The CPT code set for 2022 includes 249 new codes, 93 revisions, and 63 deleted codes that went into effect January 1st, 2022. Changes in codes and guidelines were made in all sections of CPT- so be sure to review the 2022 CPT code set in its entirety to ensure proper coding and reporting. Key changes in the Surgery section will be highlighted in this blog.
The guideline regarding simple repairs has been revised to clarify that when hemostasis and local or topical anesthesia are performed in conjunction with a simple repair, they are not to be reported separately. The guideline revision also clarifies that chemical cauterization, electrocauterization, or wound closure using adhesive strips as the sole repair material should not be reported as a simple repair, as this is included in the E/M code.
“Simple repair is used when the wound is superficial (eg, involving primarily epidermis or dermis, or subcutaneous tissues without significant involvement of deeper structures) and requires simple one-layer closure. This includes local anesthesia and chemical or electrocauterization of wounds not closed. Hemostasis and local or topical anesthesia, when performed, are not reported separately.”
The musculoskeletal system section of CPT has had a large number of updates in both guidelines and definitions. The introductory guidelines have been revised to clarify the following:
- All services in the musculoskeletal system section include the application and removal of the first cast, splint, or traction device when performed
- A cast removal code (29700, 29705, 29710) should be reported if a cast is removed by someone other than the physician or other health care professional who applied the cast
- Subsequent replacement of cast, splint, or strapping (29000-29750) and/or traction device (eg, 20690, 20692) during or after the global period may be reported separately
- There is no coding correlation between the type of fracture/dislocation (eg, open, closed) and the type of treatment (eg, open, closed, percutaneous) provided. For example, a closed fracture may require an open reduction.
Fracture/dislocation treatment definitions have also been revised to provide clarification of each treatment provided. Definitions for the following have been revised, so be sure to review each definition in detail to ensure proper code assignment:
- Closed treatment
- Percutaneous skeletal fixation
- Open treatment
- External fixation
- Uniplanar external fixation
- Multiplanar external fixation
A new code has been added (42975) to report flexible, diagnostic drug-induced sleep endoscopy to evaluate sleep-disordered breathing (eg, obstructive sleep apnea). This procedure includes examination of the nasal cavity, nasopharynx, oropharynx, hypopharynx and larynx while under anesthesia. The procedure may also include repositioning of the patient with manipulation of the head and neck to determine the effect of body position on the patient’s sleep disordered breathing.
42975, Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep disordered breathing, flexible, diagnostic
Eye and Ocular Adnexa
Two new codes (66991 and 66989) have been added to report placement of an anterior segment aqueous drainage device into the trabecular meshwork without an external reservoir. New guidelines have also been added to give instruction on the appropriate use of the new codes.
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
# 66989 with insertion of intraocular (eg, trabecular meshwork, supraciliary, suprachoroidal) anterior segment aqueous drainage device, without extraocular reservoir, internal approach, one or more
66984, Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation or aspiration or phacoemulsification); without endoscopic cyclophotocoagulation
# 66991 with insertion of intraocular (eg, trabecular meshwork, supraciliary, suprachoroidal) anterior segment aqueous drainage device, without extraocular reservoir, internal approach, one or more
Additional information regarding CPT Code Updates for FY 2022 can be found below:
- American Medical Association (AMA) CPT 2022 Professional Edition (includes rules and guidelines from the AMA’s CPT Editorial Panel)
- AHA Coding Clinic for HCPCS, Third Quarter 2021
- AHA Coding Clinic for HCPCS, Fourth Quarter 2021
- AMA’s CPT Assistant, December 2021 Page: 19 Drug-induced sleep endoscopy
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