As next year approaches, we expect to see many changes - in how we do business, how we plan for the future, and how we code our pain management services.
That’s right, the CPT® 2021 code book has been released. It details coding additions, revisions, and deletions to be implemented next year.
We will provide an overview of some of these changes below, with a more in-depth look at the code book at the end of this document.
Updates on Injection Procedures
Six injection codes are designated as revisions; however, the descriptor wording has not changed. The punctuation has been changed for consistency in these revisions, and the punctuation separator is a now a semicolon, not a comma.
Elimination of Category III Codes
Four Category III codes are being eliminated after ten years in the CPT® code book. They are:
- 0228T, Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with ultrasound guidance, cervical or thoracic; single level
- 0229T, ... each additional level (List separately in addition to code for primary procedure)
- 0230T, Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with ultrasound guidance, lumbar or sacral; single level
- 0231T, ... each additional level (List separately in addition to code for primary procedure)
Several other Category III codes of interest to anesthesia and pain management are among those scheduled to "sunset” (be reviewed for usage and demand) in 2021, such as:
- 0213T, Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, cervical or thoracic; single level
- +0214T, ... second level (List separately in addition to code for primary procedure)
- +0215T, ... third and any additional level(s) (List separately in addition to code for primary procedure)
- 0216T, Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, lumbar or sacral; single level
- +0217T, ... second level (List separately in addition to code for primary procedure)
- +0218T, ... third and any additional level(s) (List separately in addition to code for primary procedure)
Evaluation and Management (E/M) Overhaul
Coders who report pain management services will need to get familiar with the E/M shifts, which include:
- Eliminating history and physical exam as elements for code selection.
- Allowing physicians to choose the best patient care by permitting code level selection based on medical decision-making (MDM) or total time.
- Promoting payer consistency with more detail added to CPT® code descriptors and guidelines.
These changes are intended to make these codings and documentation simpler and more effective, freeing physicians and care teams from unnecessary burdens.
More to Come
These changes are not the extent of the CPT® 2021 code book. As you learn these and plan to implement them in your practice, stay tuned to see the full changes and revisions coming in 2021.
If you need coding support, contact Medical Business Management! We ensure all coding is up-to-date, accurate, and helps you get the most out of your claims.
To read more about these initial updates, click here!
