Catheter Coding: 36245-+36248: Determine Which Codes See a Global Period Change in 2012

Related revisions are currently in place for 36200.

In case you want evidence that annual CPT code updates go beyond definition revisions, look into these moderate sedation as well as global surgical package changes to 36200 and 36245-+36248.

1. Revision Sign Indicates Moderate Sedation Change

You'll find the following CPT codes on the list of revised codes for 2012:

36200 (Introduction of catheter, aorta)

36245 (Selective catheter placement, arterial system; each first order abdominal, pelvic, or lower extremity artery branch, within a vascular family)

36246 (… initial second order abdominal, pelvic, or lower extremity artery branch, within a vascular family)

36247 ( … initial third order or more selective abdominal, pelvic, or lower extremity artery branch, within a vascular family)

+36248 ( … additional second order, third order, and beyond, abdominal, pelvic, or lower extremity artery branch, within a vascular family (List in addition to code for initial second or third order vessel as appropriate))

A quick comparison of the 2011 and 2012 definitions of these CPT codes will show you that the wording remains the same. The revision is in the addition of the moderate sedation symbol to these CPT codes

The symbol means payers include moderate (or conscious) sedation as part of the fee for the procedure code. So the physician performing the catheter introduction or placement should not separately report 99143-+99145 (Moderate sedation services ...) for 36200 or 36245-+36248 services performed on or after Jan. 1, 2012.

Source URL :- http://www.supercoder.com/coding-newsletters/my-radiology-coding-alert/catheter-coding-36245-36248-discover-which-codes-see-a-global-period-change-in-2012-109796-article

2. Review the MPFS for Changes, Too

Prior to submitting a claim for these CPT codes for catheter introduction and placement in 2012, ensure you take into account changes to the global periods of CPT codes 36200, 36246, and 36247.

In 2011, the global period for each of these CPT codes was XXX. In 2012, 36200, 36246, and 36247 have a global period of 000.

Impact: The global period change means you must no longer independently report related E/M services executed on the same date as 36200, 36246, or 36247.

Here's why: In 2011, the CPT codes had the classification XXX. That classification means the service is free of global surgical bundling issues, and you can independently report services that your physician carries out on the similar date as the surgical procedure, for instance E/M services.

The XXX value means that the global concept is not applicable to the procedure

In 2012, the codes have a 000 indicator, which is applicable to the date of the procedure only. Medicare will bundle all related services that the physician carries out on that surgery date into codes with the 000 indicator.