By Mark Wright, OD, FCOVD,
and Carole Burns, OD, FCOVD
Nov. 3, 2021
The recent release of the CPT 2022 isn’t as earth-shaking as last year’s release, which included major changes made to the 99000 E/M coding.i This year, the AMA continues its work on streamlining documentation and reducing “note bloat” with the result that we will only have to make a few adjustments to be up to date with the latest codes and descriptors.
There are 405 editorial changes in the 2022 CPT code set, including 249 new codes, 63 deletions and 93 revisions. Over 40 percent of the editorial changes are tied to new technology services described in Category III CPT codes and the continued expansion of the proprietary laboratory analyses section of the CPT code set.
The new code book incorporates a series of 24 vaccine-specific codes that are the model for efficiently reporting and tracking immunizations and administrative services against the coronavirus (SARS-CoV-2).
The 2022 CPT code set includes the creation of five new CPT codes (98975, 98976, 98977, 98980, 98981) to report therapeutic remote monitoring.
A new appendix (Appendix R – Digital Medicine – Services Taxonomy) is included in the 2022 CPT code set. This appendix classifies CPT codes related to digital medicine services into the discrete categories of: clinician-to-patient services, clinician-to-clinician services (consultation), patient-monitoring services and digital-diagnostic services. (Be sure to understand that synchronous services represent real-time interactions and asynchronous services are store-and-forward transmissions.)
A Tweak to the Descriptor for 99211
CPT 2021 removed the time component from the code (Typically, five minutes are spent performing or supervising these services) and CPT 2022 further truncated the code descriptor by removing: Usually, the presenting problem(s) are minimal.
Keep in mind that in the 2021 E/M guidelines, the AMA released its definition of “minimal” as a problem “that may not require the presence of the physician or other qualified health care professional, but the service is provided under the physician’s or other qualified health care professional’s supervision.” That definition stays in the coding manual for 2022 and can be found under the section “GUIDELINES FOR OFFICE OR OTHER OUTPATIENT E/M SERVICES.”
The orthoptic training code has been revised, however, the revision is not in CPT 2022. Instead, the code book refers the reader to another document: “CPT Changes: An Insider’s View 2022.” As soon as we get the revision, we will pass it on.
Other Articles to Explore
There is a brand-new code describing a drug-eluting implant procedure involving the eye:
• 68841 (Insertion of drug-eluting implant, including punctal dilation when performed, into lacrimal canaliculus, each)
68841 will be used when placing a corticosteroid insert into the canaliculus to deliver dexamethasone (brand name Dextenza) to treat pain and inflammation following eye surgery.
Previously, this service was described using Category III code 0356T (Insertion of drug-eluting implant, including punctal dilation when performed, into lacrimal canaliculus, each). With the addition of the new code, the old code (0356T) will go away January 1, 2022.
Revisions to Retinal Detachment Codes
In CPT 2022, the verbiage of retinal detachment codes, has been changed as follows:
• 67141 (Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; cryotherapy, diathermy) has been changed, with a strike-through demonstrating the verbiage that will be deleted effective January 1.
• 67145 (Prophylaxis of retinal detachment (e.g., retinal break, lattice degeneration) without drainage; photocoagulation has been revised, with the deleted verbiage shown under the strike-through.
According to the 2022 Medicare Physician Fee Schedule Proposed Rule, which was published July 23, 2020, “the codes were edited to remove the reference to ‘1 or more sessions’ so that the services may be valued as a 10-day procedure versus the current 90-day global.”