Some 2020 CPT® and HCPCS Code Changes
With 394 codes changes in the 2020 CPT code set, here’s a quick reference guide
Choose your specialty.

This blog was originally published on January 30, 2018 and was updated on November 25, 2019 to reflect coding changes.
As we head into 2020, there are 394 code changes in the 2020 CPT code set, including 248 new codes, 71 deletions and 75 revisions. Many of the changes were sparked by recent advances in healthcare technology, including new digital communication tools such as patient portals and e-visits as well as at-home blood pressure monitoring tools. With increased access to care right in a patient’s home, I predict we will continue to see more codes to accommodate the changing health tech landscape for years to come.
A notable item is the revision of the Intermediate and Complex Repair code descriptions that could affect any specialty doing a closure.
These new codes will go into effect starting January 1, 2020. Below you will find new, revised and deleted CPT codes for various medical specialties that will be accessible in our electronic health (EHR) systems EMA® and gGastro®.
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New CPT Codes for 2020 – All Specialties
Code | Description |
---|---|
98970 | Qualified nonphysician health care professional online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 5-10 minutes |
98971 | Qualified nonphysician health care professional online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 11-20 minutes |
98972 | Qualified nonphysician health care professional online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 21 or more minutes |
99421 | Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 5-10 minutes |
99422 | Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 11-20 minutes |
99423 | Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 21 or more minutes |
Deleted CPT Codes for 2020 – All Specialties
Code | Description |
---|---|
98969 | Online assessment and management service provided by a qualified nonphysician health care professional to an established patient or guardian, not originating from a related assessment and management service provided within the previous 7 days, using the Internet or similar electronic communications network |
99444 | Online evaluation and management service provided by a physician or other qualified health care professional who may report evaluation and management services provided to an established patient or guardian, not originating from a related E/M service provided within the previous 7 days, using the Internet or similar electronic communications network |
New Dermatology CPT Codes for 2020
Code | Description |
---|---|
15769 | Grafting of autologous soft tissue, other, harvested by direct excision (eg, fat, dermis, fascia) |
15771 | Grafting of autologous fat harvested by liposuction technique to trunk, breasts, scalp, arms, and/or legs; 50 cc or less injectate |
15772 | Grafting of autologous fat harvested by liposuction technique to trunk, breasts, scalp, arms, and/or legs; each additional 50 cc injectate, or part thereof (List separately in addition to code for primary procedure) |
15773 | Grafting of autologous fat harvested by liposuction technique to face, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet; 25 cc or less injectate |
15774 | Grafting of autologous fat harvested by liposuction technique to face, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet; each additional 25 cc injectate, or part thereof (List separately in addition to code for primary procedure) |
80230 | Infliximab |
80285 | Voriconazole |
Watch a video on how easy it is to document a dermatology visit with our EMA® EHR >>
New Ophthalmology CPT Codes for 2020
Code | Description |
---|---|
0563T | Evacuation of meibomian glands, using heat delivered through wearable, open-eye eyelid treatment devices and manual gland expression, bilateral |
66987 | Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device, suture support for intraocular lens, or primary posterior capsulorrhexis) or performed on patients in the amblyogenic developmental stage; with endoscopic cyclophotocoagulation |
66988 | Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with endoscopic cyclophotocoagulation |
92201 | Ophthalmoscopy, extended; with retinal drawing and scleral depression of peripheral retinal disease (eg, for retinal tear, retinal detachment, retinal tumor) with interpretation and report, unilateral or bilateral |
92202 | Ophthalmoscopy, extended; with drawing of optic nerve or macula (eg, for glaucoma, macular pathology, tumor) with interpretation and report, unilateral or bilateral |
92549 | Computerized dynamic posturography sensory organization test (CDP-SOT), 6 conditions (ie, eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, platform and visual sway), including interpretation and report; with motor control test (MCT) and adaptation test (ADT) |
EMA suggests medical coding based on your clinical documentation. Learn more >>
Revised Ophthalmology CPT Codes for 2020
Code | Description |
---|---|
0402T | Collagen cross-linking of cornea, including removal of the corneal epithelium and intraoperative pachymetry, when performed (Report medication separately) |
2022F | Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist documented and reviewed; with evidence of retinopathy (DM) |
2024F | 7 standard field stereoscopic retinal photos with interpretation by an ophthalmologist or optometrist documented and reviewed; with evidence of retinopathy (DM) |
2026F | Eye imaging validated to match diagnosis from 7 standard field stereoscopic retinal photos results documented and reviewed; with evidence of retinopathy (DM) |
66711 | Ciliary body destruction; cyclophotocoagulation, endoscopic, without concomitant removal of crystalline lens |
66982 | Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device, suture support for intraocular lens, or primary posterior capsulorrhexis) or performed on patients in the amblyogenic developmental stage; without endoscopic cyclophotocoagulation |
66984 | Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); without endoscopic cyclophotocoagulation |
92548 | Computerized dynamic posturography sensory organization test (CDP-SOT), 6 conditions (ie, eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, platform and visual sway), including interpretation and report |
Watch a video on how easy it is to document an ophthalmology visit with our EMA EHR >>
Deleted Ophthalmology CPT Codes for 2020
Code | Description |
---|---|
0341T | Quantitative pupillometry with interpretation and report, unilateral or bilateral |
0380T | Computer-aided animation and analysis of time series retinal images for the monitoring of disease progression, unilateral or bilateral, with interpretation and report |
92225 | Ophthalmoscopy, extended, with retinal drawing (eg, for retinal detachment, melanoma), with interpretation and report; initial |
92226 | Ophthalmoscopy, extended, with retinal drawing (eg, for retinal detachment, melanoma), with interpretation and report; subsequent |
Check out our ophthalmology case studies to see how EMA helps our clients save time documenting >>
New Orthopedics CPT Codes for 2020
Code | Description |
---|---|
0565T | Autologous cellular implant derived from adipose tissue for the treatment of osteoarthritis of the knees; tissue harvesting and cellular implant creation |
0566T | Autologous cellular implant derived from adipose tissue for the treatment of osteoarthritis of the knees; injection of cellular implant into knee joint including ultrasound guidance, unilateral |
20560 | Needle insertion(s) without injection(s); 1 or 2 muscle(s) |
20561 | Needle insertion(s) without injection(s); 3 or more muscles |
20700 | Manual preparation and insertion of drug-delivery device(s), deep (eg, subfascial) (List separately in addition to code for primary procedure) |
20701 | Removal of drug-delivery device(s), deep (eg, subfascial) (List separately in addition to code for primary procedure) |
20702 | Manual preparation and insertion of drug-delivery device(s), intramedullary (List separately in addition to code for primary procedure) |
20703 | Removal of drug-delivery device(s), intramedullary (List separately in addition to code for primary procedure) |
20704 | Manual preparation and insertion of drug-delivery device(s), intra-articular (List separately in addition to code for primary procedure) |
20705 | Removal of drug-delivery device(s), intra-articular (List separately in addition to code for primary procedure) |
Watch a video on how easy it is to document an orthopedic visit with our EMA EHR >>
Revised Orthopedics CPT Codes for 2020
Code | Description |
---|---|
64400 | Injection(s), anesthetic agent(s) and/or steroid; trigeminal nerve, each branch (ie, ophthalmic, maxillary, mandibular) |
64405 | Injection(s), anesthetic agent(s) and/or steroid; greater occipital nerve |
64408 | Injection(s), anesthetic agent(s) and/or steroid; vagus nerve |
64415 | Injection(s), anesthetic agent(s) and/or steroid; brachial plexus |
64416 | Injection(s), anesthetic agent(s) and/or steroid; brachial plexus, continuous infusion by catheter (including catheter placement) |
64417 | Injection(s), anesthetic agent(s) and/or steroid; axillary nerve |
64418 | Injection(s), anesthetic agent(s) and/or steroid; suprascapular nerve |
64420 | Injection(s), anesthetic agent(s) and/or steroid; intercostal nerve, single level |
64421 | Injection(s), anesthetic agent(s) and/or steroid; intercostal nerve, each additional level (List separately in addition to code for primary procedure) |
64425 | Injection(s), anesthetic agent(s) and/or steroid; ilioinguinal, iliohypogastric nerves |
64430 | Injection(s), anesthetic agent(s) and/or steroid; pudendal nerve |
64435 | Injection(s), anesthetic agent(s) and/or steroid; paracervical (uterine) nerve |
64445 | Injection(s), anesthetic agent(s) and/or steroid; sciatic nerve |
64446 | Injection(s), anesthetic agent(s) and/or steroid; sciatic nerve, continuous infusion by catheter (including catheter placement) |
64447 | Injection(s), anesthetic agent(s) and/or steroid; femoral nerve |
64448 | Injection(s), anesthetic agent(s) and/or steroid; femoral nerve, continuous infusion by catheter (including catheter placement) |
64449 | Injection(s), anesthetic agent(s) and/or steroid; lumbar plexus, posterior approach, continuous infusion by catheter (including catheter placement) |
64450 | Injection(s), anesthetic agent(s) and/or steroid; other peripheral nerve or branch |
See how our EMA EHR is helping your peers save time during documentation >>
Deleted Orthopedics CPT Codes for 2020
Code | Description |
---|---|
0375T | Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection), cervical, three or more levels |
64402 | Injection, anesthetic agent; facial nerve |
64410 | Injection, anesthetic agent; phrenic nerve |
64413 | Injection, anesthetic agent; cervical plexus |
78320 | Bone and/or joint imaging; tomographic (SPECT) |
95831 | Muscle testing, manual (separate procedure) with report; extremity (excluding hand) or trunk |
95832 | Muscle testing, manual (separate procedure) with report; hand, with or without comparison with normal side |
95833 | Muscle testing, manual (separate procedure) with report; total evaluation of body, excluding hands |
95834 | Muscle testing, manual (separate procedure) with report; total evaluation of body, including hands |
EMA suggests medical coding based on your clinical documentation. Learn more >>
New Otolaryngology CPT Codes for 2020
Code | Description |
---|---|
0583T | Tympanostomy (requiring insertion of ventilating tube), using an automated tube delivery system, iontophoresis local anesthesia |
Watch a video on how easy it is to document an ENT visit with our EMA EHR >>
Revised Otolaryngology CPT Codes for 2020
Code | Description |
---|---|
31233 | Nasal/sinus endoscopy, diagnostic; with maxillary sinusoscopy (via inferior meatus or canine fossa puncture) |
31235 | Nasal/sinus endoscopy, diagnostic; with sphenoid sinusoscopy (via puncture of sphenoidal face or cannulation of ostium) |
31292 | Nasal/sinus endoscopy, surgical, with orbital decompression; medial or inferior wall |
31293 | Nasal/sinus endoscopy, surgical, with orbital decompression; medial and inferior wall |
31294 | Nasal/sinus endoscopy, surgical, with optic nerve decompression |
31295 | Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); maxillary sinus ostium, transnasal or via canine fossa |
31296 | Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); frontal sinus ostium |
31297 | Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); sphenoid sinus ostium |
31298 | Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); frontal and sphenoid sinus ostia |
74210 | Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study |
74220 | Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study |
74230 | Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study |
92626 | Evaluation of auditory function for surgically implanted device(s) candidacy or postoperative status of a surgically implanted device(s); first hour |
92627 | Evaluation of auditory function for surgically implanted device(s) candidacy or postoperative status of a surgically implanted device(s); each additional 15 minutes (List separately in addition to code for primary procedure) |
94728 | Airway resistance by oscillometry |
Learn how our EMA EHR is helping physicians at one ENT practice leave work on time >>
New Plastic Surgery CPT Codes for 2020
Code | Description |
---|---|
15771 | Grafting of autologous fat harvested by liposuction technique to trunk, breasts, scalp, arms, and/or legs; 50 cc or less injectate |
15772 | Grafting of autologous fat harvested by liposuction technique to trunk, breasts, scalp, arms, and/or legs; each additional 50 cc injectate, or part thereof (List separately in addition to code for primary procedure) |
15773 | Grafting of autologous fat harvested by liposuction technique to face, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet; 25 cc or less injectate |
15774 | Grafting of autologous fat harvested by liposuction technique to face, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet; each additional 25 cc injectate, or part thereof (List separately in addition to code for primary procedure) |
Watch a video on how easy it is to document a plastic surgery visit with our EMA EHR >>
New Gastroenterology CPT Codes for 2020
Code | Description |
---|---|
46948 | Hemorrhoidectomy, internal, by transanal hemorrhoidal dearterialization, 2 or more hemorrhoid columns/groups, including ultrasound guidance, with mucopexy, when performed |
49013 | Preperitoneal pelvic packing for hemorrhage associated with pelvic trauma, including local exploration |
49014 | Re-exploration of pelvic wound with removal of preperitoneal pelvic packing, including repacking, when performed |
74221 | Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study |
74248 | Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination) |
80280 | Vedolizumab |
90912 | Biofeedback training, perineal muscles, anorectal or urethral sphincter, including EMG and/or manometry, when performed; initial 15 minutes of one-on-one physician or other qualified health care professional contact with the patient |
90913 | Biofeedback training, perineal muscles, anorectal or urethral sphincter, including EMG and/or manometry, when performed; each additional 15 minutes of one-on-one physician or other qualified health care professional contact with the patient (List separately in addition to code for primary procedure) |
gGastro® EHR suggests medical coding based on your clinical documentation. Learn more >>
Revised Gastroenterology CPT Codes for 2020
Code | Description |
---|---|
46945 | Hemorrhoidectomy, internal, by ligation other than rubber band; single hemorrhoid column/group, without imaging guidance |
46946 | Hemorrhoidectomy, internal, by ligation other than rubber band; 2 or more hemorrhoid columns/groups, without imaging guidance |
74022 | Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest |
74240 | Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study |
74246 | Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study, including glucagon, when administered |
74250 | Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study |
74251 | Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) study, including glucagon, when administered |
74270 | Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study |
74280 | Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administered |
Watch a video on how our gGastro suite can help streamline your workflow >>
Deleted Gastroenterology CPT Codes for 2020
Code | Description |
---|---|
0249T | Ligation, hemorrhoidal vascular bundle(s), including ultrasound guidance |
0377T | Anoscopy with directed submucosal injection of bulking agent for fecal incontinence |
43401 | Transection of esophagus with repair, for esophageal varices |
74241 | Radiologic examination, gastrointestinal tract, upper; with or without delayed images, with KUB |
74245 | Radiologic examination, gastrointestinal tract, upper; with small intestine, includes multiple serial images |
74247 | Radiological examination, gastrointestinal tract, upper, air contrast, with specific high density barium, effervescent agent, with or without glucagon; with or without delayed images, with KUB |
74249 | Radiological examination, gastrointestinal tract, upper, air contrast, with specific high density barium, effervescent agent, with or without glucagon; with small intestine follow-through |
74260 | Duodenography, hypotonic |
90911 | Biofeedback training, perineal muscles, anorectal or urethral sphincter, including EMG and/or manometry |
Learn how our gGastro EHR helped one GI practice improve operational efficiency >>
Please note that this is not intended as a comprehensive list but a quick reference guide for some key 2020 CPT and HCPCS codes for the selected medical specialties. Please refer to the American Medical Association (AMA) for all CPT Code Changes.
Sources
-
American Medical Association (AMA). AMA Releases 2020 CPT Code Set. https://www.ama-assn.org/press-center/press-releases/ama-releases-2020-cpt-code-set. Published September 4, 2019. Accessed November 25, 2019.
-
Finnegan, Joanne. Fierce Healthcare. CPT changes in 2020 include new codes to allow doctors to bill for digital health. https://www.fiercehealthcare.com/practices/cpt-changes-2020-include-new-codes-to-allow-doctors-to-bill-for-digital-health. Published September 5, 2019. Accessed November 25, 2019.

Ronda Tews, CPC, CHC, CCS-P
DIRECTOR OF BILLING AND CODING COMPLIANCE
Ronda Tews, Certified Professional Coder (CPC), Certified in Healthcare Compliance (CHC), and Certified Coding Specialist-Physician (CCS-P), is the director of billing and coding compliance at Modernizing Medicine® and brings over two decades of robust healthcare compliance experience to the organization. In her current role, she develops and manages the billing and coding compliance program for the company. Ronda performs billing and coding compliance audits among other related functions while maintaining knowledge of current regulatory and compliance guidance.
Prior to her time at Modernizing Medicine, Ronda held various roles such as managing provider compliance for a large health plan in Oklahoma and creating a fraud, waste and abuse program. Ronda’s duties have consisted of conducting E/M audits on physicians and mid-level providers, establishing internal auditing and monitoring, as well as teaching basic coding classes to co-workers and providing E/M documentation training to physicians and mid-level providers. She has also implemented compliance education and training programs, managed the Compliance Report Line as well as compliance auditing and monitoring. Ronda also provided coding and documentation education at Missouri State University to the physician assistant students on an annual basis. Ronda has held various roles such as serving as a Quality Improvement analyst and working as a corporate compliance project manager for a large Mid-Western health system.
Ronda founded the Springfield, MO AAPC chapter where she served as the president and treasurer. She remains very active in the industry as she writes articles for industry publications and can be found speaking at conferences. Connect with Ronda on LinkedIn.
With 335 CPT code changes and other HCPCS changes for 2019, here’s what you need to know.

This blog was originally published on January 30, 2018 and was updated on December 14, 2018 to reflect coding changes.
On September 5, 2018, the American Medical Association (AMA) released the 2019 CPT Code Set in an official press release. With 2019 just around the corner, this is a good time to understand what has changed and how it may affect your medical practice moving forward.
Based on the comments from AMA President Barbara L. McAneny, MD, here are some of the overall themes to note with the changes made for CPT codes as we head into 2019.
- Many of the changes reflect new technological and scientific advancements
- Updates reflect the ability to better share information efficiently and accurately across the medical community
- Overall, CPT codes serve as a common language for reporting current procedures.
These category 1 CPT code changes will take effect for reporting as of January 1, 2019.
Jordan Miller, MD, senior medical director of dermatology, advised that, in 2019 many new CPT and ICD-10 codes will go into effect. The biggest changes for Modernizing Medicine dermatology clients will revolve around these new, specific biopsy codes:
- Tangential biopsies (11102 and 11103)
- Punch biopsies (11104 and 11105)
- Incisional biopsies (11106 and 11107)
While almost all of these changes will occur on the backend in our EHR system, EMA™, and have no impact on the provider’s documentation, users should be aware of a few new plans:
- If you perform a biopsy for tissue culture there are now two new plans, Shave Biopsy for Tissue Culture and Punch Biopsy for Tissue Culture, which were created to account for these new codes. The old plan, Biopsy for Tissue Culture, will be sunset because it was not specific enough.
- The new plan Incisional Biopsy will allow you to bill the 11106 and 11107 series of codes. Incisional biopsies are biopsies which sample the full thickness of a lesion without attempting to remove the entire lesion. Incisional biopsy codes also include the layered closure of the wound if required.
Detailed below are some of the 2019 CPT and HCPCS code updates for the respective medical specialties that will be reflected in EMA.
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Dermatology CPT Codes
2018: Dermatology CPT Codes | 2019: Dermatology CPT Codes |
---|---|
11100 Skin Biopsy Single Lesion | 11102 Tangential Skin Biopsy Single Lesion |
11101 Skin Biopsy Ea Sep/Additional Lesion | 11103 Tangential Skin Biopsy Ea Sep/Additional Lesion |
11104 Punch Skin Biopsy Single Lesion | |
11105 Punch Skin Biopsy Ea Sep/Additional Lesion | |
11106 Incisional Skin Biopsy Single Lesion | |
11107 Incisional Skin Biopsy Ea Sep/Additional Lesion |
Dermatology HCPCS Codes
2018: Dermatology HCPCS Codes | 2019: Dermatology HCPCS Codes |
---|---|
Q4131 Epifix | Q4186 Epifix |
Q4131 Epicord | Q4187 Epicord |
Q4172 PuraPly | Q4195 PuraPly |
Q4172 PuraPly AM | Q4196 PuraPly AM |
Ophthalmology CPT Codes
2018: Ophthalmology CPT Codes | 2019: Ophthalmology CPT Codes |
---|---|
92275 Erg w/ Interpretation & Report | 0509T Pattern Erg w/Interpretation & Report |
92273 Full Field Erg w/ Interpretation & Report | |
92274 Multifocal Erg w/ Interpretation & Report | |
11100 Skin Biopsy Single Lesion | 11102 Tangential Skin Biopsy Single Lesion |
11101 Skin Biopsy Ea Sep/Additional Lesion | 11103 Tangential Skin Biopsy Ea Sep/Additional Lesion |
11104 Punch Skin Biopsy Single Lesion | |
11105 Punch Skin Biopsy Ea Sep/Additional Lesion |
Ophthalmology HCPCS Codes
2018: Ophthalmology HCPS Codes | 2019: Ophthalmology HCPCS Codes |
---|---|
J3490 Photrexa (Riboflavin) | J2787 Photrexa (Riboflavin) |
Orthopedic and Pain CPT Codes
2018: Orthopedic and Pain CPT Codes | 2019: Orthopedic and Pain CPT Codes |
---|---|
27370 Injection Knee Arthrography | 27369 Injection Procedure For Contrast Knee Arthrography Or Contrast Enhanced Ct/Mri Knee Arthrography |
No Code in 2018 | 99491 Chronic Care Mgmt Svc At Least 30 Min Per Month |
Orthopedic and Pain HCPCS Codes
2018: Orthopedic and Pain HCPCS Codes | 2019: Orthopedic and Pain HCPCS Codes |
---|---|
Q9993 Zilretta, 1 Mg | J3304 Zilretta, 1 Mg |
Otolaryngology (ENT) CPT Codes
2018: Otolaryngology CPT Codes | 2019: Otolaryngology CPT Codes |
---|---|
10021 Fine Needle Aspiration w/o Imaging Guidance | 10021 Fine Needle Aspiration w/o Imaging Guidance; 1st Lesion |
10022 Fine Needle Aspiration w/ Imaging Guidance | 10004 Fine Needle Aspiration w/o Imaging Guidance; Each Additional Lesion |
10005 Fine Needle Aspiration w/ Imaging Guidance; 1st Lesion | |
10006 Fine Needle Aspiration w/ Imaging Guidance; Each Additional Lesion | |
11100 Skin Biopsy Single Lesion | 11102 Tangential Skin Biopsy Single Lesion |
11101 Skin Biopsy Ea Sep/Additional Lesion | 11103 Tangential Skin Biopsy Ea Sep/Additional Lesion |
11104 Punch Skin Biopsy Single Lesion | |
11105 Punch Skin Biopsy Ea Sep/Additional Lesion | |
11106 Incisional Skin Biopsy Single Lesion | |
11107 Incisional Skin Biopsy Ea Sep/Additional Lesion | |
No Code in 2018 | 99491 Chronic Care Mgmt Svc At Least 30 Min Per Month |
Otolaryngology (ENT) HCPCS Codes
2018: Otolaryngology (ENT) Codes | 2019: Otolaryngology (ENT) Codes |
---|---|
No Code in 2018 | C9749 - Repair Of Nasal Vestibular Lateral Wall Stenosis With Implant(s) |
Plastic Surgery CPT Codes
2018: Plastic Surgery CPT Codes | 2019: Plastic Surgery CPT Codes |
---|---|
10021 Fine Needle Aspiration w/o Imaging Guidance | 10021 Fine Needle Aspiration w/o Imaging Guidance; 1st Lesion |
10022 Fine Needle Aspiration w/ Imaging Guidance | 10004 Fine Needle Aspiration w/o Imaging Guidance; Each Additional Lesion |
10005 Fine Needle Aspiration w/ Imaging Guidance; 1st Lesion | |
10006 Fine Needle Aspiration w/ Imaging Guidance; Each Additional Lesion | |
11100 Skin Biopsy Single Lesion | 11102 Tangential Skin Biopsy Single Lesion |
11101 Skin Biopsy Ea Sep/Additional Lesion | 11103 Tangential Skin Biopsy Ea Sep/Additional Lesion |
11104 Punch Skin Biopsy Single Lesion | |
11105 Punch Skin Biopsy Ea Sep/Additional Lesion | |
11106 Incisional Skin Biopsy Single Lesion | |
11107 Incisional Skin Biopsy Ea Sep/Additional Lesion |
Gastroenterology CPT Codes
2018: Gastroenterology CPT Codes | 2019: Gastroenterology CPT Codes |
---|---|
43760 Change Gastrostomy Tube Percutaneous w/o Guidance | 43762 Replacement Of Gastrostomy Tube, Percutaneous, Includes Removal, When Performed, Without Imaging Or Endoscopic Guidance; Not Requiring Revision Of Gastrostomy Tract |
43763 Replacement Of Gastrostomy Tube, Percutaneous, Includes Removal, When Performed, Without Imaging Or Endoscopic Guidance; Not Requiring Revision Of Gastrostomy Tract |
Gastroenterology HCPCS Codes
2018: Gastroenterology HCPCS Codes | 2019: Gastroenterology CPT Code |
---|---|
No Code in 2018 | Q5103 Injection, Infliximab-dyyb, Biosimilar (Inflectra), 10 Mg |
No Code in 2018 | Q5104 Injection, Infliximab-dyyb, Biosimilar (Renflexis), 10 Mg |
No Code in 2018 | Q5109 Injection, Infliximab-qbtx, Biosimilar (Ixifi), 10 Mg |
Urology CPT Codes
2018: Urology CPT Codes | 2019: Urology CPT Codes |
---|---|
11100 Skin Biopsy Single Lesion | 11102 Tangential Skin Biopsy Single Lesion |
11101 Skin Biopsy Ea Sep/Additional Lesion | 11103 Tangential Skin Biopsy Ea Sep/Additional Lesion |
11104 Punch Skin Biopsy Single Lesion | |
11105 Punch Skin Biopsy Ea Sep/Additional Lesion | |
11106 Incisional Skin Biopsy Single Lesion | |
11107 Incisional Skin Biopsy Ea Sep/Additional Lesion |
With Modernizing Medicine’s electronic health record system, EMA helps suggest automated codes based on what the provider documents in a visit to reflect the 2019 CPT and HCPCS changes.
Sources
- American Medical Association (AMA). AMA releases 2019 CPT code set. https://www.ama-assn.org/ama-releases-2019-cpt-code-set. Published September 5, 2018. Accessed December 10, 2018.
- American Medical Association. CPT Changes 2019: An Insider’s View. American Medical Association. Published November 10, 2018. Accessed December 10, 2018.
- Centers for Medicare & Medicaid Services (CMS), HHS. Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2019; Medicare Shared Savings Program Requirements; Quality Payment Program; Medicaid Promoting Interoperability Program; Quality Payment Program-Extreme and Uncontrollable Circumstance Policy for the 2019 MIPS Payment Year; Provisions From the Medicare Shared Savings Program-Accountable Care Organizations-Pathways to Success; and Expanding the Use of Telehealth Services for the Treatment of Opioid Use Disorder Under the Substance Use-Disorder Prevention That Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act. https://www.federalregister.gov/documents/2018/11/23/2018-24170/medicare-program-revisions-to-payment-policies-under-the-physician-fee-schedule-and-other-revisions. Published November 23, 2018. Accessed December 10, 2018.
- Grider, Deborah. AMA Releases 2019 CPT® Code Set. https://www.icd10monitor.com/ama-releases-2019-cpt-code-set. Published September 10, 2018. Accessed December 10, 2018.

Danielle Zarnowiec, MBA
Requirements Analyst
Danielle Zarnowiec joined Modernizing Medicine in October 2012 and in her current role she serves as the team lead for EMA’s Medical Coding Engine and RCM’s Intelligent Claims Engine.
Previously, Danielle was the owner and operator of a Revenue Cycle Management (RCM) company specializing in medical coding consulting, revenue cycle management and physician quality reporting.
Danielle earned a bachelor’s degree in business administration from St. Andrews University where she served as captain of the NCAA women’s soccer and tennis teams. She then graduated from Palm Beach Atlantic University with an MBA in international business.
A Quick Guide to Some Key 2018 CPT Changes
A new year often brings new changes. One such change includes 2018 CPT® codes.
On December 31, 2017, the Modernizing Medicine team updated the smart billing engine in our electronic health record (EHR) systems, EMA™ & gGastro™ to reflect the 2018 CPT changes. Patient visits finalized on or after January 1, 2018, will reflect the 2018 CPT codes on medical billing insurance claims.
There are a total of 314 code changes throughout the 2018 CPT manual:
- 172 of these CPT codes are new
- 60 codes are revised
- 82 codes were deleted
As for the changes, they vary based on specialty.
Dermatology/Plastic Surgery CPT Changes: PDT and Facial Flap Repair
Photodynamic Therapy (PDT) is commonly performed to treat conditions such as actinic keratosis, acne, inflammatory rosacea and other skin diseases.
Two new PDT CPT codes were created, 96573 and 96574, and the existing CPT 96567 was revised. According to the AMA, the rationale behind the change relates to the physician-work component of each CPT RVU (relative value unit). Now the codes reflect the physician identification, application of the photosynthesizing agent and whether the debridement of a hyperkeratotic lesion occurred on the date of service.
Below is the description of the physician-work component included in each code:
- 96567: “Performed by Nurse, MA or Aesthetician”
- 96573: “Performed by MD, PA-C or NP”
- 96574: “Performed by MD, PA-C or NP with Pre-Procedure Debridement of Hyperkeratotic Lesions”
In 2018 we say goodbye to the deleted CPT 15732, a muscle, myocutaneous or fasciocutaneous flap of head and neck. 15732 splits into two new CPT codes to provide clarification on flaps with no named vascular pedicle vs named vascular pedicle.
- 15730 – “Midface flap without a named vascular pedicle”
- 15733 – “Muscle, myocutaneous, or fasciocutaneous flap of the head and neck with named vascular pedicle”
Ophthalmology CPT Changes: VEP
When it comes to ophthalmology, the new CPT code 0464T was created to perform Visual Evoked Potential (VEP) testing on glaucoma patients. Consequently the existing CPT code 95930 was revised to exclude glaucoma. No changes were made to 0333T which is used to test visual acuity during computer automated visual acuity screening.
Orthopedics/Interventional Pain/ENT CPT Changes: Chest X-Ray Interpretation
For Orthopedics, Interventional Pain and ENT practices, all nine of the 2017 Chest X-Ray Interpretation CPT codes were deleted and four new codes replaced them in 2018.
The 2018 CPT codes are as follows:
- 71045: Chest, single view
- 71046: Chest, 2 views
- 71047: Chest, 3 views
- 71048: Chest, 4 or more views
Specifically for Interventional Pain practices, the International Normalization Management (INR Test) related to anticoagulation management, CPT codes 99363 and 99364 were deleted in 2018 CPT changes. They have split into two codes to differentiate if the management is occurring at home or outpatient.
- 92792 – “Outpatient”
- 92793 – “Home”
Gastroenterology CPT Changes: Anesthesia
GI sees big changes in Anesthesia related endoscopic procedures. In 2017 there was only one CPT for upper GI endoscopic procedures, 00740, and only one CPT for lower GI endoscopic procedures, 00810. Both 00740 and 00810 have been deleted in 2018.
The new upper GI codes describe upper endoscopic procedures vs endoscopic retrograde cholangiopancreatography (ERCP). The lower GI procedures differentiate between screening colonoscopies vs diagnostic/therapeutic lower endoscopic procedures. There is also a new code to report when both upper and lower endoscopic procedures are performed in the same session.
Here is a list of the 2018 Anesthesia CPT changes:
- 00731 – Upper GI – endoscope, proximal to duodenum
- 00732 – Upper GI – endoscope, ERCP
- 00811 – Lower GI – endoscope, distal to duodenum
- 00812 – Lower GI – endoscope, screening colonoscopy
- 00812 – Upper and Lower GI – endoscope, both proximal to and distal to the duodenum
ENT CPT Changes: Balloon Sinus Dilation and Endoscopy
The existing balloon sinus dilation CPT codes from 2017 remain the same in 2018, but there is the addition of 31298 for when dilation is performed on the frontal and sphenoid sinus ostia.
There are two new Nasal/sinus endoscopy codes in 2018:
- 31241 – Nasal/sinus endoscopy with ligation of sphenopalatine artery
- 31254 – Nasal/sinus endoscopy, surgical with ethmoidectomy; partial
In addition, the 31200 section has many new instruction notes regarding the reporting of codes in conjunction to one another. There are also new modifier guidelines for modifier 52 and modifier 53 on endoscopy codes 31241-31235.
For EMA and gGastro users, the most specific 2018 ICD-10, CPT codes and modifiers will automatically generate medical codes in real time. CMS guidelines have been applied to our smart medical coding engine which can assist with clean claims and faster insurance payment. Overall this can help bring efficiency to your practice.
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Please note that this is not intended as a comprehensive list but a quick reference guide for some key 2018 CPT codes for the selected medical specialties. Please refer to the American Medical Association (AMA) for all CPT Code Changes. Another good source includes CodingAhead.com which lists new CPT codes as well as deleted CPT codes.
Sources
Breaking news: CPT 2018 update delivers 4 new E/M codes, mass revisions and updates. PartBNews. https://pbn.decisionhealth.com/Blogs/Detail.aspx?id=200623. Accessed January 8, 2018.
CPT 2018 Changes: An Insider’s View. American Medical Association. Accessed January 11, 2018.