The American Medical Association (AMA) has released the 2019 CPT code set, and it is now available in OP. The additions, changes, and deletions of codes are effective for reporting as of January 1, 2019. Click the links below for a printable PDF copy.
Note: The update of the CPT Codes does not remove deleted codes from OP software. It changes the description to read, Do Not Use 2019.
As always, there are many CPT changes that are effective 1/1/2019 that affect the practice of pediatrics. While certainly not all practices will be affected by the changes, OP offers this survey as a summary of CPT changes that may affect at least some of our clients' practices.
Developmental testing. Simple developmental instrument screening (e.g. Ages & Stages, MCHAT) will still be reported with 96110. However, CPT 96111, previously used to report extended interactive developmental testing, will be eliminated and is replaced with two time-based codes, CPT 96112 (for the first hour) and CPT 96113 (for each additional 30 minutes.)
Neurobehavioral and neuropsychological testing. For those practices with integrated mental/behavioral health who perform IQ testing (WISC), memory testing, TOVA testing, and so on, CPT codes 96101-3 and 96118-96120 have been eliminated. The replacement codes include neurobehavioral code 96121, psychological testing 96130-1, and neuropsych testing codes 96132-3, 96136-9, and 96146.
Behavioral therapy codes. For services provided by qualified personnel face to face or with caregivers, singly or in groups, new codes 97153-97158 may be used for adaptive behavior therapy.
Telemedicine consults. If you provide a telephone/Internet/EHR-based referral for another medical professional and provide a written report, 5-29 minutes of your time can be reported using 99451 and 30+ minutes can be reported using 99452.
Chronic care management. CPT 99490 may still be used to report staff time in excess of 20 minutes per month working on care planning for patients with two or more chronic conditions. Now 99491 can be used to report clinician time in excess of 30 minutes per month for parallel services.
If you are affected by these changes, be sure to update your CPT codes in OP in the following places:
* Your clinical templates and your superbill templates
* Your fee schedules and charges
* Your payer contracts
OP encourages practices to use the excellent pediatric coding services provided by the American Academy of Pediatrics, including the annually-updated book Coding for Pediatrics which can be purchased at the AAP website and the email Coding Hotline service (free to AAP members.)