The 2016 CPT code books are in! To help your urgent care sort through the bevy of code updates for the new year, we’ve made a helpful list of code changes specific to urgent care. Keep in mind not all these CPT codes may affect your urgent care, and your coders will decide what’s relevant for billing needs at your clinic.
Auditory
69209 ” New Code ” Ear irrigation/lavage, code 69209 cannot be used in conjunction with 69210 when performed on the same ear (can be performed by a nurse)
Radiology
72081 ” 72084 ” New Codes ” Radiologic exam, spine and pelvis (and subsequent codes for multiple views), code 72090 has been deleted and replaced with above options
73501 ” 73503 ” New Codes ” Radiologic exam, hips, unilateral (and subsequent codes for multiple views), codes 73500, 73510, 73530, 73540 have been deleted and replaced with above options
73521 ” 73523 ” New Codes ” Radiologic exam, hips, bilateral (and subsequent codes for multiple views), code 73520 has been deleted and replaced with above options
73551 ” 73552 ” New Codes ” Radiologic exam, femur (and subsequent codes for multiple views), code 73550 has been deleted and replaced with above options
74712 ” New Code ” Magnetic resonance imaging, fetal
74713 ” New Code ” Each additional gestation to above code
Pathology and Laboratory
80081 ” New Code ” Obstetric panel (includes HIV testing)
Medicine ” Vaccines, Toxoids
90632 ” 90634 ” Code Updates ” Hepatitis A vaccine (and subsequent doses) descriptor change
90647 ” 90648 ” Code Updates ” Influenza type B vaccine (and subsequent doses) descriptor change
90649 ” 90650 ” Code Updates ” HP vaccine, descriptor change
90653 ” 90668 ” Code Updates ” Influenza virus vaccine, in trivalent, split virus, live, pandemic formulations (and subsequent doses, dosage types, and applications) descriptor change
90670 ” Code Update ” Pneumococcal conjugate vaccine, descriptor change
90680 ” 90681 ” Code Updates ” Rotavirus vaccine, descriptor change
90685 ” 90688 ” Code Updates ” Influenza virus vaccine, quadrivalent (and subsequent doses, dosage types, and applications) descriptor change
90696, 90698, 90702, 90714 ” Code Updates ” DTP vaccine and toxoids, (and subsequent doses, dosage types, and applications) descriptor change
90697 ” New Code ” DTP, influenza type B, and hepatitis B vaccine
90716 ” Code Update ” Varicella virus vaccine, descriptor change
90732 ” Code Update ” Pneumococcal polysaccharide vaccine, descriptor change
90644, 90733, 90734 ” Code Updates ” Meningococcal polysaccharide vaccine and conjugate vaccine, descriptor change
90620 ” New Code ” Meningococcal recombinant protein and outer membrane vesicle vaccine
90621 ” New Code ” Meningococcal recombinant lipoprotein vaccine
90736 ” Code Update ” Shingles vaccine, descriptor change
90739 ” 90748 ” Code Updates ” Hepatitis B vaccine, including combination with influenza type b vaccine (and subsequent doses, dosage types, and applications) descriptor change
HCPCS
Review new, revised, and discontinued HCPCS codes for 2016
The above code changes went into effect on January 1, and if you have questions regarding code selection, please consult your billing team. It’s important your urgent care is aware of coding changes, and various payer requirements so you can keep selections (and reimbursements) accurate.
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