Part 2 – New 2019 CPT Codes: Musculoskeletal System

by | Jan 15, 2019 | Coding Tips, CPT, Education, New CPT Codes, Patricia Maccariella-Hafey, Series | 0 comments

Patricia Maccariella-Hafey, RHIA, CDIP, CCS, CCS-P, CIRCC has over 35 years expertise in the areas of ICD-9-CM, CPT, DRG/APC validation Professional Fee E&M coding, Interventional Radiology, and Facility E&M coding. Patricia is currently Director of Education a healthcare consulting firm specializing in coding compliance review, education and contract coding services.

Pat Maccariella‑Hafey
RHIA, CDIP, CCS, CCS‑P, CIRCC

Executive Director Of Education
AHIMA‑Approved ICD‑10‑CM/PCS Trainer and Ambassador

This is Part 2 of a five part series on the new 2019 CPT codes. In this series we will explore the CPT changes for FY2019 and include examples to help the coder understand the new codes. There are 4 new musculoskeletal CPT codes added with 2 deletions and 0 revisions.

New Allograft Add On Codes

Save & Exit There are three new allograft add on codes that are differentiated by type:

  • Osteoarticular, including articular surface and contiguous bone
  • Hemicortical intercalary, partial (i.e., hemicylindrical)(Intercalary means inserted between other parts)
  • Intercalary, complete (i.e., cylindrical)

These types of grafts are typically used after radical resections of bone tumors such as osteosarcomas.

They are usually made of cadaver bone. Here are the new add on codes:
+20932 Allograft, includes templating, cutting, placement and internal fixation, when performed; osteoarticular, including articular surface and contiguous bone (list in addition to primary)
+20933 hemicortical intercalary, partial (ie, hemicylindrical) (list in addition to primary)
+20934 intercalary, complete (ie, cylindrical) (list in addition to primary
Coders must pay attention to the “do not report with” notes under each of these codes, as that would be over coding.

Knee Arthrography

Old code 27370 for injection of contrast for knee arthrography has been deleted​​​. This was done because many physician offices were assigning this code for aspiration of knee joints, and that is incorrect use of the code. So the AMA came up with new code 27369, Injection procedure for contrast knee arthrography or contrast enhanced CT/MRI knee arthrography. There is a warning for coders to not report this code when knee arthrocentesis or knee injection of any other material other than contrast for angiography. For arthrocentesis, the coder should look at codes 20610, 20611; arthrocentesis of major joint, without and with ultrasound guidance. Coders should not report code 27369 with 20610, 20611 or 29871. If fluoroscopic guidance is used for the enhances CT arthrography, add 77002 and 73701 or 73702 to 27369.

Sinus Tarsi Implant

Three new category III codes have been assigned to address the sinus tarsi implant. This implant treats overpronation and mobile flatfoot. Placing an implant into the gap between the calcaneus and the talus called the sinus tarsi controls excessive rolling in of the foot. When the foot rolls in, this gap reduces in size. It expands when the foot rolls out. By placing the right size implant in the sinus tarsi, surgeons can limit the amount of rolling in (pronation) of the foot. It is normally well tolerated but in certain cases it can cause irritation and would have to be removed. The codes are:
0335T Insertion of sinus tarsi implant (Do not bill with fusion or dislocation repair)
0510T Removal of sinus tarsi implant
0511T Removal and reinsertion of sinus tarsi implant

The information contained in this post is valid at the time of posting. Viewers are encouraged to research subsequent official guidance in the areas associated with the topic as they can change rapidly.

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