23 New Billable ASC CPT Codes for 2011

CPT copyright 2009 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.

 

The 2011 CMS ASC final rule gave ASCs six new procedures they can bill Medicare for which were previously excluded from coverage, according to the ASC Association. As a result of the annual process of replacing discontinued codes with newly instituted codes, ASC have a net gain of 23 payable codes in 2011.

 

CMS deleted 14 codes from the ASC list for 2011.

 

Here are the new billable ASC CPT codes, the short description, 2011 national ASC rate and the reason for the addition and when the code becomes billable, according to the ASC Association. This list includes codes which became payable in March and July (noted under the final column). Editor's note: The six procedures previously excluded from Medicare coverage added in 2011 are CPT 37204, 37210, 37221, 37223, 50593 and 52649.

 

HCPCS Code

Description

2011 National ASC Rate

Reason for the addition

0226T

Anosc high resol dx +-coll

$26.78

New Code Billable July 1, 2010

0227T

Anosc high resol dx w/bx

$231.07

New Code Billable July 1, 2010

0228T

US tfrml edrl inj crv/t 1lvl

$288.11

New Code Billable July 1, 2010

0229T

US tfrml edrl inj crv/t +lvl

$148.93

New Code Billable July 1, 2010

0230T

US tfrml edrl inj l/s 1lvl

$288.11

New Code Billable July 1, 2010

0231T

US tfrml edrl inj l/s +lvl

$148.93

New Code Billable July 1, 2010

0232T

Inj plsm img guid hrvst&prep

$26.78

New Code Billable July 1, 2010

0238T

Trluml perip athrc iliac art

$3,592.47

New Code Billable January 1, 2011

0249T

Ligation hemorrhoid w/us

$624.25

New Code Billable January 1, 2011

0250T

Insert bronchial valve

$1,109.14

New Code Billable January 1, 2011

0251T

Remov bronchial valve addl

$406.83

New Code Billable January 1, 2011

0252T

Bronchscpc rmvl bronch valve

$406.83

New Code Billable January 1, 2011

0253T

Insert aqueous drain device

$945.91

New Code Billable January 1, 2011

0260T

Hypthrm bdy neonate 28d/<

No Separate Payment

New Code Billable January 1, 2011

0261T

Hypthrm head neonate 28d/<

No Separate Payment

New Code Billable January 1, 2011

11045

Deb subq tissue add-on

$105.84

New Code Billable January 1, 2011

11046

Deb musc/fascia add-on

$105.84

New Code Billable January 1, 2011

11047

Deb bone add-on

$329.04

New Code Billable January 1, 2011

29914

Hip arthro w/femoroplasty

$1,876.83

New Code Billable January 1, 2011

29915

Hip arthro acetabuloplasty

$1,876.83

New Code Billable January 1, 2011

29916

Hip arthro w/labral repair

$1,876.83

New Code Billable January 1, 2011

31295

Sinus endo w/balloon dil

$1,198.96

New Code Billable January 1, 2011

31296

Sinus endo w/balloon dil

$1,198.96

New Code Billable January 1, 2011

31297

Sinus endo w/balloon dil

$1,198.96

New Code Billable January 1, 2011

31634

Bronch w/balloon occlusion

$406.83

New Code Billable January 1, 2011

37204

Transcatheter occlusion

$3,728.28

Previously Excluded Procedure

37210

Embolization uterine fibroid

$2,266.64

Previously Excluded Procedure

37220

Iliac revasc

$2,126.38

New Code Billable January 1, 2011

37221

Iliac revasc w/stent

$2,126.38

Previously Excluded Procedure

37222

Iliac revasc add-on

$2,126.38

New Code Billable January 1, 2011

37223

Iliac revasc w/stent add-on

$2,126.38

Previously Excluded Procedure

38900

Io map of sent lymph node

No Separate Payment

New Code Billable January 1, 2011

43753

Tx gastro intub w/asp

$26.01

New Code Billable January 1, 2011

43754

Dx gastr intub w/asp spec

$26.01

New Code Billable January 1, 2011

43755

Dx gastr intub w/asp specs

$37.27

New Code Billable January 1, 2011

43756

Dx duod intub w/asp spec

$46.97

New Code Billable January 1, 2011

43757

Dx duod intub w/asp specs

$46.97

New Code Billable January 1, 2011

49327

Lap ins device for rt

$1,497.48

New Code Billable January 1, 2011

49418

Insert tun ip cath perc

$1,201.08

New Code Billable January 1, 2011

50593

Perc cryo ablate renal tum

$2,178.82

Previously Excluded Procedure

52649

Prostate laser enucleation

$1,773.68

Previously Excluded Procedure

53860

Transurethral rf treatment

$778.30

New Code Billable January 1, 2011

57156

Ins vag brachytx device

$140.26

New Code Billable January 1, 2011

61781

Scan proc cranial intra

No Separate Payment

New Code Billable January 1, 2011

61782

Scan proc cranial extra

No Separate Payment

New Code Billable January 1, 2011

61783

Scan proc spinal

No Separate Payment

New Code Billable January 1, 2011

64566

Neuroeltrd stim post tibial

$103.38

New Code Billable January 1, 2011

64568

Inc for vagus n elect impl

$21,333.84

New Code Billable January 1, 2011

64569

Revise/repl vagus n eltrd

$841.60

New Code Billable January 1, 2011

64570

Remove vagus n eltrd

$1,444.14

New Code Billable January 1, 2011

64611

Chemodenerv saliv glands

$41.86

New Code Billable January 1, 2011

65778

Cover eye w/membrane

$314.70

New Code Billable January 1, 2011

65779

Cover eye w/membrane stent

$291.90

New Code Billable January 1, 2011

66174

Translum dil eye canal

$1,675.21

New Code Billable January 1, 2011

66175

Trnslum dil eye canal w/stnt

$1,675.21

New Code Billable January 1, 2011

C9800

Dermal filler inj px/suppl

$177.60

New Procedure Billable March 23, 2010

 

Here are the 14 deleted HCPCS codes.

 

HCPCS Code

Description

2010 National ASC Rate

0017T

Photocoagulat macular drusen

$234.07

0016T

Thermotx choroid vasc lesion

$234.07

0193T

Rf bladder neck microremodel

$801.25

0177T

Aqu canal dilat w retent

$1,576.84

0176T

Aqu canal dilat w/o retent

$1,576.84

43600

Biopsy of stomach

$342.03

35492

Atherectomy, percutaneous

$3,734.27

35473

Repair arterial blockage

$2,027.94

61795

Brain surgery using computer

No Separate Payment

64573

Implant neuroelectrodes

$9,116.01

20000

Incision of abscess

$58.25

49420

Insert abdom drain, temp

$993.68

11040

Debride skin, partial

$23.45

11041

Debride skin, full

$25.98

 

Source: ASC Association.

 

The information provided should be utilized for educational purposes only. Please consult with your billing and coding expert. Facilities are ultimately responsible for verifying the reporting policies of individual commercial and MAC/FI carriers prior to claim submissions.

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