2013 CPT Code Changes May Impact Your Practice

Under the section on Vestibular Function Tests, Without Electrical Recording, the language clarifies that the spontaneous nystagmus test (92531) and positional nystagmus test (92532) are considered part of the physical exam and should not be reported with evaluation and management services.

The coding for chemodenervation has been changed with the addition of code 64615, which relates to muscles innervated by facial, trigeminal, cervical spinal and accessory nerve, bilateral (as in chronic migraine). This code can only be reported once per session and cannot be reported in conjunction with other codes that are listed. This is the code to be reported generally by otolaryngologists who treat migraine headaches with botulinum toxin injections.

Slight changes have been made to the Allergy and Clinical Immunology Procedures section, specifying that interpretation and reports associated with testing are not reported separately from the tests themselves. It also clarifies that counseling for use of devices (such as air filters) is reported with evaluation and management codes. A new subsection and two new codes for Ingestion Challenge Testing, 95076 and +95079, are available for 2013. The code 95075 has been deleted. Codes 95076 and +95079 are time-based, and if time spent is less than 61 minutes, an E&M service is reported, if appropriate.

New Codes

Two new codes have been added for reporting pediatric sleep studies when an otolaryngologist is supervising the sleep lab and is interpreting the attended sleep study in a child. One new code is 95782, related to polysymnography in a child younger than age 6, with four or more parameters of sleep, when attended by a technologist. Code 95783 is also related to a child younger than age 6, with four or more additional parameters of sleep and initiation of continuous positive airway pressure therapy or bilevel positive airway pressure ventilation, when attended by a technologist.

The 2013 changes also include two new add-on codes related to intraoperative neurophysiological monitoring, replacing code 95920. In this section, the language is clarified to specify that the monitoring of nerve function should be reported by the person actually monitoring rather than by the surgeon. The language related to codes 95940 and 95941 makes clear that if the monitoring is performed by the surgeon or anesthesiologist, those professional services are included in the surgeon’s or anesthesiologist’s primary service code(s) for the procedure. Additionally, these codes are not to be used for automated monitoring devices that do not require continuous attendance by a professional qualified to interpret the testing and monitoring.