January 2003 · Vol. 15, No. 1Keeping up with CPT 2003
What do obstetric ultrasounds, large-uterus vaginal hysterectomies, and body-fat-composition tests have in common? They all got coding makeovers for 2003. Read on for details on these and more OBG-specific changes.
MELANIE WITT
RN,
CPC, MAMs. Witt, former program manager in the department of coding and nomenclature at the American College of Obstetricians and Gynecologists, is an independent coding and documentation consultant.
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KEY POINTS
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Obstetric ultrasound codes have been revamped to allow maternal-fetal specialists to report accurately the ultrasound procedures they perform.
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Several Ob/Gyn-relevant Category III codes—which represent emerging technology—have been added, though payers may not yet reimburse for these procedures.
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CPT changed the uterine-fibroid removal codes to account for the more-involved surgical work required for larger or multiple fibroids.
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Hysterectomy codes were revised to account for the additional work involved in removing a large uterus vaginally.
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There’s good news and bad news for OBG coders in 2003. The bad news is that the wealth of new Current Procedural Terminology (CPT) codes means practices must make some serious changes to their office procedures encounter form. The good news is that these long-awaited changes should make it easier for physicians to communicate to insurers the type and difficulty of many routine procedures.
In addition to the OBG-relevant changes highlighted in this article, a wide range of other code and editorial updates have been made. For instance, CPT has deleted the optional 5-digit modifier codes that could have been used instead of the 2 digit modifier. (For example, CPT defined that the modifier to signify a separate and significant E/M service could be reported as either modifier -25 or by using the code 09925. With CPT 2003, only the modifier would be reported.) This change was necessary because the uniform electronic claim set up as a result of Health Insurance Portability and Accountability Act regulations can only accommodate 2-character modifiers. Coders should therefore review CPT 2003 in full to ensure that all relevant changes are captured.
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