The new year is upon us and so it’s time to double check and make sure we are ready. As always, there were changes to all the official code sets (i.e., ICD-10-CM, CPT, HCPCS.) which could affect your practice.
Diagnosis Code Changes
For the official ICD-10-CM code set fiscal year 2019 which began October 1, 2018, there were 279 new codes, 51 deleted codes, and 143 revised codes. However, there weren’t very many changes which affect chiropractic. As we mentioned back in September, the most significant change is the expansion of code M79.1 “Myalgia” to 4 new codes. M79.12 “Myalgia of auxiliary muscles, head and neck” and M79.18 “Myalgia, other site” will most likely be the ones used in your office. Since M79.12 says ‘auxiliary muscles’, it seems that M79.18 would be the most commonly used code of the two.
Code G71.0 “Muscular dystrophy” has also been expanded to define the type of dystrophy.
In the External Causes, Chapter 20, there were no new codes added that are of primary interest in a chiropractic setting. However, it should be noted that there were quite a few minor revisions to the External Causes, Chapter 20. For example, snowboarding is now one word instead of two (e.g., snow boarding) and baby stroller is two words instead of one.
Procedure Code Changes
For the CPT code set, there are 168 new codes, 72 deleted codes, and 49 revised codes for 2019. There were also many HCPCS code set revisions, but out of all these changes, there were only a few of particular note for chiropractic.
- Remote Patient Monitoring Code Changes: Code 99090 “Analysis of clinical data stored in computers” was deleted. There were also changes to code 99091 and they added three new codes for these services (99453, 99454, 99457). There is also a new HCPCS code (G2010) for remotely evaluating recorded video and/or images submitted by an established patient.
- New virtual check-in code: G2012 “Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion”
- Deletion of Code 64550 “Application of surface (transcutaneous) neurostimulator (eg, TENS unit)” has been deleted. It appears that the surface application of neurostimulators is no longer separately payable.
Supply Code Changes
Please note that when the 2019 ChiroCode DeskBook was published, the HCPCS code set had not been released. The following are changes which might affect your practice:
- Code A9273 description changed to “Cold or hot fluid bottle, ice cap or collar, heat and/or cold wrap, any type”
- Code E0218 description changed to “Fluid circulating cold pad with pump, any type”
- New code for diabetic foot inserts: A5514 “For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each”
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