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Molecular Pathology Procedure Effective From July 2017

81400 – Molecular pathology procedure, Level 1 (eg, identification of single germ line variant [eg, SNP] by techniques such as restriction enzyme digestion or melt curve analysis)

81401 – Molecular pathology procedure, Level 2 (eg, 2-10 SNPs, 1 methylated variant, or 1 somatic variant [typically using non sequencing target variant analysis], or detection of a dynamic mutation disorder/triplet repeat)


Coding Update 90587, 90620, 90621,…

90587 – Dengue is a mosquito-borne illness typically associated with tropical and subtropical areas. Patients suffer from high fever, rash, and muscle and joint pain that have earned the disease the descriptive nickname “break bone fever.” Treatment is often limited to hydration and pain medication.

90620 – MenB-4C is the complete scientific abbreviation assigned by the Advisory Committee on Immunization Practices (ACIP). The CPT vaccine code descriptors in the May 2014 meetings.

90621 – Also note the reference to the “2 or 3 dose schedule,” which differs from the reference to only a three-dose schedule in the 90621 descriptor published in the 2017 printed manual. Meningococcal diseases can affect the brain and spinal cord, and cause bloodstream infections. Antibiotics can treat infected patients.

90651 – Human Papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vHPV), 3 dose schedule, for intramuscular use.


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CMS Delays Cardiac and Ortho Bundled Payment Programs Implementation

The start date for many of the bundle payment programs is pushed back by CMS to allow time for additional review and to complete the comment and rule making process. CMS has announced 3 months delay for the start of the CJR (Comprehensive Care for Joint Replacement) pilot, the Cardiac Rehabilitation Incentive Payment Model, and three other Medicare cardiac care payment programs.

Per CMS “This interim final rule with comment period (IFC) further delays the effective date of the final rule entitled “Advancing Care Coordination Through Episode Payment Models (EPMs); Cardiac Rehabilitation Incentive Payment Model; and Changes to the Comprehensive Care for Joint Replacement Model” published in the January 3, 2017 Federal Register from March 21, 2017 until May 20, 2017”. They also stated “This IFC also delays the applicability date of the regulations at 42 CFR part 512 from July 1, 2017 to October 1, 2017 and effective date of the specific CJR regulations itemized in the DATES section from July 1, 2017 to October 1, 2017.

This delay may impact the providers who were hoping to implement the models during the MACRA attestation process. As originally envisioned by CMS that the programs would help clinicians accrue incentives under the Alternative Payment Model (APM) track.


Cardiology Coding Updates for Valvuloplasty – 2017

Valvuloplasty codes 33400, 33401, and 33403 are no more in use.  There codes are replaced by two new codes 33390, 33391, with two classification Simple or Complex, depending on the extend of procedure performed.

These new codes are defined as:

33390: Valvuloplasty, aortic valve, open with cardiopulmonary bypass; simple (ie, valvotomy, debridement, debulking, and/or simple commissural resuspension)

33391: Valvuloplasty, aortic valve, open with cardiopulmonary bypass; complex (eg, leaflet extension, leaflet resection, leaflet reconstruction, or annuloplasty)

Aortic Valve Repairs (to treat aortic valve stenosis or narrowing) are done via an open approach with the patient on cardiopulmonary bypass


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