Happy New Year – 2019 is Almost Here!

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By Melody W. Mulaik, MSHS, CRA, FAHRA, RCC, CPC, CPC-H

It is hard to believe that 2018 is almost over; 2019 will be here before we know it. There are always coding changes every year, and 2019 is no exception. Being appropriately prepared will ensure smooth operations and appropriate reimbursement.

My session at the 2018 AHRA Fall Virtual Conference, “2019 Coding, Compliance & Reimbursement Preview” will cover all of the new 2019 codes along with related authoritative guidance. Key areas of concern will also be highlighted so that you determine what issues you will need to follow-up on with your individual payors after the beginning of the year. An example of this includes the new knee arthrography injection code and how payors will handle the fluoroscopy code 77002.

There are several new coding guidelines that will be reviewed as well as all of the diagnostic and interventional procedure codes. There are code deletions for 2019 that will capture how certain procedures are billed, such as the add-on fluoroscopy code 76001. Specific topics will be reviewed in detail, including the nine new fine needle aspiration (FNA) codes, how to handle the coding for multiple lesions with the same and different imaging modalities, and when an FNA and a core biopsy can be billed at the same time.

The peripherally inserted central catheter (PICC) codes have been revised to exclude imaging guidance and two new comprehensive codes have been created that include all imaging guidance necessary to perform the procedure. Additionally, the replacement code has been revised to include all imaging guidance as well. These changes demonstrate the continued trend towards comprehensive codes that include imaging. Official guidance has been published regarding the correct coding for midline catheters, and the answer is not what you expect.

The existing non-imaging G-Tube replacement code has been deleted and replaced with two new without imaging codes. Additionally, the existing urinary dilation code for nephrostomy track creation has been deleted and replaced with two new codes and are differentiated by whether a new access is required.

Other topics that will be addressed include: knee arthography injection, MR elastography, ultrasound elastography, targeted ultrasound microbubble studies, breast MRI, and US bone density.

As you can see, it is another year of big coding changes for 2019. Ensuring accurate coding and compliance is a journey and not an event, so attending this session is step one of many to ensuring you are ready for 2019. I hope to “see” you soon!


Melody W. Mulaik, MSHS, CRA, FAHRA, RCC, CPC, CPC-H is the president of Coding Strategies, Inc. She is also a member of the AHRA Regulatory Affairs Committee. She can be reached at Melody.mulaik@codingstrategies.com.  

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