New Category III codes announced July 1, 2015

On July 1, 2015 the American Medical Association (AMA) released its semi-annual update to its list of CPT Category III codes. The AMA identified 34 new Category III codes; these codes all are scheduled to become effective as of January 1, 2016.  Of particular interest to Echocardiographers is 0399T – Myocardial strain imaging as described below:

  • 0399T: Myocardial strain imaging (quantitative assessment of myocardial mechanics using image-based analysis of local myocardial dynamics)
    ►(Use 0399T in conjunction with 93303, 93304, 93306, 93307, 93308, 93312, 93314, 93315, 93317, 93350, 93351, 93355)◄
    ►(Report 0399T once per session)◄

Reminders for your practice

  1. Typically Category III codes replace unlisted codes that were previously used for new procedures or services.   Prepare to update your charge sheets.
  2. If a Category III code describes the procedure or service performed, it must be reported. An unlisted code or less specific Category I cannot be reported in place of an active Category III code.
  3. Reimbursement of Category III codes is at the discretion of payers.  During the six months between announcement of new Category III code and active date, practices interested in utilizing new code should begin working with local payers to obtain coverage and payment.
  4. Category III codes are released on a semi-annual basis in January and July and are published on the AMA’s website.  Please reference the AMA website for a complete listing of all recently approved Category III codes

Also, with the passage of the Medicare Access and CHIP Reauthorization Act of 2015 (MACA) Congress permanently repealed and replaced the Sustainable Growth Rate Formula and a providing to increase the Medicare conversation faction by .05%. This increase will go into effect today, July 1.

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