RCPA - Rehabilitation and Community Providers Association


More on CPT Code Changes
October 5, 2012

The National Council has provided information regarding significant, upcoming changes to Current Procedural Terminology (CPT) codes. The National Council-developed fact sheet outlines code changes, the code change and adoption process, and crosswalks 2012 and 2013 codes to be implemented January 13, 2013. A webinar is scheduled November 9,12:00 – 2:00 p.m. Registration information is not yet available. The National Council “strongly encourages” members to purchase copies of the 2013 CPT code book available from the American Medical Association.

A September 28 PCPA Info, CPT Code Changes Coming provided a link to tables developed by the American Psychiatric Association (APA) that crosswalk code changes. In addition, members are encouraged to review Evaluation and Management (E/M) coding information from the Centers for Medicare and Medicaid Services (CMS) (l). The Medicare Learning Network (MLN) December 2010 Evaluation and Management Services Guide includes two sets of documentation guidelines for E/M coding. One is from 1995 and the other 1997. The APA suggests that the 1997 guidelines are most appropriate for use by psychiatrists. An MLN fact sheet Evaluation and Management (E/M) Services: Complying with Documentation Requirements may also be helpful. The Medicare Claims Processing Manual, (Publication 100-4), Chapter 12, Section 30.6 contains additional information about E/M Service codes. Members may find the May 2012 Office of the Inspector General report, Coding Trends of Medicare Evaluation and Management Services informative.

Members are encouraged to review contracts with insurers regarding limitations in permissible coding and to raise issues accordingly. Address questions regarding CPT code changes to Betty Simmonds.

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