Health Information Management

Q&A: Is CMS going to start accepting new Category III CPT® codes for July?

APCs Insider, June 27, 2014

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Q: Is CMS going to start accepting new Category III CPT® codes for July?
 
A: The AMA releases Category III CPT codes in January and July each year. The codes released in January are effective the following July; the codes released in July are effective the following January. As part of the OPPS July 2014 update, CMS is implementing 27 Category III codes that were released in January 2014. Seventeen of the codes are separately payable under APCs. 
The new codes involve:
  • Radiostereometric analysis services
  • Optical coherence tomography of the breast and ancillary lymph nodes
  • Intraluminal GI tract imaging (capsule endoscopy)
  • Insertion of drug-eluting implant in the lacrimal canaliculus
  • Bioelectrical impedance analysis
  • Behavioral assessments
  • Adaptive behavior treatments
More information on the codes and their status indicators is listed in Table 2 in Transmittal 2971 and the payments are listed in Addendum B for July 2014.
 
Editor’s note: Denise Williams, RN, CPC-H, vice president of revenue integrity services at Health Revenue Assurance Associates, Inc., in Plantation, Florida, answered this question.



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