2023 CPT Changes: Part A
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This year for 2023 we are going to see significant changes in every section of the CPT except Anesthesia. CPT? 2023 includes 225 ● new codes, 93 ▲ revised codes, and 75 Del deleted codes.
The most notable changes are to the evaluation and management (E/M), percutaneous pulmonary artery revascularization, hernia repairs, lab and pathology, and COVID-19 vaccination codes. Also added are two new appendices for artificial intelligence (AI) taxonomy (Appendix S) and synchronous real-time interactive audio-only telemedicine services (Appendix T).
Here is an overview of the changes by section, all of which are effective Jan. 1, 2023.
Evaluation and Management: The Evaluation and Management (E/M) section have one addition, 26 deletions, and 50 revisions for 2023.
??E/M Introductory Guidelines related to Hospital Inpatient and Observation Care Services codes 99221-99223, 99231-99239, Consultations codes 99242- 99245, 99252-99255, Emergency Department Services codes 99281-99285, Nursing Facility Services codes 99304-99310, 99315, 99316, Home or Residence Services codes 99341, 99342, 99344, 99345, 99347-99350
??Deletion of Hospital Observation Services E/M codes 99217-99220, Revision of Hospital Inpatient and Observation Care Services E/M codes 99221-99223, 99231-99239, and guidelines.
??Deletion of Consultations E/M codes 99241 and 99251- Deleted: 99241 Office consultation straight-forward level and 99251 Inpatient consultation straight-forward level
??Revision of Consultations E/M codes 99242-99245, 99252-9925,5 and guidelines
??Revision of Emergency Department Services E/M codes 99281-99285 and guidelines
??Deletion of Nursing Facility Services E/M code 99318
??Revision of Nursing Facility Services E/M codes 99304-99310, 99315, 99316 and guidelines
??Deletion of Domiciliary, Rest Home (eg, Boarding Home), or Custodial Care Services E/M codes 99324-99238, 99334-99337, 99339, 99340
??Deletion of Home or Residence Services E/M code 99343
??Revision of Home or Residence Services E/M codes 99341, 99342, 99344, 99345, 99347-99350 and guidelines
??Deletion of Prolonged Services E/M codes 99354-99357
??Revision of guidelines for Prolonged Services E/M codes 99358, 99359, 99415, 99416
??Revision of Prolonged Services E/M code 99417 and guidelines
??Establishment of Prolonged Services E/M code 993X0 and guidelines
Integumentary Section:?There are three new codes in the integumentary system section, plus one deletion and one revision:
??● Code 15778 describes the implantation of absorbable mesh or another prosthesis for delayed closure defects.
??●Codes 15853 and 15854 describe the removal of sutures or staples not requiring anesthesia.
??●Code 15850, describing the removal of sutures under anesthesia, has been deleted.
??▲Code 15851 has been revised to include the removal of staples.
Del 15850 - Removal of sutures under anesthesia (other than local), same surgeon
Musculoskeletal system- One new code and two minor revisions
??▲Code 22857 for total disc arthroplasty is revised to make “single interspace, lumbar” a suffix.
??● Add on code + 22860 when total disc arthroplasty is performed on the second interspace of the lumbar spine
??▲ Code 27280 - Arthrodesis, sacroiliac joint, open, includes obtaining bone graft, including instrumentation when performed.
Respiratory system- One new code
??● Code 30469 (Repair of nasal valve collapse with low energy, temperature-controlled (i.e. radiofrequency) subcutaneous/submucosal remodeling) for the repair of a nasal valve collapse is added to report the use of low-energy, temperature-controlled subcutaneous/ submucosal remodeling.
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Cardiovascular system: There are seven new codes in the cardiovascular system and one revision:
??● Codes 33900–33904 describe percutaneous pulmonary artery revascularization by stent replacement.
??● Codes 36836 and 36837 describe a percutaneous arteriovenous fistula creation of an upper extremity.
??▲ Code 35883 has a revision to the example listed within the long descriptor
Digestive system: The Digestive system includes 17 new codes and 18 deletions.
??● Codes 43290 and 43291 describe an esophagogastroduodenoscopy with the deployment or removal of an intragastric bariatric balloon
??●Codes 49591-49596 and 49613-49618 describe the repair of an anterior abdominal hernia, including the implantation of mesh or another prosthesis.
??●Codes 49621-49623 describe the repair of a parastomal hernia, including the implantation of mesh or other prosthesis or the removal of a non-infected mesh or prosthesis (49623).
Digestive system: The Digestive system includes 17 new codes and 18 deletions.
??●Codes 43290 and 43291 describe an esophagogastroduodenoscopy with the deployment or removal of an intragastric bariatric balloon.
??●Codes 49591-49596 and 49613-49618 describe the repair of an anterior abdominal hernia, including the implantation of mesh or another prosthesis.
??●Codes 49621-49623 describe the repair of a parastomal hernia, including the implantation of mesh or other prosthesis or the removal of a non-infected mesh or prosthesis (49623).
●Add on Code + 49623 - Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparoscopic, robotic) (List separately in addition to code for primary procedure). Add on code 49623 can be reported only with codes 49591-49622.
??All 18 deleted codes in this section describe the repair of various types of hernias.
Del 49560- Repair initial incisional or ventral hernia; reducible
49561- Repair initial incisional or ventral hernia; incarcerated or strangulated
49565- Repair recurrent incisional or ventral hernia; reducible
49566- Repair recurrent incisional or ventral hernia; incarcerated or strangulated
49568- - Implantation of mesh or other prosthesis for open incisional or ventral hernia repair or mesh for closure of debridement for necrotizing soft tissue infection
49570- -- - Repair epigastric hernia (eg, preperitoneal fat); reducible (separate procedure)
49572 - Repair epigastric hernia (eg, preperitoneal fat); incarcerated or strangulated
49580 - Repair umbilical hernia, younger than age 5 years; reducible
49582 - Repair umbilical hernia, younger than age 5 years; incarcerated or strangulated
49585 - Repair umbilical hernia, age 5 years or older; reducible
49587 - Repair umbilical hernia, age 5 years or older; incarcerated or strangulated
49590 - Repair spigelian hernia
49652 - Laparoscopy, surgical, repair, ventral, umbilical, spigelian or epigastric hernia (includes mesh insertion, when performed); reducibl e
49653 - Laparoscopy, surgical, repair, ventral, umbilical, spigelian or epigastric hernia (includes mesh insertion, when performed); incarcerated or strangulated
49654 - Laparoscopy, surgical, repair, incisional hernia (includes mesh insertion, when performed); reducible
49655 - Laparoscopy, surgical, repair, incisional hernia (includes mesh insertion, when performed); incarcerated or strangulated
49656 - Laparoscopy, surgical, repair, recurrent incisional hernia (includes mesh insertion, when performed); reducibl e
49657 - Laparoscopy, surgical, repair, recurrent incisional hernia (includes mesh insertion, when performed); incarcerated or strangulated