AMA releases CPT Category III codes

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July 18, 2003
Vol. 4, No. 28

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AMA releases CPT Category III codes effective January 2004

Here is the new list of temporary CPT codes representing emerging technology, services, and procedures released July 1 by AMA. You must use always a Category III code when it is available, instead of a Category I unlisted code that might also apply.

The AMA says that using the Category III codes is critical in the evaluation of health care delivery and the formation of public and private policy. Although these codes may not show up in an outpatient setting very often, it is important to be aware of them.

AMA releases Category III codes semi-annually via its Web site and the full set of temporary codes for emerging technology, services, and procedures are published annually in the CPT book.

CPT Category III codes

• 0054T Computer assisted musculoskeletal surgical navigational orthopedic procedure, with image-guidance based on fluoroscopic images (List separately in addition to code for primary procedure)

• 0055T Computer assisted musculoskeletal surgical navigational orthopedic procedure, with image-guidance based on CT and MRI images (List separately in addition to code for primary procedure)

• 0056T Computer assisted musculoskeletal surgical navigational orthopedic procedure, image-less (List separately in addition to code for primary procedure)

• 0057T Upper gastrointestinal endoscopy, including esophagus, stomach, and either the duodenum and/or jejunum as appropriate, with delivery of thermal energy to the muscle of lower esophageal sphincter and/or gastric cardia, for treatment of gastroesophageal reflux disease

• 0058T Cryopreservation; reproductive tissue, ovarian

• 0059T Oocyte(s) (For cryopreservation of embryo(s), sperm and testicular reproductive tissue, see 89258, 89259, 89335)

• 0060T Electrical impedance scan of the breast, bilateral (risk assessment device for breast cancer)

• 0061T Destruction/reduction of malignant breast tumor including breast carcinoma cells in the margins, microwave phased array thermotherapy, disposable catheter with combined temperature monitoring probe and microwave sensor, externally applied microwave energy, including interstitial placement of sensor (For imaging guidance performed in conjunction with 0061T, see 76942, 76986)

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Question: Is it appropriate to bill telemetry monitoring during an outpatient hospital visit such as observation under CPT 93225?

Answer: CPT 93225 should not be used to bill telemetry during an outpatient visit. Code 93225 is reported for holter monitoring using superimposed scanning. The reimbursement for telemetry monitoring is included in the applicable OPPS payment for observation or the facility's E/M reimbursement.

Facilities should check their chargemaster and make sure this CPT code is not connected to any telemetry revenue code.

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TIP OF THE WEEK Properly code and bill drug-eluting intracoronary stents

Questions from readers are answered by a team of experts working in the APC area within the health care industry. Their answers are provided as advice. Readers should consult the federal regulations governing OPPS, related CMS sources, and with their local fiscal intermediary before making any decisions regarding the application of OPPS to their particular situations.

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