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Showing posts with label CPT Updates. Show all posts
Showing posts with label CPT Updates. Show all posts

Guidelines for billing CPT G2211

About CPT G2211 & Objectives

Effective from January 1, 2024, the Centers for Medicare and Medicaid Services (CMS) began reimbursing for G2211, an HCPCS add-on code meant to be billed alongside an office or outpatient evaluation and management (E/M) code in certain situations. 

This results in higher payment for the E/M service, regardless of its level. The national payment rate for G2211 is $16.05.

CPT code G2211 was originally proposed by CMS in 2021 to more accurately reflect the costs associated with providing care for patients over extended periods, such as during primary care or specialist encounters. 

However, due to budget neutrality concerns and the anticipated impact on physician payments, Congress delayed the implementation of this code for several years. 2024 marks the first year that G2211 can be billed and reimbursed.

CPT Code Description

CPT G2211 - Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established)

This add-on code acknowledges the payment effective from Jan 1st, 2024 for Medicare & Medicare Advantage plan, Medicare HMO's and required when a provider delivers consistent, continuous services for a patient's ongoing care.

The CPT G2211 should be reported alongside an office or other outpatient E/M service alone (CPT 99202, 99203, 99204,99205, 99212, 99213, 99214 & 99215).

A CPT code G2211 accounts for the time, intensity, and practice expense associated with providing services to a patient on an ongoing basis.

These services are part of a comprehensive, continuous relationship between the provider and patient, often with the provider serving as the primary coordinator of the patient's care

The key factor in deciding when to bill for services covered by G2211 is the presence or development of a longitudinal relationship between the patient and the practitioner.
 

Documentation Requirements

The Providers & other qualified healthcare professional are required to document the reason for billing the office or other outpatient E/M visit. 

These visits must be medically reasonable and necessary for the practitioner to report CPT code G2211 alongside of office and outpatient codes . 

The documentation should demonstrate the medical necessity of the level of E/M visit. While the CMS not specified require any specific additional documentation for billing of CPT G2211.

The services may need to meet the following criteria to fulfill the billing requirements for CPT code G2211,

  • Treatment of respective problems,
  • Management of the conditions,
  • Care coordination,
  • Patient education,
  • Shared decision-making,
  • Commitment to achieving health goals.

Who Can Bill CPT G2211

Any practitioner, regardless of specialty, may bill for G2211 if the medical documentation supports the use of the code.

When Can Bill CPT G2211

If a provider is delivering ongoing care for a single, serious condition or a complex condition such as sickle cell disease or HIV, The CPT code G2211 may be reported along with office and outpatient E/M codes 99202 to 99215

Key Factor

CPT G2211 should not be added in every claim/visits for the office or outpatient E/M services. The documentation and the relationship between the provider and the patient must support the use of the code.

The patients may be responsible for additional deductibles and coinsurance payments when this code is billed under the Medicare program.

Coverage

Recent research indicates that coverage for CPT code G2211 is expanding beyond direct Medicare to include some Medicare Advantage plans, Medicare HMO's, and commercial payers. Examples are below,

As of March 1, 2024, three national payers have confirmed coverage of CPT code G2211,

  • Cigna (Medicare Advantage only),
  • Humana (commercial and Medicare Advantage),
  • United Healthcare (commercial and Medicare Advantage).

Do Not Use

G2211 cannot be used in the inpatient hospital or skilled nursing setting.
G2211 cannot be used with audio only telephone services (99441 – 99443)
G2211 cannot be billed when the E/M code is billed with modifier 25.
G2211 may not be used when a procedure is performed on the same day, by the same practitioner.
G2211 cannot be used for acute care.
G2211 payers will not reimburse you unless you report it with an appropriate primary code.

New Rules for CPT Category III T Codes

Attach the Medical Records at initial Claim Submission

Please note that when submitting your initial claim for any one of the CPT codes specified below, it is imperative to include documentation for Medicare, your Medicare HMO plan, and any Medicare Advantage insurances. 

These documents are required for processing your claim efficiently. Failure to provide these documents may result in delays or rejection and or denials of your claims.

First Coast Service Options' Medicare, FCSO, requests the following documentation to accompany the initial claim submission for the specified T codes effective from February 26, 2024

In cases where records are not submitted to support the billed code, the service will be rejected and will not be processed. 

Consequently, the claim must be resubmitted with the appropriate documentation,

  • History and physical examination
  • Lab/Diagnostic test results, if applicable
  • Progress or office notes for the service performed
  • Operative or procedure report, if applicable
  • Full text peer reviewed articles
  • Society guidelines
  • Any additional documentation that supports the need for the service
 
0174T - Computer algorithm analysis of digital image data

0175T - Remote computer algorithm analysis of digital image data

0253T - Insertion of anterior segment aqueous drainage device, without extraocular reservoir, internal approach, into the suprachoroidal space

0263T - Intramuscular autologous bone marrow cell therapy, with preparation of harvested cells, multiple injections, one leg, including ultrasound guidance, if performed; complete procedure

0264T - Intramuscular autologous bone marrow cell therapy, with preparation of harvested cells, multiple injections, one leg, including ultrasound guidance, if performed; complete procedure excluding bone marrow harvest

0265T - Intramuscular autologous bone marrow cell therapy, with preparation of harvested cells, multiple injections, one leg, including ultrasound guidance, if performed; unilateral or bilateral bone marrow harvest only for intramuscular autologous bone marrow cell therapy

0333T - Visual evoked potential, screening of visual acuity, automated, with report

0335T - Insertion of sinus tarsi implant

0338T - Destruction of nerves of arteries of both kidneys accessed through the skin with fluoroscopy and radiological supervision and interpretation

0339T - Destruction of nerves of arteries of one kidney accessed through the skin with fluoroscopy and radiological supervision and interpretation

0342T - Therapeutic apheresis with selective hdl delipidation and plasma reinfusion

0345T - Transcatheter mitral valve repair percutaneous approach via the coronary sinus

0373T - Adaptive behavior treatment with protocol modification, each 15 minutes of technicians' time face-to-face with a patient, requiring the following components: administration by the physician or other qualified health care professional who is on site; with the assistance of two or more technicians; for a patient who exhibits destructive behavior; completion in an environment that is customized to the patient's behavior.

0379T -  Visual field assessment, with concurrent real time data analysis and accessible data storage with patient initiated data transmitted to a remote surveillance center for up to 30 days; technical support and patient instructions, surveillance, analysis, and transmission of daily and emergent data reports as prescribed by a physician or other qualified health care professional

0402T - Collagen cross-linking of cornea, including removal of the corneal epithelium, when performed, and intraoperative pachymetry, when performed

0403T -  Preventive behavior change, intensive program of prevention of diabetes using a standardized diabetes prevention program curriculum, provided to individuals in a group setting, minimum 60 minutes, per day

0422T - Tactile breast imaging by computer-aided tactile sensors, unilateral or bilateral

0443T - Real-time spectral analysis of prostate tissue by fluorescence spectroscopy, including imaging guidance (List separately in addition to code for primary procedure)

0444T - Initial placement of a drug-eluting ocular insert under one or more eyelids, including fitting, training, and insertion, unilateral or bilateral

0445T - Subsequent placement of a drug-eluting ocular insert under one or more eyelids, including re-training, and removal of existing insert, unilateral or bilateral

0446T - Creation of subcutaneous pocket with insertion of implantable interstitial glucose sensor, including system activation and patient training

0447T - Removal of implantable interstitial glucose sensor from subcutaneous pocket via incision

0448T - Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and insertion of new implantable sensor, including system activation

0450T - Insertion of aqueous drainage device, without extraocular reservoir, internal approach, into the subconjunctival space; each additional device (List separately in addition to code for primary procedure)

0469T - Retinal polarization scan, ocular screening with on-site automated results, bilateral

0474T - Insertion of anterior segment aqueous drainage device, with creation of intraocular reservoir, internal approach, into the supraciliary space

0481T - Injection(s), autologous white blood cell concentrate (autologous protein solution), any site, including image guidance, harvesting and preparation, when performed

0489T - Autologous adipose-derived regenerative cell therapy for scleroderma in the hands; adipose tissue harvesting, isolation and preparation of harvested cells including incubation with cell dissociation enzymes, removal of non-viable cells and debris, determination of concentration and dilution of regenerative cells

0490T - Autologous adipose-derived regenerative cell therapy for scleroderma in the hands; multiple injections in one or both hands

0494T - Surgical preparation and cannulation of marginal (extended) cadaver donor lung(s) to ex vivo organ perfusion system, including decannulation, separation from the perfusion system, and cold preservation of the allograft prior to implantation, when performed

0495T - Initiation and monitoring marginal (extended) cadaver donor lung(s) organ perfusion system by physician or qualified health care professional, including physiological and laboratory assessment (eg, pulmonary artery flow, pulmonary artery pressure, left atrial pressure, pulmonary vascular resistance, mean/peak and plateau airway pressure, dynamic compliance and perfusate gas analysis), including bronchoscopy and X ray when performed; first two hours in sterile field

0496T - Initiation and monitoring marginal (extended) cadaver donor lung(s) organ perfusion system by physician or qualified health care professional, including physiological and laboratory assessment (eg, pulmonary artery flow, pulmonary artery pressure, left atrial pressure, pulmonary vascular resistance, mean/peak and plateau airway pressure, dynamic compliance and perfusate gas analysis), including bronchoscopy and X ray when performed; each additional hour (List separately in addition to code for primary procedure)

0505T - Endovenous femoral-popliteal arterial revascularization, with transcatheter placement of intravascular stent graft(s) and closure by any method, including percutaneous or open vascular access, ultrasound guidance for vascular access when performed, all catheterization(s) and intraprocedural roadmapping and imaging guidance necessary to complete the intervention, all associated radiological supervision and interpretation, when performed, with crossing of the occlusive lesion in an extraluminal fashion

0506T - Macular pigment optical density measurement by heterochromatic flicker photometry, unilateral or bilateral, with interpretation and report

0509T - Electroretinography (ERG) with interpretation and report, pattern (PERG)

0511T - Removal and reinsertion of sinus tarsi implant

0541T - Imaging of heart muscle using magnetocardiography to detect deficient blood flow, single study

0542T - Interpretation and report of imaging of heart muscle using magnetocardiography to detect deficient blood flow

0547T - Bone material quality testing by microindentations of shin bone

0554T - Bone strength and fracture risk assessment: retrieval and transmission of CT scan data, assessment of bone strength and fracture risk and bone mineral density, interpretation and report

0555T - Bone strength and fracture risk assessment: retrieval and transmission of CT scan data only

0556T - Bone strength and fracture risk assessment: assessment of bone strength and fracture risk and bone mineral density

0557T - Bone strength and fracture risk assessment: interpretation and report

0558T - CT scan for biomechanical computed tomography analysis

0559T - Anatomic model 3D-printed from image data set(s); first individually prepared and processed component of an anatomic structure

0560T - Anatomic model 3D-printed from image data set(s); each additional individually prepared and processed component of an anatomic structure (List separately in addition to code for primary procedure)

0561T - Anatomic guide 3D-printed and designed from image data set(s); first anatomic guide

0562T - Anatomic guide 3D-printed and designed from image data set(s); each additional anatomic guide (List separately in addition to code for primary procedure)

0564T - Evaluation of toxicity of chemotherapy drugs on cancer stem cells

0567T - Blockage of fallopian tubes with implants inserted through cervix

0568T - Introduction of saline and air into fallopian tubes to test for blockage

0583T - Tympanostomy (requiring insertion of ventilating tube), using an automated tube delivery system, iontophoresis local anesthesia

0584T - Transplantation of insulin-producing cells, via catheter accessed through skin using imaging guidance

0585T - Transplantation of insulin-producing cells using endoscope inserted through wall of abdomen

0586T - Transplantation of insulin-producing cells, open procedure

0591T - Face-to-face health and well-being coaching of individual, initial assessment

0592T - Face-to-face health and well-being coaching of individual, follow-up session, at least 30 minutes

0593T - Face-to-face health and well-being coaching of group, at least 30 minutes

0594T - Incision of upper arm bone and insertion of bone-lengthening device in marrow cavity

0602T - Measurement of kidney filtration rate using skin sensor and single dose of fluorescent agent

0603T - Monitoring of kidney filtration rate using skin sensor and multiple doses of fluorescent agent

0610T - Transmission of MR spectroscopy data on biomarkers for spinal disc pain

0613T - Implantation of shunt in partition between upper heart chambers via catheter, accessed through skin

0620T - Endovascular venous arterialization, tibial or peroneal vein, with transcatheter placement of intravascular stent graft(s) and closure by any method, including percutaneous or open vascular access, ultrasound guidance for vascular access when performed, all catheterization(s) and intraprocedural roadmapping and imaging guidance necessary to complete the intervention, all associated radiological supervision and interpretation, when performed

0621T - Laser incision of drainage tissue within eye (trabecular meshwork)

0622T - Laser incision of drainage tissue within eye (trabecular meshwork) using ocular endoscope

0643T - Implantation of restoration device into left lower chamber of heart through catheter

0645T - Implantation of coronary sinus reduction device in heart through catheter

0647T - Insertion of gastrostomy tube, percutaneous, with magnetic gastropexy, under ultrasound guidance, image documentation and report

0651T - Examination of esophagus and stomach using a magnetically controlled capsule endoscope

0656T - Tethering of 7 or fewer lower spine bones

0657T Tethering of 8 or more lower spine bones

0660T - Implantation of drug-releasing device in front chamber of eye

0661T - Removal and reimplantation of drug-releasing device in front chamber of eye

0662T - Scalp cooling, mechanical; initial measurement and calibration of cap

0663T - Scalp cooling, mechanical; placement of device, monitoring, and removal of device (List separately in addition to code for primary procedure)

0664T - Removal of uterus from cadaver donor

0665T - Removal of uterus from living donor

0666T - Removal of uterus from living donor using a laparoscope

0667T - Transplantation of uterus from donor

0668T - Preparation of donor uterus for transplantation

0669T - Reconstruction of donor uterus, each vein-to-vein connection

0670T - Reconstruction of donor uterus, each artery-to-artery connection

0672T - Radiofrequency remodeling of tissues surrounding female bladder neck and proximal urethra for urinary incontinence

0674T - Insertion of permanent implantable synchronized diaphragmatic stimulation system for augmentation of heart function, including an implantable pulse generator and diaphragmatic leads, using a laparoscope

0675T - Insertion of first lead of permanent implantable synchronized diaphragmatic stimulation system for augmentation of heart function, with connection to existing pulse generator, using a laparoscope

0676T - Insertion of additional lead of permanent implantable synchronized diaphragmatic stimulation system for augmentation of heart function, with connection to existing pulse generator, using a laparoscope

0677T - Repositioning of first lead of permanent implantable synchronized diaphragmatic stimulation system for augmentation of heart function, with connection to existing pulse generator, using a laparoscope

0678T - Repositioning of additional lead of permanent implantable synchronized diaphragmatic stimulation system for augmentation of heart function, with connection to existing pulse generator, using a laparoscope

0679T - Removal of permanent implantable synchronized diaphragmatic stimulation system for augmentation of heart function using a laparoscope

0680T - Insertion or replacement of pulse generator only of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing lead

0681T - Relocatation of pulse generator only of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads

0682T - Removal of pulse generator only of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function

0683T - In-person programming device evaluation of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function with analysis, review and report by qualified health care professional

0684T - In-person programming device evaluation and programming of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function before procedure

0685T - In-person interrogation device evaluation of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function with analysis, review and report by qualified health care professional

0686T - Acoustic energy destruction of malignant liver tissue using imaging guidance

0687T - Device supply, educational set-up, and initial session for online digital treatment of amblyopia

0688T - Assessment of patient performance and program data for online digital treatment of amblyopia by healthcare professional with report, per calendar month

0689T - Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained without diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure)

0690T - Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure) (List separately in addition to code for primary procedure)

0691T - Automated analysis of existing CT study for fractue of spine, with data preparation, interpretation, and report

0692T - Therapeutic ultrafiltration

0693T - Comprehensive full body computer-based markerless 3D motion analysis and report

0694T - Real-time 3-dimensional volumetric imaging and reconstruction of breast or axillary lymph node tissue in surgical specimen, with interpretation and report

0695T - Body surface-activation mapping of cardiac resynchronization therapy device, with review, and report, at time of implant or replacement

0696T - Body surface-activation mapping of cardiac resynchronization therapy device, with review, and report, at time of follow-up device evaluation

0700T - Molecular fluorescent imaging of first suspicious mole

0701T - Molecular fluorescent imaging of additional suspicious mole

0704T - Device supply, initial set-up, and patient education for remote treatment of amblyopia using eye tracking device

0705T - Surveillance center technical support for remote treatment of amblyopia using eye tracking device, at least 18 training hours, each 30 days

0706T - Health care professional interpretation and report of remote treatment of amblyopia using eye tracking device, per 30 days

0708T - Injection of bone-substitute material into defect of bone using imaging guidance and endoscope

0709T - Preparation and initial injection of cancer immunotherapy into skin

0710T - Additional injection of cancer immunotherapy into skin

0711T - Noninvasive analysis of plaque in artery using software processing of CT data, with data preparation and transmission, interpretation and report

0712T - Preparation and transmission of data for noninvasive analysis of plaque in artery using software processing of CT data

0713T - Evaluation of artery wall and plaque to assess stability of plaque noninvasive analysis of plaque in artery using software processing of CT data

0714T - Data review, interpretation and report for noninvasive analysis of plaque in artery using software processing of CT data

0716T - Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score

0717T - Harvesting of patient's own fatty tissue and preparation of cells for autologous adipose-derived regenerative cell (ADRC) therapy for partial thickness rotator cuff tear

0718T - Injection of autologous adipose-derived regenerative cell (ADRC) therapy into supraspinatus tendon of one shoulder using ultrasound guidance, for partial thickness rotator cuff tear

0719T - Replacement of posterior joint in single segment of spine in lower back (lumbar) using imaging guidance

0720T - Electrical nerve field stimulation of cranial nerves through skin

0721T - Quantitative computed tomography (CT scan) tissue characterization with interpretation and report

0722T - Quantitative computed tomography (CT scan) tissue characterization with interpretation and report and concurrent CT examination of any structure contained in the concurrently acquired diagnostic imaging dataset

0723T - Quantitative magnetic resonance (MR scan) imaging of gallbladder, bile ducts, pancreas and pancreatic duct cholangiopancreatography (QMRCP), with data preparation and transmission, interpretation and report

0724T - Quantitative magnetic resonance (MR scan) imaging of gallbladder, bile ducts, pancreas and pancreatic duct cholangiopancreatography (QMRCP), with data preparation and transmission, interpretation and report and with diagnostic magnetic resonance imaging (MRI) examination of same anatomy

0725T - Implantation of vestibular nerve stimulation device in one ear

0726T - Removal of vestibular nerve stimulation device from one ear

0727T - Removal and replacement of vestibular nerve stimulation device from one ear

0728T - Diagnostic analysis and initial programming of vestibular nerve stimulation device in one ear

0729T - Diagnostic analysis and subsequent programming of vestibular nerve stimulation device in one ear

0730T - Laser incision of drainage tissue within eye (trabeculotomy) using optical coherence tomography (OCT) guidance

0731T - Augmentative artificial intelligence-based analysis of facial features (facial phenotype) for possible genetic syndromes with report

0732T - Administration of immunotherapy into muscle using electric pulse (electroporation)

0733T - Device supply and technical support for remote real-time, motion capture-based neurorehabilitative therapy, per 30 days

0734T - Treatment management service for remote real-time, motion capture-based neurorehabilitative therapy, per calendar month

0735T - Preparation of tumor cavity and placement of radiation therapy applicator for intraoperative radiation therapy (IORT) at time of primary incision of skull

0736T - Insertion of rectal catheter and flushing of colon with gravity-fed 35 or more liters of water

0737T - Implantation of nonhuman tissue graft into surface of joint

0738T - Treatment planning for magnetic field induction ablation of malignant prostate tissue, using data from previously performed magnetic resonance imaging (MRI) examination

0749T - Bone strength and fracture-risk assessment using digital X-ray radiogrammetrybone mineral density (DXR-BMD) analysis of bone mineral density (BMD) utilizing data from a digital X ray, retrieval and transmission of digital X ray data, assessment of bone strength and fracture-risk and BMD, interpretation and report;

0750T - Bone strength and fracture-risk assessment using digital X-ray radiogrammetrybone mineral density (DXR-BMD) analysis of bone mineral density (BMD) utilizing data from a digital X ray, retrieval and transmission of digital X ray data, assessment of bone strength and fracture-risk and BMD, interpretation and report; with single-view digital X-ray examination of the hand taken for the purpose of DXR-BMD

0766T - Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, initial treatment, with identification and marking of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve

0767T - Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, initial treatment, with identification and marking of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; each additional nerve (List separately in addition to code for primary procedure)

0768T - Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, subsequent treatment, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve

0769T - Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, subsequent treatment, including noninvasive electroneurographic localization (nerve conduction localization), when performed;each additional nerve (List separately in addition to code for primary procedure)

0770T - Virtual reality technology to assist therapy (List separately in addition to code for primary procedure)

0771T - Virtual reality (VR) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the VR procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the monitoring of the patient's level of dissociation or consciousness and physiological status; initial 15 minutes of intraservice time, patient age 5 years or older

0772T - Virtual reality (VR) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the VR procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the monitoring of the patient's level of dissociation or each additional 15 minutes intraservice time (List separately in addition to code for primary service) consciousness and physiological status;

0773T - Virtual reality (VR) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the VR procedural dissociation supports; initial 15 minutes of intraservice time, patient age 5 years or older

0774T - Virtual reality (VR) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the VR procedural dissociation supports; each additional 15 minutes intraservice time (List separately in addition to code for primary service

0776T - Therapeutic induction of intra-brain hypothermia, including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head, including monitoring (eg, vital signs and sport concussion assessment tool 5 [SCAT5]), 30 minutes of treatment

0778T - Surface mechanomyography (sMMG) with concurrent application of inertial measurement unit (IMU) sensors for measurement of multi-joint range of motion, posture, gait, and muscle function

0779T - Gastrointestinal myoelectrical activity study, stomach through colon, with interpretation and report

0781T - Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; bilateral mainstem bronchi

0782T - Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; unilateral mainstem bronchus

0795T - Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; complete system (ie, right atrial and right ventricular pacemaker components)

0796T - Right atrial pacemaker component (when an existing right ventricular single leadless pacemaker exists to create a dual-chamber leadless pacemaker system)

0797T - Right ventricular pacemaker component (when part of a dual-chamber leadless pacemaker system)

0798T - Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; complete system (ie, right atrial and right ventricular pacemaker components)

0799T - Right atrial pacemaker component

0800T - Right ventricular pacemaker component (when part of a dual-chamber leadless pacemaker system)

0801T - Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; dual-chamber system (ie, right atrial and right ventricular pacemaker components)

0802T - Right atrial pacemaker component

0803T - Right ventricular pacemaker component (when part of a dual-chamber leadless pacemaker system)

0804T - Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values, with analysis, review, and report, by a physician or other qualified health care professional, leadless pacemaker system in dual cardiac chambers

0807T - Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed tomography (CT) images, including data preparation and transmission, quantification of pulmonary tissue ventilation, data review, interpretation and report

0808T - in combination with computed tomography (CT) images taken for the purpose of pulmonary tissue ventilation analysis, including data preparation and transmission, quantification of pulmonary tissue

0809T - Arthrodesis, sacroiliac joint, percutaneous or minimally invasive (indirect visualization), with image guidance, placement of transfixing device(s) and intraarticular implant(s), including allograft or synthetic device(s

0810T - Subretinal injection of a pharmacologic agent, including vitrectomy and 1 or more retinotomies

0815T - Ultrasound-based radiofrequency echographic multi-spectrometry (REMS), bone-density study and fracture-risk assessment, 1 or more sites, hips, pelvis, or spine

0816T - Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (e.g., array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous

0817T - Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (e.g., array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subfascial

0818T - Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous

0819T - Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subfascial

0823T - Transcatheter insertion of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or programming), when performed

0824T - Transcatheter removal of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography), when performed

0825T - Transcatheter removal and replacement of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or programming), when performed

0826T - Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, leadless pacemaker system in single-cardiac chamber

0860T - Noncontact near-infrared spectroscopy with provocative maneuvers, image acquisition, interpretation and report for screening for peripheral arterial disease

0861T - Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)

0862T - Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only

0863T - Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming;transmitter component only

0865T - Quantitative magnetic resonance image (MRI) analysis of the brain with comparison to prior magnetic resonance (MR) study(ies), including lesion identification, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transmission, interpretation and report, obtained without diagnostic MRI examination of the brain during the same session

0866T - Quantitative magnetic resonance image (MRI) analysis of the brain with comparison to prior magnetic resonance (MR) study(ies), including lesion detection, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transmission, interpretation and report, obtained with diagnostic MRI examination of the brain (List separately in addition to code for primary procedure)



ICD 10 CM Updates

Guidelines for billing CPT G2211

About CPT G2211 & Objectives Effective from January 1, 2024, the Centers for Medicare and Medicaid Services (CMS) began reimbursing for ...