Important 2016 CPT and HCPCS Code Changes for Urgent Care

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. 

This resource was first published prior to the 2019 merger between DocuTAP and Practice Velocity. The content reflects our legacy brands.