Revenue Cycle Management Blog | GroupOne Health Source

Changes to CPT Coding in 2015: Profit or Pain for Physicians?

Written by Kaitlyn Houseman | January 6, 2015

2015 is here and with it comes 550 changes to CPT coding. Every year brings updates, additions, and deletions of CPT codes. How you handle the changes can make your start to 2015 profitable or painful.

Some practices choose to continue submitting claims and wait for insurance carrier denials to learn what changes have taken place as it affects their specialty.  This is certainly not how revenue cycle management should be handled. Most practices can’t afford their everyday denials that come in, let alone the possibility of denials based on code changes! Instead of waiting for denials and losing money, be proactive and learn about the changes that apply to your practice.

Here are a few items to be on the lookout for with CPT coding changes:

Drug screening

Note the changes that have taken place with drug screening codes. This could financially impact your practice if you perform in house drug screening.

Gastroenterology and General Surgery

There are a number of changes to colonoscopy and sigmoidoscopy codes. A lot of general surgery and gastroenterology practices perform colonoscopies on a regular basis. Make sure you are aware of the code changes. 

Arthrocentesis

If you perform arthrocentesis, there are new codes that allow for ultrasonic guidance.

Radiology

Changes have been made to note bundling of codes. 

New Modifiers

XE, XS, XP, and XU are new modifiers that could be more descript than modifier 59. Payers will likely request documentation if you are using the 59 modifier so become familiar with these new modifiers.

 

What should you do to familiarize yourself with your specialty’s codes? 

  • Create an account on AMA’s website to take advantage of a number of tools and resources
  • Subscribe to a coding resource. Some to consider are Super Coder, Find-A-Code, and AAPC
  • Join specialty specific webinars hosted by a number of companies. With so many companies hosting webinars on medical coding, I’d recommend joining a variety to find out which company will provide the level of learning you are seeking.
  • Invest in certified professional coders that can assist with all coding changes and are also familiar with your specialty.
  • Don’t rely on your EMR to make coding changes for you or identify new codes as they pertain to your practice.  Be proactive and educate yourself. 

Don’t forget that ICD-10 is 9 months away.  Don’t underestimate the 68,000 codes that will come with ICD-10. A recent survey conducted by AHIMA and the eHealth Initiative found that thirty-five percent of providers believe they will take a hit to their revenue cycle from the new code set. If the 2015 CPT coding changes are problematic for your practice now, imagine what ICD-10 will be like.