For 2019, there are not extensive changes to the CPT code set that typically pertain to vein care. However, AVLS members will want to take note that two new codes are in effect for 2019 that offer a way to document time spent on “inter-professional telephone/internet/electronic health record” consultations.
Two new codes, which are time-based, that may be used by a consultative physician are:
99451 Interprofessional telephone/Internet/electronic health record assessment and management service provided by a consultative physician, including a written report to the patient’s treating/requesting physician or other qualified health care professional, 5 minutes or more of medical consultative time
A referring physician would use this code: 99452 Interprofessional telephone/Internet/electronic health record referral service(s) provided by a treating/ requesting physician or other qualified health care professional, 30 minutes
In recent years, other codes have been created to capture telehealth and other e-services, and these two new codes fall in the larger family of e-services codes for interprofessional telephone/internet/EHR consultations. Refer to codes 99446-99449 for a complete description.
Keep in mind, to use codes 99446–99449, you have to do both written and verbal reports to the referring physician. Code 99451 requires only a written report, which may be provided in the electronic health record or other secure means.
Also, using these new codes should not be confused with the use of an appropriate E&M code the day of an in-person office consultation.
With respect to some of the most common vein procedures, AVLS members and their billing staff should review pages 263-265 of the 2019 CPT Manual. Many new “Do not Report” parenthetical statements have been added, mostly elaborating on codes that should not be reported when a primary bundled vein procedure code is used. These “do not report” codes include many radiological supervision and interpretation codes, as well as the extremity venous studies codes(93970 & 93971) if performed in the same surgical field.
As always, carrier polices may vary, so members should be mindful of their particular carrier polices
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