New and Revised CPT & HCPCS Codes For 2013
The following are changes to Current Procedural Terminology (CPT © American Medical Association) and Health Care Common Procedure Coding System (HCPCS) Level II codes that are effective January 1, 2013. We are including comments from the Centers for Medicare and Medicaid Services (CMS) regarding the coding changes because health plans may adopt Medicare coding rules.
New CPT Codes
New codes related to nerve conduction studies and intraoperative neurophysiologic monitoring have been added for 2013.
Nerve Conduction Studies
These new nerve conduction study codes replace two H-reflex codes (see Deleted Codes).
- 95907 Nerve conduction studies; 1–2 studies
- 95908 3–4 studies
- 95909 5–6 studies
- 95910 7–8 studies
- 95911 9–10 studies
- 95912 11–12 studies
- 95913 13 or more studies
The numerical ranges included in the descriptors refer to the number of nerve conduction studies performed. Tests must be performed with separate electrodes for stimulating, recording, and grounding on only those specific nerves needed for the diagnosis in question. Waveforms must be reviewed on site in real time with reports by the examiner and interpretation by the physician or other qualified health care professional. Each type of nerve conduction study is counted only once on the same nerve.
Intraoperative Neurophysiologic Monitoring (IONM)
These new IONM codes replace CPT 95920 (see Deleted CPT Codes).
- 95940 Continuous intraoperative neurophysiology monitoring in the operating room, one on one monitoring requiring personal attendance, each 15 minutes (List separately in addition to code for primary procedure)
- 95941 Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby) or for monitoring of more than one case while in the operating room, per hour (List separately in addition to code for primary procedure) (See Medicare Note)
- G0453 Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes (list in addition to primary procedure) (This is a Medicare-only code. See Medicare Note)
These CPT codes are add-on codes to be listed in addition to the primary surgical procedure. They describe ongoing neurophysiologic monitoring, testing, and data interpretation distinct from the performance of specific types of baseline neurophysiologic studies performed during surgical procedures. Do not report these codes for automated monitoring devices that do not require continous attendance by a professional qualifed to interpret the testing and monitoring. Both 95940 and G0453 are billed in units of 15 minutes and should be listed in addition to the primary surgical procedure. Continuous and immediate communication directly with the operating room is also required, and the codes include the ongoing monitoring time distinct from the performance of baseline studies.
Medicare Note: 95941 may not be used for Medicare beneficiaries because it allows a provider to remotely monitor several patients at the same time. Because the CMS allows a provider to monitor only one patient at a time, it created G0453, which covers continuous remote (outside the operating room) monitoring for one patient.
Deleted CPT Codes
- 95920 Intraoperative neurophysiology testing, per hour (see 95940-1, G0453)
- 95934 H-reflex, amplitude and latency study; record gastrocnemius/soleus muscle (see 95907-13)
- 95936 record muscle other than gastrocnemius/soleus muscle (see 95907-13)
New HCPCS Level II Codes
New codes related to frequency modulated (FM) and digitally modulated (DM) systems have been added for 2013.
- V5281, personal FM/DM system, monaural, (one receiver, transmitter and microphone)
- V5282, personal FM/DM system, binaural (two receivers, transmitter and microphone)
- V5283, personal FM/DM neck, loop induction receiver
- V5284, personal FM/DM, ear level receiver
- V5285, personal FM/DM, direct audio input receiver
- V5286, personal blue tooth FM/DM receiver
- V5287, personal FM/DM receiver, not otherwise specified
- V5288, personal FM/DM transmitter assistive listening device
- V5289, personal FM/DM adapter/boot coupling device for receiver, any type
- V5290, transmitter microphone, any type
Medicare Note: Although FM/DM systems are not a Medicare benefit, the codes will be instrumental for Medicaid and private insurance programs that supplement hearing aid and cochlear implants recipients, especially children, with the technology.
Revised HCPCS Level II Codes
The following code was revised to include assistive listening device supplies not otherwise specified
- V5267, hearing aid or assistive listening device/supplies/accessories, not otherwise specified