Drug Coding Advisor-CPT codes adjusted to reflect AMA updates

The Health Care Financing Administration (HCFA) has added several new replacement codes to the ambulatory surgery centers' (ASC) list of services furnished on or after Jan. 1, 2000. The American Medical Association's (AMA) Jan. 1, 2000, update to the current physicians terminology (CPT) book had caused some ASC codes to be deleted, resulting in several carriers and intermediaries denying payment for the deleted codes.

HCFA's Transmittal No. AB-00-28 also added CPT code 36833 to the list, since the AMA's definition for ASC code 36832 was split. CPT codes 15580 and 15625 were deleted and will not be replaced due to the revised CPT code descriptions. Finally, the transmittal says that type of service (TOS) "F" (ASC facility usage for surgical services) should be used when modifier SG appears on an ASC claim. Otherwise, TOS "2" (surgery) for professional services rendered in an ASC should be used.

For carriers, the implementation date for those changes was May 29, 2000; for intermediaries, the implementation deadline is Oct. 1, 2000. To read HCFA's announcement, which includes the full list of replacement codes, go to http://www.hcfa.gov/pubforms/transmit/AB002860.pdf.