This week we examine several CPT changes, including updates to evaluating physical therapy visits as well as new codes for glaucoma treatment.

Coding Correction – 95940 and 95941

August 2017’s CPT Assistant clarifies that modifier 26 or TC should not be appended to codes 95940 Continuous intraoperative one-on-one neurophysiology OR monitoring requiring personal attendance, each 15 minutes (List separately in addition to code for primary procedure and 95941 Continuous intraoperative neurophysiology monitoring while in the OR of more than one case from outside the operating room (remote or nearby), per hour (List separately in addition to code for primary procedure)as previously noted in CPT Assistant, April 2014, pg.11. Facility fees (cost of clinical staff, supplies and equipment) are separately reported by the facility, and should not be captured using CPT Codes 95940 and 95941.

CPT Assistant, August 2017, pg.8


Evaluating Physical Therapy Visits

Significant changes have been made to the codes and descriptions in the CPT 2017 Medicine/Physical Medicine and Rehabilitation (PM&R) subsection for physical therapy evaluation and re-evaluations. Evaluation and Management term definitions differ from the Physical Medicine and Rehabilitation section - therefore, it is very important NOT to use the Definitions of Commonly Used Terms in the Evaluation and Management Guidelines.

CPT Assistant, August 2017, pg.4


New Codes for Glaucoma Treatment

New Category III codes 0444T Initial Placement under one or more eyelids of a drug-eluting ocular insert, including a fitting, training, and insertion, unilateral or bilateral and 0445T Subsequent placement under one or more eyelids of a drug eluting ocular insert, including re-training and removal of existing insert, unilateral or bilateral were created in 2017 for emerging technology and services for glaucoma treatment. These are not to be confused with 0356T Surgical insertion into the canaliculus through the punctum of a drug-eluting implant.

CPT Assistant, August 2017, pg.7