Search This Blog

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

CPT Changes - Revised CPT Codes '2024

The summary of the New, Revised, and Deleted CPT code across all the sections of the CPT codes below,

  • New – 230 Codes 
  • Revised – 70 Codes 
  • Deleted – 49 Codes

Revised CPT Codes

 

0351U Infectious disease (bacterial or viral), biochemical assays, tumor necrosis factor-related apoptosis-inducing ligand (TRAIL), interferon gamma-induced protein-10 (IP-10), and C-reactive protein, serum, or venous whole blood, algorithm reported as likelihood of bacterial infection
 
0356U Oncology (oropharyngeal or anal), evaluation of 17 DNA biomarkers using droplet digital PCR (ddPCR), cell-free DNA, algorithm reported as a prognostic risk score for cancer recurrence
 
0517T Insertion of wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming, and imaging supervision and interpretation, when performed; both components of pulse generator (battery and transmitter) only
 
0518T Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; battery component only
 
0519T Removal and replacement of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; both components (battery and transmitter)
 
0520T Removal and replacement of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only
 
0587T Percutaneous implantation or replacement of integrated single device neurostimulation system for bladder dysfunction including electrode array and receiver or pulse generator, including analysis, programming, and imaging guidance when performed, posterior tibial nerve
 
0588T Revision or removal of percutaneously placed integrated single device neurostimulation system for bladder dysfunction including electrode array and receiver or pulse generator, including analysis, programming, and imaging guidance when performed, posterior tibial nerve
 
0589T Electronic analysis with simple programming of implanted integrated neurostimulation system for bladder dysfunction (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (Hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detection algorithms, closed-loop parameters, and passive parameters, when performed by physician or other qualified health care professional, posterior tibial nerve, 1-3 parameters
 
0590T Electronic analysis with complex programming of implanted integrated neurostimulation system for bladder dysfunction (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (Hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detection algorithms, closed-loop parameters, and passive parameters, when performed by physician or other qualified health care professional, posterior tibial nerve, 4 or more parameters
 
0640T Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; first anatomic site
 
0656T Anterior lumbar or thoracolumbar vertebral body tethering; up to 7 vertebral segments
 
0657T Anterior lumbar or thoracolumbar vertebral body tethering; 8 or more vertebral segments
 
0766T Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, 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, 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)
 
1119F Initial evaluation for condition (HEP C) (EPI, DSP)
 
1121F Subsequent evaluation for condition (HEP C) (EPI)
 
28292 Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with resection of proximal phalanx base, when performed, any method
 
28295 Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with proximal metatarsal osteotomy, any method
 
28296 Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with distal metatarsal osteotomy, any method
 
28297 Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with first metatarsal and medial cuneiform joint arthrodesis, any method
 
28298 Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with proximal phalanx osteotomy, any method
 
28299 Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with double osteotomy, any method
 
3095F Central dual-energy X-ray absorptiometry (DXA) results documented (OP) (IBD)
 
3096F Central dual-energy X-ray absorptiometry (DXA) ordered (OP) (IBD)
 
3216F Patient has documented immunity to Hepatitis B (HEP-C) (IBD)
 
3372F AJCC Breast Cancer Stage I: T1mic, T1a or T1b (tumor size <= 1 cm) documented (ONC)
 
3496F CD4+ cell count >=500 cells/mm3 (HIV)
 
3498F CD4+ cell percentage >=15% (HIV)
 
4194F Patient receiving >=10 mg daily prednisone (or equivalent) for longer than 6 months, and improvement or no change in disease activity (RA)
 
63685 Insertion or replacement of spinal neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver
 
63688 Revision or removal of implanted spinal neurostimulator pulse generator or receiver, with detachable connection to electrode array
 
64590 Insertion or replacement of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver
 
64595 Revision or removal of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, with detachable connection to electrode array
 
77402 Radiation treatment delivery, >=1 MeV; simple
 
77407 Radiation treatment delivery, >=1 MeV; intermediate
 
77412 Radiation treatment delivery, >=1 MeV; complex
 
81171 AFF2 (ALF transcription elongation factor 2 [FMR2]) (eg, fragile X intellectual disability 2 [FRAXE]) gene analysis; evaluation to detect abnormal (eg, expanded) alleles
 
81172 AFF2 (ALF transcription elongation factor 2 [FMR2]) (eg, fragile X intellectual disability 2 [FRAXE]) gene analysis; characterization of alleles (eg, expanded size and methylation status) FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability [XLID]) gene analysis; evaluation to detect abnormal (eg, expanded) alleles
 
81244 FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability [XLID]) gene analysis; characterization of alleles (eg, expanded size and promoter methylation status)
 
81403 Molecular pathology procedure, Level 4 (eg, analysis of single exon by DNA sequence analysis, analysis of >10 amplicons using multiplex PCR in 2 or more independent reactions, mutation scanning or duplication/deletion variants of 2-5 exons) ARX (aristaless related homeobox) (eg, X-linked lissencephaly with ambiguous genitalia, X-linked intellectual disability), duplication/deletion analysis
 
81404 Molecular pathology procedure, Level 5 (eg, analysis of 2-5 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 6-10 exons, or characterization of a dynamic mutation disorder/triplet repeat by Southern blot analysis) ARX (aristaless related homeobox) (eg, X-linked lissencephaly with ambiguous genitalia, X-linked intellectual disability), full gene sequence 
 
81405 Molecular pathology procedure, Level 6 (eg, analysis of 6-10 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 11-25 exons, regionally targeted cytogenomic array analysis) FTSJ1 (FtsJ RNA 2'-O-methyltransferase 1) (eg, X-linked intellectual disability 9), duplication/deletion analysis
 
81406 Molecular pathology procedure, Level 7 (eg, analysis of 11-25 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 26-50 exons) FTSJ1 (FtsJ RNA 2'-O-methyltransferase 1) (eg, X-linked intellectual disability 9), full gene sequence
 
81407 Molecular pathology procedure, Level 8 (eg, analysis of 26-50 exons by  DNA sequence analysis, mutation scanning or duplication/deletion variants of >50 exons, sequence analysis of multiple genes on one  platform) KDM5C (lysine demethylase 5C) (eg, X-linked intellectual disability), full gene sequence
 
81445 Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; DNA analysis or combined DNA and RNA analysis
 
81449 Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; RNA analysis
 
81450 Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mRNA expression levels, if performed; DNA analysis or combined DNA and RNA analysis
 
81451 Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mRNA expression levels, if performed; RNA analysis
 
81456 Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform expression or mRNA expression levels, if performed; RNA analysis
 
87467 Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], fluorescence immunoassay [FIA], immunochemiluminometric assay [IMCA]), qualitative or semiquantitative; hepatitis B surface antigen (HBsAg), quantitative
 
0351U Infectious disease (bacterial or viral), biochemical assays, tumor necrosis factor-related apoptosis inducing ligand (TRAIL), interferon gamma-induced  protein-10 (IP-10), and C-reactive protein, serum, or venous whole blood, algorithm reported as likelihood of bacterial infection
 
0356U Oncology (oropharyngeal or anal), evaluation of 17 DNA biomarkers using droplet digital PCR (ddPCR), cell-free DNA, algorithm reported as a prognostic risk score for cancer recurrence
 
91304 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, 5 mcg/0.5 mL dosage, for intramuscular use
 
96446 Chemotherapy administration into the peritoneal cavity via implanted port or catheter
 
96920 Excimer laser treatment for psoriasis; total area less than 250 sq cm
 
96921 Excimer laser treatment for psoriasis; 250 sq cm to 500 sq cm
 
96922 Excimer laser treatment for psoriasis; over 500 sq cm
 
99202 Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.
 
99203 Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.
 
99204 Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.
 
99205 Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.
 
99212 Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 10 minutes must be met or exceeded.
 
99213 Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.
 
99214 Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.
 
99215 Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.
 
99306 Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 50 minutes must be met or exceeded.
 
99308 Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.


CPT Changes - Deleted CPT Codes '2024

The summary of the New, Revised, and Deleted CPT code across all the sections of the CPT codes below,

  • New – 230 Codes 
  • Revised – 70 Codes 
  • Deleted – 49 Codes

Deleted CPT Codes

0014M Liver disease, analysis of 3 biomarkers (hyaluronic acid [HA], procollagen III amino terminal peptide [PIIINP], tissue inhibitor of metalloproteinase 1 [TIMP-1]), using immunoassays, utilizing serum, prognostic algorithm reported as a risk score and risk of liver fibrosis and liver-related clinical events within 5 years

0404T Transcervical uterine fibroid(s) ablation with ultrasound guidance, radiofrequency

0424T Insertion or replacement of neurostimulator system for treatment of central sleep apnea; complete system (transvenous placement of right or left stimulation lead, sensing lead, implantable pulse generator)

0425T Insertion or replacement of neurostimulator system for treatment of central sleep apnea; sensing lead only

0426T Insertion or replacement of neurostimulator system for treatment of central sleep apnea; stimulation lead only

0427T Insertion or replacement of neurostimulator system for treatment of central sleep apnea; pulse generator only

0428T Removal of neurostimulator system for treatment of central sleep apnea; pulse generator only

0429T Removal of neurostimulator system for treatment of central sleep apnea; sensing lead only

0430T Removal of neurostimulator system for treatment of central sleep apnea; stimulation lead only

0431T Removal and replacement of neurostimulator system for treatment of central sleep apnea, pulse generator only

0432T Repositioning of neurostimulator system for treatment of central sleep apnea; stimulation lead only

0433T Repositioning of neurostimulator system for treatment of central sleep apnea; sensing lead only

0434T Interrogation device evaluation implanted neurostimulator pulse generator system for central sleep apnea

0435T Programming device evaluation of implanted neurostimulator pulse generator system for central sleep apnea; single session

0436T Programming device evaluation of implanted neurostimulator pulse generator system for central sleep apnea; during sleep study

0465T Suprachoroidal injection of a pharmacologic agent (does not include supply of medication)

0499T Cystourethroscopy, with mechanical dilation and urethral therapeutic drug delivery for urethral stricture or stenosis, including fluoroscopy, when performed

0501T Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation software analysis of functional data to assess the severity of coronary artery disease; data preparation and transmission, analysis of fluid dynamics and simulated maximal coronary hyperemia, generation of estimated FFR model, with anatomical data review in comparison with estimated FFR model to reconcile discordant data, interpretation and report

0502T Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation software analysis of functional data to assess the severity of coronary artery disease; data preparation and transmission

0503T Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation software analysis of functional data to assess the severity of coronary artery disease; analysis of fluid dynamics and simulated maximal coronary hyperemia, and generation of estimated FFR model

0504T Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation software analysis of functional data to assess the severity of coronary artery disease; anatomical data review in comparison with estimated FFR model to reconcile discordant data, interpretation and report

0508T Pulse-echo ultrasound bone density measurement resulting in indicator of axial bone mineral density, tibia

0533T Continuous recording of movement disorder symptoms, including bradykinesia, dyskinesia, and tremor for 6 days up to 10 days; includes set-up, patient training, configuration of monitor, data upload, analysis and initial report configuration, download review, interpretation and report

0534T Continuous recording of movement disorder symptoms, including bradykinesia, dyskinesia, and tremor for 6 days up to 10 days; set-up, patient training, configuration of monitor

0535T Continuous recording of movement disorder symptoms, including bradykinesia, dyskinesia, and tremor for 6 days up to 10 days; data upload, analysis and initial report configuration

0536T Continuous recording of movement disorder symptoms, including bradykinesia, dyskinesia, and tremor for 6 days up to 10 days; download review, interpretation and report

0641T Noncontact near-infrared spectroscopy studies of flap or wound (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation [StO2]); image acquisition only, each flap or wound

0642T Noncontact near-infrared spectroscopy studies of flap or wound (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation [StO2]); interpretation and report only, each flap or wound

0715T Percutaneous transluminal coronary lithotripsy (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)

0775T Arthrodesis, sacroiliac joint, percutaneous, with image guidance, includes placement of intra-articular implant(s) (eg, bone allograft[s], synthetic device[s])

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

74710 Pelvimetry, with or without placental localization


CPT Changes - New CPT Codes '2024

The summary of the New, Revised, and Deleted CPT code across all the sections of the CPT codes below,

  • New – 230 Codes 
  • Revised – 70 Codes 
  • Deleted – 49 Codes

Presenting the significant 2024 updates related to Evaluation and Management, Here's a concise overview of the latest changes.

Evaluation & Management:

Time ranges eliminated from office/outpatient E/M codes.

Replaced with a single total time amount, set as the lowest number of minutes in the current range for each code.

New descriptors stress that practitioners must meet or exceed this specified time. Shared the required time spent details for each E&M code.

New CPT Codes

0420U Oncology (urothelial), mRNA expression profiling by real-time quantitative PCR of MDK, HOXA13, CDC2, IGFBP5, and CXCR2 in combination with droplet digital PCR (ddPCR) analysis of 6 single-nucleotide polymorphisms (SNPs) genes TERT and FGFR3, urine, algorithm reported as a risk score for urothelial carcinoma

0421U Oncology (colorectal) screening, quantitative real-time target and signal amplification of 8 RNA markers (GAPDH, SMAD4, ACY1, AREG, CDH1, KRAS, TNFRSF10B, EGLN2) and fecal hemoglobin, algorithm reported as a positive or negative for colorectal cancer risk

0422U Oncology (pan-solid tumor), analysis of DNA biomarker response to anti-cancer therapy using cell-free circulating DNA, biomarker comparison to a previous baseline pre-treatment cell-free circulating DNA analysis using next-generation sequencing, algorithm reported as a quantitative change from baseline, including specific alterations, if appropriate

0423U Psychiatry (eg, depression, anxiety), genomic analysis panel, including variant analysis of 26 genes, buccal swab, report including metabolizer status and risk of drug toxicity by condition

0424U Oncology (prostate), exosome-based analysis of 53 small noncoding RNAs (sncRNAs) by quantitative reverse transcription polymerase chain reaction (RT-qPCR), urine, reported as no molecular evidence, low-, moderate- or elevated-risk of prostate cancer

0425U Genome (eg, unexplained constitutional or heritable disorder or syndrome), rapid sequence analysis, each comparator genome (eg, parents, siblings)

0426U Genome (eg, unexplained constitutional or heritable disorder or syndrome), ultra-rapid sequence analysis

0427U Monocyte distribution width, whole blood (List separately in addition to code for primary procedure)

0428U Oncology (breast), targeted hybrid-capture genomic sequence analysis panel, circulating tumor DNA (ctDNA) analysis of 56 or more genes, interrogation for sequence variants, gene copy number amplifications, gene rearrangements, microsatellite instability, and tumor mutation burden

0429U Human papillomavirus (HPV), oropharyngeal swab, 14 high-risk types (ie, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68)

0430U Gastroenterology, malabsorption evaluation of alpha-1-antitrypsin, calprotectin, pancreatic elastase and reducing substances, feces, quantitative

0431U Glycine receptor alpha1 IgG, serum or cerebrospinal fluid (CSF), live cell-binding assay (LCBA), qualitative

0432U Kelch-like protein 11 (KLHL11) antibody, serum or cerebrospinal fluid (CSF), cell-binding assay, qualitative

0433U Oncology (prostate), 5 DNA regulatory markers by quantitative PCR, whole blood, algorithm, including prostate-specific antigen, reported as likelihood of cancer

0434U Drug metabolism (adverse drug reactions and drug response), genomic analysis panel, variant analysis of 25 genes with reported phenotypes

0435U Oncology, chemotherapeutic drug cytotoxicity assay of cancer stem cells (CSCs), from cultured CSCs and primary tumor cells, categorical drug response reported based on cytotoxicity percentage observed, minimum of 14 drugs or drug combinations

0436U Oncology (lung), plasma analysis of 388 proteins, using aptamer-based proteomics technology, predictive algorithm reported as clinical benefit from immune checkpoint inhibitor therapy

0437U Psychiatry (anxiety disorders), mRNA, gene expression profiling by RNA sequencing of 15 biomarkers, whole blood, algorithm reported as predictive risk score

0438U Drug metabolism (adverse drug reactions and drug response), buccal specimen, gene-drug interactions, variant analysis of 33 genes, including deletion/duplication analysis of CYP2D6, including reported phenotypes and impacted gene-drug interactions

0784T Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging guidance, when performed

0785T Revision or removal of neurostimulator electrode array, spinal, with integrated neurostimulator

0786T Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed

0787T Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator

0788T Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (Hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detection algorithms, closed-loop parameters, and passive parameters, when performed by physician or other qualified health care professional, spinal cord or sacral nerve, 1-3 parameters

0789T Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (Hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detection algorithms, closed-loop parameters, and passive parameters, when performed by physician or other qualified health care professional, spinal cord or sacral nerve, 4 or more parameters

0790T Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body tethering, including thoracoscopy, when performed

0811T Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); set-up and patient education on use of equipment

0812T Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); device supply with automated report generation, up to 10 days

0813T Esophagogastroduodenoscopy, flexible, transoral, with volume adjustment of intragastric bariatric balloon

0814T Percutaneous injection of calcium-based biodegradable osteoconductive material, proximal femur, including imaging guidance, unilateral

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) (eg, 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) (eg, 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

0820T Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; first physician or other qualified health care professional, each hour

0821T Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; second physician or other qualified health care professional, concurrent with first physician or other qualified health care professional, each hour (List separately in addition to code for primary procedure)

0822T Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; clinical staff under the direction of a physician or other qualified health care professional, concurrent with first physician or other qualified health care professional, each hour (List separately in addition to code for primary procedure)

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

0827T Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation (List separately in addition to code for primary procedure)

0828T Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; simple filter method with interpretation (List separately in addition to code for primary procedure)

0829T Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (eg, Saccomanno technique) (List separately in addition to code for primary procedure)

0830T Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (List separately in addition to code for primary procedure)

0831T Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (List separately in addition to code for primary procedure)

0832T Digitization of glass microscope slides for cytopathology, smears, any other source; screening and interpretation (List separately in addition to code for primary procedure)

0833T Digitization of glass microscope slides for cytopathology, smears, any other source; preparation, screening and interpretation (List separately in addition to code for primary procedure)

0834T Digitization of glass microscope slides for cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains (List separately in addition to code for primary procedure)

0835T Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site (List separately in addition to code for primary procedure)

0836T Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (List separately in addition to code for primary procedure)

0837T Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; interpretation and report (List separately in addition to code for primary procedure)

0838T Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (List separately in addition to code for primary procedure)

0839T Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (List separately in addition to code for primary procedure)

0840T Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (List separately in addition to code for primary procedure)

0841T Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (List separately in addition to code for primary procedure)

0842T Digitization of glass microscope slides for pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for primary procedure)

0843T Digitization of glass microscope slides for pathology consultation during surgery; cyt-ologic examination (eg, touch preparation, squash preparation), initial site (List separately in addition to code for primary procedure)

0844T Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), each additional site (List separately in addition to code for primary procedure)

0845T Digitization of glass microscope slides for immunofluorescence, per specimen; initial single antibody stain procedure (List separately in addition to code for primary procedure)

0846T Digitization of glass microscope slides for immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure)

0847T Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, KRAS mutational analysis) (List separately in addition to code for primary procedure)

0848T Digitization of glass microscope slides for in situ hybridization (eg, FISH), per specimen; initial single probe stain procedure (List separately in addition to code for primary procedure)

0849T Digitization of glass microscope slides for in situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure)

0850T Digitization of glass microscope slides for in situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure (List separately in addition to code for primary procedure)

0851T Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial single probe stain procedure (List separately in addition to code for primary procedure)

0852T Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure)

0853T Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex probe stain procedure (List separately in addition to code for primary procedure)

0854T Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (List separately in addition to code for primary procedure)

0855T Digitization of glass microscope slides for bone marrow, smear interpretation (List separately in addition to code for primary procedure)

0856T Digitization of glass microscope slides for electron microscopy, diagnostic (List separately in addition to code for primary procedure)

0857T Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation, augmentative analysis and report (List separately in addition to code for primary procedure)

0858T Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report

0859T Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; each additional anatomic site (List separately in addition to code for primary procedure)

0860T Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), for screening for peripheral arterial disease, including provocative maneuvers, image acquisition, interpretation, and report, one or both lower extremities

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

0864T Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy

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)

22836 Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; up to 7 vertebral segments

22837 Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; 8 or more vertebral segments

22838 Revision (eg, augmentation, division of tether), replacement, or removal of thoracic vertebral body tethering, including thoracoscopy, when performed

27278 Arthrodesis, sacroiliac joint, percutaneous, with image guidance, including placement of intra-articular implant(s) (eg, bone allograft[s], synthetic device[s]), without placement of transfixation device

31242 Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve

31243 Nasal/sinus endoscopy, surgical; with destruction by cryoablation, posterior nasal nerve

33276 Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s]), including vessel catheterization, all imaging guidance, and pulse generator initial analysis with diagnostic mode activation, when performed

+33277 Insertion of phrenic nerve stimulator transvenous sensing lead (List separately in addition to code for primary procedure)

33278 Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; system, including pulse generator and lead(s)

33279 Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s) only

33280 Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator only

33281 Repositioning of phrenic nerve stimulator transvenous lead(s)

33287 Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator

33288 Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s)

52284 Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when performed

58580 Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency

61889 Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or cortical strip electrode array(s)

61891 Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)

61892 Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed

64596 Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array

+64597 Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (List separately in addition to code for primary procedure)

64598 Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator

67516 Suprachoroidal space injection of pharmacologic agent (separate procedure)

75580 Noninvasive estimate of coronary fractional flow reserve (FFR) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified health care professional

76984 Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic

76987 Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report

76988 Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only

76989 Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only

81457 Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis, microsatellite instability

81458 Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis, copy number variants and microsatellite instability

81459 Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements

81462 Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants and rearrangements

81463 Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis, copy number variants, and microsatellite instability

81464 Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements

81517 Liver disease, analysis of 3 biomarkers (hyaluronic acid [HA], procollagen III amino terminal peptide [PIIINP], tissue inhibitor of metalloproteinase 1 [TIMP-1]), using immunoassays, utilizing serum, prognostic algorithm reported as a risk score and risk of liver fibrosis and liver-related clinical events within 5 years

82166 Anti-mullerian hormone (AMH)

86041 Acetylcholine receptor (AChR); binding antibody

86042 Acetylcholine receptor (AChR); blocking antibody

86043 Acetylcholine receptor (AChR); modulating antibody

86366 Muscle-specific kinase (MuSK) antibody

87523 Infectious agent detection by nucleic acid (DNA or RNA); hepatitis D (delta), quantification, including reverse transcription, when performed

90589 Chikungunya virus vaccine, live attenuated, for intramuscular use

90623 Meningococcal pentavalent vaccine, conjugated Men A, C, W, Y- tetanus toxoid carrier, and Men B-FHbp, for intramuscular use

90679 Respiratory syncytial virus vaccine, preF, recombinant, subunit, adjuvanted, for intramuscular use

90380 Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 mL dosage, for intramuscular use

90381 Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 mL dosage, for intramuscular use 

90683 Respiratory syncytial virus vaccine, mRNA lipid nanoparticles,for intramuscular use 

92622 Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes

+92623 Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (List separately in addition to code for primary procedure)

92972 Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure)

93150 Therapy activation of implanted phrenic nerve stimulator system, including all interrogation and programming

93151 Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system

93152 Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography

93153 Interrogation without programming of implanted phrenic nerve stimulator system

+93584 Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart (List separately in addition to code for primary procedure)

+93585 Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (List separately in addition to code for primary procedure)

+93586 Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (List separately in addition to code for primary procedure)

+93587 Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate vein) (List separately in addition to code for primary procedure)

+93588 Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena cava) (List separately in addition to code for primary procedure)

+96547 Intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) procedure, including separate incision(s) and closure, when performed; first 60 minutes (List separately in addition to code for primary procedure)

+96548 Intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) procedure, including separate incision(s) and closure, when performed; each additional 30 minutes (List separately in addition to code for primary procedure)

97037 Application of a modality to 1 or more areas; low-level laser therapy (ie, nonthermal and non-ablative) for post-operative pain reduction

97550 Caregiver training in strategies and techniques to facilitate the patient’s functional performance in the home or community (eg, activities of daily living [ADLs], instrumental ADLs [iADLs], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patient present), face to face; initial 30 minutes

97551 Caregiver training in strategies and techniques to facilitate the patient’s functional performance in the home or community (eg, activities of daily living [ADLs], instrumental ADLs [iADLs], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patient present), face to face; each additional 15 minutes (List separately in addition to code for primary service)

97552 Group caregiver training in strategies and techniques to facilitate the patient's functional performance in the home or community (eg, activities of daily living [ADLs], instrumental ADLs [iADLs], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patient present), face to face with multiple sets of caregivers

+99459 Pelvic examination (List separately in addition to code for primary procedure)


Biofeedback Procedures Guidelines

CPT Code History & Guidelines

There are three CPT codes are available,

  • 90901 -  Biofeedback training by any modality
  • 90912 - Biofeedback training, perineal muscles, anorectal or urethral sphincter, including EMG and/or manometry, when performed; initial 15 minutes of one-on-one physician or other qualified health care professional contact with the patient
  • +90913 - Biofeedback training, perineal muscles, anorectal or urethral sphincter, including EMG and/or manometry, when performed; each additional 15 minutes of one-on-one physician or other qualified health care professional contact with the patient (List separately in addition to code for primary procedure)

The CPT 90911 was deleted in 2022 and the CPT 90912 & +90913 was added in Jan'2020. The purpose of this codes added,

The provider or other qualified healthcare professional will be trained the patients to control of involuntary bodily functions. There are,

  • Altering brain activity,
  • Blood pressure,
  • Heart rate, and
  • Other bodily functions that the patient cannot normally control voluntarily.

This service is done for conditions such as fecal or urinary incontinence. EMG and manometry, if performed, are included with this service.

  • The CPT 90912 can reported for the first 15 minutes of face–to–face service with the patients, and 
  • The CPT 90913 can be reported for each additional 15 minutes of face–to–face biofeedback training with the patient.

 

Clinical View

The physician uses the equipment that measures and responds to very slight changes in the body, such as changes in temperature, heart rate, blood pressure, and muscle tension, and provides feedback to the patient via lights, sounds, and meters.

And by using this equipment, and other therapeutic methods, the provider guides the patient through practices to alter his bodily functions and learn to control his reactions to help treat his disorders.

In this service, the provider is usually a urologist who first assesses and documents that reasons why the patient is a good candidate for biofeedback.

The provider then uses biofeedback–assisted pelvic muscle education (PME) which may include measurement of muscle contraction through an electromyography (EMG) and vaginal or rectal sensors and/or rectal manometry devices to help the patient become more aware of the pelvic muscles and assist in their movement.

The service may also include other techniques, such as relaxation, to help control involuntary bodily movements.

After completion of the test, the providers will take the printouts from the testing and his/her written interpretation of each of the tests in the patient’s medical record.

Limitation and Frequency

The Biofeedback sessions often have limits of four to six treatments over a four–week period. If it's exceeded as a result, payers will deny claims that exceed the frequency limit unless you can prove that the patient's specific condition requires additional services.

Payer Specific Updates

Some payers still consider biofeedback bladder training to be experimental and investigational services.

BCBS Updates

 

Covered ICD Codes

The listed below diagnosis are considered as the medical necessity

  • G44.201 Tension-type headache, unspecified, intractable
  • G44.209 Tension-type headache, unspecified, not intractable
  • G44.211 Episodic tension-type headache, intractable
  • G44.219 Episodic tension-type headache, not intractable
  • G44.221 Chronic tension-type headache, intractable
  • G44.229 Chronic tension-type headache, not intractable
  • G43.001 Migraine without aura, not intractable, with status migrainosus
  • G43.009 Migraine without aura, not intractable, without status migrainosus
  • G43.011 Migraine without aura, intractable, with status migrainosus
  • G43.019 Migraine without aura, intractable, without status migrainosus
  • G43.101 Migraine with aura, not intractable, with status migrainosus
  • G43.109 Migraine with aura, not intractable, without status migrainosus
  • G43.111 Migraine with aura, intractable, with status migrainosus
  • G43.119 Migraine with aura, intractable, without status migrainosus
  • G43.401 Hemiplegic migraine, not intractable, with status migrainosus
  • G43.409 Hemiplegic migraine, not intractable, without status migrainosus
  • G43.411 Hemiplegic migraine, intractable, with status migrainosus
  • G43.419 Hemiplegic migraine, intractable, without status migrainosus
  • G43.501 Persistent migraine aura without cerebral infarction, not intractable, with status migrainosus
  • G43.509 Persistent migraine aura without cerebral infarction, not intractable, without status migrainosus
  • G43.511 Persistent migraine aura without cerebral infarction, intractable, with status migrainosus
  • G43.519 Persistent migraine aura without cerebral infarction, intractable, without status migrainosus
  • G43.601 Persistent migraine aura with cerebral infarction, not intractable, with status migrainosus
  • G43.609 Persistent migraine aura with cerebral infarction, not intractable, without status migrainosus
  • G43.611 Persistent migraine aura with cerebral infarction, intractable, with status migrainosus
  • G43.619 Persistent migraine aura with cerebral infarction, intractable, without status migrainosus
  • G43.701 Chronic migraine without aura, not intractable, with status migrainosus
  • G43.709 Chronic migraine without aura, not intractable, without status migrainosus
  • G43.711 Chronic migraine without aura, intractable, with status migrainosus
  • G43.719 Chronic migraine without aura, intractable, without status migrainosus
  • G43.801 Other migraine, not intractable, with status migrainosus
  • G43.809 Other migraine, not intractable, without status migrainosus
  • G43.811 Other migraine, intractable, with status migrainosus
  • G43.819 Other migraine, intractable, without status migrainosus
  • G43.821 Menstrual migraine, not intractable, with status migrainosus
  • G43.829 Menstrual migraine, not intractable, without status migrainosus
  • G43.831 Menstrual migraine, intractable, with status migrainosus
  • G43.839 Menstrual migraine, intractable, without status migrainosus
  • G43.901 Migraine, unspecified, not intractable, with status migrainosus
  • G43.909 Migraine, unspecified, not intractable, without status migrainosus
  • G43.911 Migraine, unspecified, intractable, with status migrainosus
  • G43.919 Migraine, unspecified, intractable, without status migrainosus
  • G89.3 Neoplasm related pain (acute) (chronic)
  • K59.00 Constipation, unspecified
  • K59.01 Slow transit constipation
  • K59.02 Outlet dysfunction constipation
  • K59.03 Drug induced constipation
  • K59.04 Chronic idiopathic constipation
  • K59.09 Other constipation
  • N39.3 Stress incontinence (female) (male)
  • N39.41 Urge incontinence
  • N39.46 Mixed incontinence
  • N39.490 Overflow incontinence
  • R15.0 Incomplete defecation
  • R15.1 Fecal smearing
  • R15.2 Fecal urgency
  • R15.9 Full incontinence of feces

Modifier

  • Some payers may require modifier GP, Services delivered under an outpatient physical therapy plan of care.

Experimental or investigational

Biofeedback is considered experimental or investigational for treatment of all other conditions, including but not limited to

  • Anxiety disorders
  • Asthma
  • Bell palsy
  • Chronic pain (including but not limited to low back pain)
  • Cluster headache
  • Depression
  • Functional urinary incontinence
  • Hypertension
  • Insomnia
  • Mechanical urinary incontinence
  • Movement disorders, such as motor function after stroke, injury, or lower-limb surgery
  • Multiple sclerosis
  • Orthostatic hypotension in patients with spinal cord injury
  • Pain management during labor
  • Post-traumatic stress disorder
  • Prevention of preterm birth
  • Psychosomatic conditions
  • Raynaud’s disease
  • Sleep bruxism
  • Tinnitus
  • Vaginismus
  • Vulvodynia

ICD 10 CM Updates

Flu Season Vaccine Updates - 2024-2025

For the 2024-2025 flu season in the United States, all vaccines are expected to be trivalent.  These trivalent vaccines are designed to prot...