytialvirus, rhinovirus), multiplex
reverse transcription and amplified probe technique, multipletypes or
subtypes, 12-25 targets
Infectious agent genotype analysis by nucleic acid (DNA or RNA);
87910
cytomegalovirus
Infectious agent genotype analysis by nucleic acid (DNA or RNA);
87912
Hepatitis B virus
35. Optical endomicroscopic image(s), interpretation and report, real-
88375
time or referred, eachendoscopic session
Influenza vaccine, inactivated, subunit, adjuvanted, for
90653
intramuscular use
90672 Influenza virus vaccine, quadrivalent, live, for intranasal use
Influenza virus vaccine, quadrivalent, split virus, preservative
90685 free, when administered tochildren 6-35 months of age, for
intramuscular use
Influenza virus vaccine, quadrivalent, split virus, preservative
90686 free, when administered toindividuals 3 years of age and older, for
intramuscular use
Influenza virus vaccine, quadrivalent, split virus, when administered to
90687
children 6-35 monthsof age, for intramuscular use
Influenza virus vaccine, quadrivalent, split virus, when administered to
90688
individuals 3 years of age and older, for intramuscular use
Hepatitis B vaccine, adult dosage (2 dose schedule), for
90739
intramuscular use
36. Interactive complexity (List separately in addition to the
90785
code for primary procedure)
90791 Psychiatric diagnostic evaluation
90792 Psychiatric diagnostic evaluation with medical services
Psychotherapy, 30 minutes with patient and/or family
90832
member
Psychotherapy, 30 minutes with patient and/or family
member when performed with anevaluation and
90833
management service (List separately in addition to the
code for primaryprocedure)
Psychotherapy, 45 minutes with patient and/or family
90834
member
Psychotherapy, 45 minutes with patient and/or family
member when performed with anevaluation and
90836
management service (List separately in addition to the
code for primaryprocedure)
37. Psychotherapy, 60 minutes with patient and/or family
90837
member
Psychotherapy, 60 minutes with patient and/or family
member when performed with anevaluation and
90838
management service (List separately in addition to the code
for primaryprocedure)
90839 Psychotherapy for crisis; first 60 minutes
Psychotherapy for crisis; each additional 30 minutes (List
90840
separately in addition to code for primary service)
Pharmacologic management, including prescription and
review of medication, whenperformed with psychotherapy
90863
services (List separately in addition to the code for
primaryprocedure)
Gastrointestinal transit and pressure measurement, stomach
91112 through colon, wireless capsule,with interpretation and
report
Percutaneous transluminal coronary angioplasty; single
92920
major coronary artery or branch
38. Get more educational
information on the next slide!
Percutaneous transluminal coronary angioplasty; each
92921 additional branch of a major coronaryartery (List
separately in addition to code for primary procedure)
Percutaneous transluminal coronary atherectomy, with
92924 coronary angioplasty when performed;single major
coronary artery or branch
Percutaneous transluminal coronary atherectomy, with
92925 coronary angioplasty when performed;each additional
branch of a major coronary artery (List separately in
addition to code for primary procedure)
39. Want to learn more?
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