AMA CPT® Assistant - 2018 Issue 2 (February)

Photodynamic Therapy (February 2018)

February 2018 page 10 Photodynamic Therapy Current Procedural Terminology (CPT®) code 96567 (photodynamic therapy) was identified by the Centers for Medicare & Medicaid Services (CMS) in a screen of high expenditure services. In the Medicare Physician Fee Schedule final rule for 2016, CMS indicated that the work and practice expense for this service should be reviewed. Code 96567—first included in CPT 2002—is not valued to include physician work. More recently, the stakeholder specialties provided information that physicians may be involved in the delivery of care to patients who receive photodynamic therapy. As a result, two new codes (96573...

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CPT® Assistant content is the official source for CPT® coding guidance. It is an instrumental tool when appealing insurance denials and validating coding to auditors. Monthly issues and an extensive archive provide comprehensive guidance on proper CPT® coding for past, present and upcoming code set releases. Archives date back to 1990 for historical use of codes, changes, rationales, coding tips and trends in the industry.

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