Q Addendum B of the APC updates for 2012 indicates the new molecular pathology codes have status indicator E (noncovered service, not paid under OPPS). Our laboratory director said we should report these new codes in addition to the codes that are payable. Can you explain why?
In total, the AMA added 60 new codes throughout the surgery section of the 2012 CPT® Manual, 18 of which appear in the cardiovascular and respiratory system subsections. The AMA also revised 86 codes and deleted 48 codes in the surgery section.
Q We're struggling with nursing documentation of stop times for IV infusions (e.g., piggybacks and hydration). The nurses also inconsistently document a patient's return to the unit from diagnostics. We know that CMS now allows us to use average times for common services, and we're interested in considering this approach at my organization. Can you share additional specifics?
Self-administered drugs present a significant issue for coders, especially when considering how they may or may not be covered by Medicare Part B. In many instances, payers may consider a drug to be self-administered in some circumstances but not in others. As a result, coders must pay special attention to how these drugs are used within their setting.
Coders can find the largest number of new codes in the pathology and laboratory section of the 2012 CPT® Manual. The AMA added a total of 103 new codes, 101 of which denote Tier 1 and Tier 2 molecular path-ology procedures.
Fortunately for providers, CMS decided not to cap outpatient payment rates for cardiac resynchronization therapy defibrillator (CRT-D) procedures at the standardized inpatient rate. The agency announced its decision as part of the CY 2012 OPPS final rule released November 1, 2011.
