2015 CPT Codes Medicare and G Codes
Alicia: Good, OK. This first question that
we’re doing is on the 2015 G codes. Q: (2015 G-Codes) I was wondering if you are
aware of Medicare not approving many of the new 2015 CPT codes? They will be continuing
with the 2014 codes, but will need to assign G codes. I found the lab codes on the CMS
website yesterday, but have not yet seen the G codes for GI and radiology oncology.
A: Well, I went and did some research and I found two fantastic websites. This first
one is preliminary analysis of the key provisions for 2015 for Radiology and Oncology. Again,
quite amazing, as Laureen
is pulling that. So, what this is again, this was a preliminary bulletin. As you scroll
down on this, let’s go down to where we’re seeing the codes.
Right here is some of the reimbursement codes, but as you go down farther we’re going to
see those G codes. This is a group that specifically did a study for this. You’ll want some of
this other information that’s on there. If you guys are in a document where you want
to look something up, Laureen just did this, just hit control-F and see how that does a
universal look up and you can put that in. So, what the statement stated was: CMS moved
forward with a proposed policy to eliminate some of the codes, and that was G0339 and
G0340 in the Medicare Fee Schedule as they did the Hospital Outpatient setting last year.
CMS is proposing that only… small based, the radiosurgery codes remain on the Medicare
Physician Fee Schedule for 2015. For 2014 those G codes are carrier priced
in the freestanding setting, and, therefore, some regional Medicare Administrative, so
MACs and stuff. This website though gave, as you read the whole document, the link is
on there so you’ll be able to go back and reference it, but it is giving you a location.
Codes Affected by Proposed Removal of Radiation
treatment Vault – these are codes that you definitely need to be aware of, when I was
going through the code list and the changes. Next, 2015 Medicare Physician Fee Schedule
Putting the Pieces Together for GI – this is actually a PowerPoint presentation. Amazing!
And I want to add the whole PowerPoint presentation because it is that good. I even asked Laureen,
I said, “Can we use this?” Because if you have the link… Stop right there, I like
that, how they said: “The voice of the GI was heard.” This is directly from a GI organization.
They said they heard us and “the revaluation of the colonoscopy code family was DELAYED…
not STOPPED,” which is a huge deal for these GI guys if you can imagine. So there are new
things happening in CMS for them. Let’s go to the next slide, we won’t go
through all of those because there are several, but again, as you’re researching they’re
going on to even tell you about 2016. Excellent! I mean, I was just eating this stuff up; I
would have loved to hear this presentation. So, you got to prepare now for the changes
that are going to happen in 2016. 2015 Reimbursement Lower GI Endoscopy – again,
several changes happened here. CMS will be reimbursing at 2014 levels – that’s very
important to know. The new 2015 Lower GI Endoscopy CPT codes will not be recognized by Medicare
for 2015. Then it goes into about the Upper GI and the
changes that were made. Now, they’re going to actually show you the CPT codes and the
prices, so from 2013 all the way up to the percentage of changes for 2014 and 2015, and
in 2015 non-facility payments. Again, this is incredibly valuable for those of you who
are dealing with the GI, but this is only the tip of the iceberg, what these slides
give you. Let me scroll down here and show you some
more stuff… Right here (2015 Coding Changes GI Endoscopy), the modifier 52 and 53, the
decision tree – they changed that. There are new codes for 2015, which is in this presentation
that you can go and you use; and then, billing G codes services in 2015 and new services.
Definition of Colonoscopy – Revised – Now, they changed the definition of a colonoscopy.
Again, as a coder, this is something that you’re going to need to know. What they
actually did was they added may include, and you know as a coder that one word can make
a huge difference. I had actually heard about this so I’m glad that they brought that
up. New Definitions of Colonoscopy in the modifier
53 and 52. They put the decision tree up for you. Now, they gave you some codes on the
in endoscopy for 2015… Final rule – they talked about that. And
they also said right here: delayed publishing updates for the RVU for the lower endoscopy
codes – they gave you examples. Established G codes to mirror those 2014 CPT codes that
were deleted in 2015; and then here’s a list of those codes: old, G and new codes.
So, old codes – colonoscopy through stoma – you’ve got your code, then you have
their G code 2015 and the new code. And so, also the flexible sigmoidoscopy and the colonoscopy
–great stuff. Just scroll through this real quick because
there are several here. Again, you’ll have reference to this, the website was noted.
But I think this particular presentation that was put out by the ASGE answers just every
change that has to do with GI. So, I’ll just scroll down through the rest of that.
I think that it gives some other good links. That’s about it for them, guys. Again, great
website. Laureen: Vicky said you’re making her dizzy.
. Alicia: I’m sorry. Go back to the main screen
because I think there’s one more website I wanted to just mention.
Laureen: This one or your answer sheet? Alicia: The answer sheet. And crosswalk codes
from 2014 to 2015. Again, excellent website for you, this is for gastroenterology. I think
you’re going to be able to find almost all of your answers probably right here… I’m
just going to give you a peek at this because honestly it’s way too much information to
go over in one sitting, but the highlight is that… real quickly you can see. There
you go: 2014 CPT and the 2015 HCPCS with the description. I could highlight some of those
but look at all the differences. There’s beaucoup kinds of colonoscopies but everything
you need is going to be right there. Laureen: I’m going to try and paste these
questions here. Alicia: Normally, we don’t do slides like
that guys just for you new people where you can just show them a website and everything,
we do them much more detailed. But actually, there was just way too much information to
put on an answer sheet or in these slides. Laureen: Hold on one second, Alicia, what
I’m going to do is grab these websites for them.
Alicia: Good idea. Laureen: I’m putting on in the chat, guys;
hopefully you can see the links for those that were asking for them. So these are the
three links that Alicia just shared, so if you want to grab them out of the chat, you
should be able to see them. [Ed. Note: here are the links:
This is a preliminary analysis of the key provisions. Summary of 2015 Proposed Rules
(Radiology Oncology) – Reimbursement Bulletin 2015 Medicare Physician Fee Schedule Putting
the Pieces Together for GI – ASGE Revaluation of the colonoscopy code family
was DELAYED…not STOPPED. Crosswalking some codes from 2014 to 2015 – 2015 Coding updates]
Alicia: Definitely bookmark them. Laureen: Yeah.
Alicia: I did notice that doing some research for some of the other slides, people will
say, “I tried to find this,” because I know before they ask us, they’re out there
looking as well. But sometimes you just have to tweak the way you look at something. It
wasn’t with this; it was actually one of the other slides that I noticed. Definitely
lots of changes for those G codes and exciting stuff going on.