Get Well-Versed With CPT® Updates

Updates to vaccine, E/M, Dermatology procedures.

CPT® 2012 will go into effect in a few weeks, thus you must get ready for novel and revised choices linked with vaccine administration and prolonged E/M service to make certain your claims stay correct. Read on this article for expert ICD and CPT tip for accurate claims.

Look for Official Addition of 90654

CPT® 2012 adds a different option to your flu vaccine coding with the addition of 90654 (Influenza virus vaccine, split virus, preservative-free, for intradermal use). The inclusion expands on the code family 90655-90657 that previously addressed influenza vaccines.

Two aspects distinguish 90654 from the other flu vaccine codes:

Code 90654 is not age specific, however 90655-90657 identify the patient's age (either 6 to 35 months of age, or age 3 years and older).

Code 90654 signifies an intradermal injection (administered to the dermal layer of skin), however 90655-90657 define intramuscular injections (administered to muscle tissue).

ICD and CPT Tip: Code 90654 signifies the vaccine product only. Include the suitable administration code (90460-90474) on your claim. In case your physician offers a noteworthy, distinctly identifiable E/M service in the encounter for the vaccine, you must also report the suitable E/ M code (99201-99205 for a new patient or 99211-99215 for an established patient).

Though 2012 will be the first time 90654 is incorporated in the CPT® book, the code has been in existence for more than a year.

Note Extra Specificity of 90460-90464

A number of other vaccine administration codes go through revision for CPT 2012. Revised codes invlove (underline indicates change):

90460 - i.e. Immunization administration ; 18 years of age through any route of administration, including counseling by a physician or other qualified health care professional; first or only component of each vaccine or toxoid which is administered

+90461 -- -- i.e. each additional vaccine or toxoid component which os administered (List separately in addition to code for primary procedure)

90581 -- i.e. Anthrax vaccine, for subcutaneous or intramuscular use

990644 -- i.e. Meningococcal conjugate vaccine, along with serogroups C & Y as well as Hemophilus influenza B vaccine (Hib-MenCY), 4 dose schedule, while administered to children 2-15 months of age, meant for intramuscular use.

Furthermore, CPT® 2012 removes vaccine codes 90470 (H1N1 immunization administration [intramuscular, intranasal [including counseling when performed) and 90663 (Influenza virus vaccine, pandemic formulation, H1N1).

Study Timeframes for Observation, Prolonged Care

E/M codes meant for observation services as well as prolonged care explain timeframes and providers with CPT® 2012 revisions.

ICD and CPT Tip: Effective Jan. 1, 2012, every code for initial observation care (99218-99220) identifies the amount of time an internist normally spends at the patient's bedside or on the patient's hospital floor. Code 99218 (Initial observation care, per day, for the evaluation and management of a patient which requires these 3 key components ...) signifies 30 minutes, code 99219 represents 50 minutes, and 99220 represents 70 minutes.