Key 2023 CPT Changes: What ASCs Must Know

By Mandeara Frye, RHIA, CPC, CPMA, CASCC, Senior Director, Coding

January is right around the corner, so it's time to begin preparing for the CPT code set that will be the standard in the new year. 2023 is bringing significant changes to the codes used in ASCs. With adequate preparation, your surgery center will be ready to hit the ground running. Let's review some of the most substantial changes for ASCs to know.

Hernia

One of the biggest changes we'll see is to the hernia CPTs. Eighteen codes are being deleted and replaced by 14 new codes. Rather than being broken down into codes for the specific hernia type and approach as they were previously, the codes will now include all anterior abdominal hernias (epigastric, incisional, ventral, umbilical, spigelian) and any approach (open, laparoscopic, robotic).

As before, the codes will be differentiated by reducible vs. incarcerated or strangulated, but the codes will now also be further broken down based on the total length of the defect(s) repaired: less than 3 cm, 3 cm – 10 cm, and greater than 10 cm.

It's important to note that the code descriptions contain "hernia(s)" and "defect(s)", meaning if multiple abdominal hernias are repaired, the total length of those defects should be added together and only one CPT reported to encompass all repairs performed.

All new hernia CPTs also include the implantation of mesh, so CPT 49568 has been deleted with no replacement code.

Examples:

• 49591 — Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible
• 49594 — 3 cm to 10 cm, incarcerated or strangulated

ENT

For ENT, there's a new code for radiofrequency remodeling

• 30469 — Repair of nasal valve collapse with low energy, temperature-controlled (ie, radiofrequency) subcutaneous/submucosal remodeling

This CPT code is associated with usage of VivAer to repair nasal valve collapse.

There are revisions to the code descriptions for bone-anchored hearing devices. The additions are in italics below:

• 69716 — Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area of bone deep to the outer cranial cortex
• 69717 — Revision or Replacement (including removal of existing device), osseointegrated implant, skull; with percutaneous attachment to external speech processor
• 69726 — Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor

Total Disc Arthroplasty

CPT 0163T — Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression), each additional interspace, lumbar (List separately in addition to code for primary procedure) — is being replaced with CPT 22860 with no change to the code description.

Nerve Block

There are changes to nerve block codes, which will now include all imaging guidance. For example:

• 64415 — Injection(s), anesthetic agent(s) and/or steroid; brachial plexus, including imaging guidance, when performed

CPT Quick Tips

As always, it's important to review all the new, revised, and deleted codes prior to the new year so your center will be prepared and avoid any billing delays. Don't forget to update your practice management software with the new CPT code set. Lastly, make sure surgeons in your ASC are aware of the changes as well and understand how the changes may affect their documentation requirements.