decisionhealth Newsletters, Coder Pink Sheets - 2010 Issue 9 (September)
Atherectomies bumped to the Category III list next year
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Article Overview
This article explains scheduled CPT code changes for peripheral atherectomy procedures, including the shift of several services into the Category III code set and the impact on reporting and payment considerations. It is relevant to interventional radiology, vascular surgery, and other practices that bill peripheral vascular interventions, as it discusses the broader context for the code changes, the organizations involved, and the general issues surrounding evidence, pricing, and code revision trends.
Why This Topic Matters
Practices that perform peripheral vascular interventions need to understand upcoming CPT code-set changes because they may affect reporting structure, payer policy, and reimbursement planning. The article also highlights how specialty-society and CMS discussions can influence whether procedures remain in Category I or move to Category III.
Article Sections
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Upcoming CPT Category III changes for peripheral atherectomy
Introduces the scheduled code-set changes affecting peripheral atherectomy procedures and the broader reporting and payment implications for 2011.
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Code transition and related reporting changes
Describes the relationship between the newly listed Category III entries and the existing atherectomy reporting structure, including bundled service considerations.
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Coverage, valuation, and evidence concerns
Summarizes the reimbursement and payer-policy concerns connected to Category III coding, along with the evidence and valuation issues discussed by the specialty community.
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Specialty-society advocacy and future coding trends
Reviews the role of professional organizations in the code changes and the article’s discussion of longer-term trends in how future procedure codes may be developed.
What You Will Learn
- Which broad atherectomy procedure categories are affected by the upcoming CPT changes
- How Category III status can influence reporting and payment considerations
- Why evidence and utilization concerns can affect code-set placement
- What general trends are shaping future code development for interventional procedures
Who Should Read This
- Interventional radiology coders
- Vascular surgery billing staff
- Physician practices performing peripheral vascular interventions
- Coding and reimbursement professionals
Codes Discussed
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