Code 58340 has been revised to reflect more current terminology. The term “hysterosonography” has been changed to “saline infusion sonohysterography.” A similar change applies to the radiological supervision code 76831 [saline infusion sonohysterography, including color flow Doppler, when performed]. This change does not alter the use of the codes in any way.
Reproductive medicine procedures
This new section of laboratory codes accommodates the technologic advancements and changing practice in reproductive medicine.
This article uses the standard CPT symbols:
- Codes new to CPT 2004
- Codes revised in CPT 2004
Indentation
When a code is followed by 1 or more indented codes, the indented text replaces everything following the semicolon in the initial code.
- Oocyte/embryo culture and fertilization techniques;
- Oocyte/embryo biopsy techniques; and
- Freezing, thawing, and storage techniques.
In addition, there are 2 new Category III codes for cryopreservation of tissue and oocytes. If the procedure performed matches one of these new Category III codes, it must be reported rather than an unlisted service code. The new and revised codes can be found in the Table.
TABLE
Reproductive medicine procedures
| OOCYTE/EMBRYO CULTURE AND FERTILIZATION TECHNIQUES | |
| • 89250 | Culture of oocyte(s)/embryo(s), less than 4 days;* |
| • 89251 | with coculture of oocyte(s)/embryos† |
| • 89268 | Insemination of oocytes |
| • 89272 | Extended culture of oocyte(s)/embryo(s), 4-7 days‡ |
| • 89280 | Assisted oocyte fertilization, microtechnique; less than or equal to 10 oocytes |
| • 89281 | greater than 10 oocytes |
| OOCYTE/EMBRYO BIOPSY TECHNIQUES | |
| • 89290 | Biopsy, oocyte polar body or embryo blastomere, microtechnique (for preimplantation genetic diagnosis); less than or equal to 5 embryos |
| • 89291 | greater than 5 embryos |
| FREEZING, THAWING, AND STORAGE TECHNIQUES | |
| • 89258 | Cryopreservation; embryo(s) |
| • 89335 | Cryopreservation, reproductive tissue, testicular |
| • 89342 | Storage (per year); embryo(s) |
| • 89343 | sperm/semen |
| • 89344 | reproductive tissue, testicular/ovarian |
| • 89346 | oocyte |
| • 89352 | Thawing of cryopreserved; embryo(s) |
| • 89353 | sperm/semen, each aliquot |
| • 89354 | reproductive tissue, testicular/ovarian |
| • 89356 | oocytes, each aliquot |
| CATEGORY III CODES | |
| • 0058T | Cryopreservation of reproductive tissue, ovarian |
| • 0059T | Cryopreservation of oocyte(s) |
| * You can now use code 89250 to report the culture of immature oocytes. Fertilization and insemination are no longer considered part of this code, and thus are reported separately. | |
| † Code 89251 represents the additional work of the microfertilization of more than 10 oocytes. | |
| ‡ Use code 89272 to report separate techniques for additional cultures over a 4- to 7-day period and in addition to code 89250. | |
Staying hip to HIPAA: Category II codes
This new section, which adds supplemental tracking codes for performance measurements, was created in an effort to comply with HIPAA regulation requirements for the code set. These codes will not affect reimbursement, but are meant to decrease the need for record abstraction and chart review. Use of these codes, it is hoped, will facilitate data collection about quality of care. Coders should be aware of the following:
- The use of these codes is optional; they may not be substituted for the regular Category I CPT codes.
- The codes describe components typically included in an evaluation and management service, as well as test results that are part of the laboratory test/procedure.
- The codes are assigned no relative value units.
- New codes for this section will be released semiannually. Updates can be found on the AMA/CPT Web site (www.ama-assn.org/ama/pub/category/3885.html).
The Category II codes effective January 1, 2004, are:
- 0001FBlood pressure, measured
- 0002FTobacco use, smoking, assessed
- 0003FTobacco use, nonsmoking, assessed
- 0004FTobacco use cessation intervention, counseling
- 0005FTobacco use cessation intervention, pharmacologic therapy
- 0006FStatin therapy, prescribed
- 0007FBeta-blocker therapy, prescribed
- 0008FAngiotensin-converting enzyme inhibitor therapy, prescribed
- 0009FAnginal symptoms and level of activity, assessed
- 0010FAnginal symptoms and level of activity, assessed using a standardized instrument (eg, Canadian Cardiovascular Society Classification-CCSC-System, Seattle Angina Questionnaire-SAQ)
- 0011FOral antiplatelet therapy, prescribed (eg, aspirin, clopidogrel/Plavix, or combination of aspirin and dipyridamole/Aggrenox)
BEST OF THE REST
Surgical procedures Urinary system.
• 53500Urethrolysis, transvaginal, secondary, open, including cystourethroscopy (eg, postsurgical obstruction, scarring)
This new code is for the treatment of obstructive voiding caused by periurethral scarring, which can occur following a urethral suspension procedure, such as a bladder neck suspension. The procedure associated with this new code usually involves the dissection, lysis, and removal of the periurethral scar tissue, as well as mobilization of the urethra away from the surrounding tissues. This code also includes cystourethroscopy (52000), which is sometimes performed to check the urethra after the procedure is done.
In addition, CPT indicates that if urethrolysis is performed via a retropubic rather than vaginal approach, unlisted code 53899 should be reported instead of 53500.
Medicine code changes