2021 Compilation of Inpatient Only Lists by Specialty
Total Page:16
File Type:pdf, Size:1020Kb
2021 Compilation of Inpatient Only Lists by Specialty xxxxx Yellow = New CPT/HCPCS Code for CY 2021 xxxxx Green = Active CPT/HCPCS changed from “IP (or mid-year CY 2020) only” to “not IP only” as of 1/1/2021 2021 Bariatric Surgery: Is the Surgery Medicare Inpatient Only or not? Disclaimer: This is not the CMS Inpatient Only Procedure List (Annual OPPS Addendum E). No guarantee can be made of the accuracy of this information which was compiled from public sources. CPT Codes are property of the AMA and are made available to the public only for non-commercial usage. Gastric Bypass or Partial Gastrectomy Procedures Inpatient Only Procedure Not an Inpatient Only Procedure 43644 Laparoscopy, surgical, gastric restrictive 43659 Unlisted laparoscopy procedure, stomach procedure; with gastric bypass and Roux-en-Y gastroenterostomy (roux limb 150 cm or less) 43645 Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and small intestine reconstruction to limit absorption 43775 Laparoscopy, surgical, gastric restrictive procedure; longitudinal gastrectomy (ie, sleeve gastrectomy) 43843 Gastric restrictive procedure, without gastric bypass, for morbid obesity; other than vertical- banded gastroplasty 43845 Gastric restrictive procedure with partial gastrectomy, pylorus-preserving duodenoileostomy and ileoileostomy (50 to 100 cm common channel) to limit absorption (biliopancreatic diversion with duodenal switch) 43846 Gastric restrictive procedure, with gastric bypass for morbid obesity; with short limb (150 cm or less) Roux-en-Y gastroenterostomy 43847 Gastric restrictive procedure, with gastric bypass for morbid obesity; with small intestine reconstruction to limit absorption 43848 Revision, open, of gastric restrictive procedure for morbid obesity, other than adjustable gastric restrictive device (separate procedure) Lap Band Procedures Inpatient Only Procedure Not an Inpatient Only Procedure 43771 Laparoscopy, surgical, gastric restrictive 43770 Laparoscopy, surgical, gastric restrictive procedure; revision of adjustable gastric procedure; placement of adjustable gastric restrictive device component only restrictive device (eg, gastric band and subcutaneous port components) 43772 Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device component only 43773 Laparoscopy, surgical, gastric restrictive procedure; removal and replacement of adjustable gastric restrictive device component only 43774 Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device and subcutaneous port components 43886 Gastric restrictive procedure, open; revision of subcutaneous port component only 43887 Gastric restrictive procedure, open; removal of subcutaneous port component only 43888 Gastric restrictive procedure, open; removal and replacement of subcutaneous port component only Vagus Nerve Procedures Inpatient Only Procedure Not an Inpatient Only Procedure 0312T Vagus nerve blocking therapy (morbid obesity); laparoscopic implantation of neurostimulator electrode array, anterior and posterior vagal trunks adjacent to esophagogastric junction (EGJ), with implantation of pulse generator, includes programming 0313T Vagus nerve blocking therapy (morbid obesity); laparoscopic revision or replacement of vagal trunk neurostimulator electrode array, including connection to existing pulse generator 0314T Vagus nerve blocking therapy (morbid obesity); laparoscopic removal of vagal trunk neurostimulator electrode array and pulse generator 0315T- Vagus nerve blocking therapy (morbid obesity); 0317T removal, replacement, analysis, or reprogramming of pulse generator; codes 0315T, 0316T, 0317T 2021 Cardiac Surgery: Is the Procedure Medicare Inpatient Only or not? Disclaimer: This is not the CMS Inpatient Only Procedure List (Annual OPPS Addendum E). No guarantee can be made of the accuracy of this information which was compiled from public sources. CPT Codes are property of the AMA and are made available to the public only for non-commercial usage. Coronary Artery Bypass Graft (CABG) and other Revascularization Procedures Inpatient Only Procedure Not an Inpatient Only Procedure 33140 Transmyocardial laser revascularization, by thoracotomy; (separate procedure) 33141 Transmyocardial laser revascularization, by thoracotomy; performed at the time of other open cardiac procedure(s) (List separately in addition to code for primary procedure) 33510- Coronary artery bypass, vein only; 1-6 coronary 33516 venous graft(s); codes 33510, 33511, 33512, 33513, 33514, 33516 33517- Coronary artery bypass, using venous graft(s) and 33523 arterial graft(s); 1-6 vein graft(s) (List separately in addition to code for primary procedure); codes 33517, 33518, 33519, 33520, 33522, 33523 33530 Reoperation, coronary artery bypass procedure or valve procedure, more than 1 month after original operation (List separately in addition to code for primary procedure) 33533- Coronary artery bypass, using arterial graft(s); 1-4 or 33536 more coronary arterial graft(s); codes 33533, 33534, 33535, 33536 33572 Coronary endarterectomy, open, any method, of left anterior descending, circumflex, or right coronary artery performed in conjunction with coronary artery bypass graft procedure, each vessel (List separately in addition to primary procedure) Valvular Procedures Inpatient Only Procedure Not an Inpatient Only Procedure 0343T Transcatheter mitral valve repair (TMVR) 92990 Percutaneous balloon valvuloplasty; pulmonary percutaneous approach including transseptal valve puncture when performed; initial prosthesis 0344T Transcatheter mitral valve repair (TMVR) percutaneous approach including transseptal puncture when performed; additional prosthesis (es) during same session (List separately in addition to code for primary procedure) 0345T Transcatheter mitral valve repair (TMVR) percutaneous approach via the coronary sinus 0483T Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; percutaneous approach, including transseptal puncture, when performed 0484T Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; transthoracic exposure (eg, thoracotomy, transapical) 0543T Transapical mitral valve repair, including transthoracic echocardiography, when performed, with placement of artificial chordae tendineae 0544T Transcatheter mitral valve annulus reconstruction, with implantation of adjustable annulus reconstruction device, percutaneous approach including transseptal puncture 0545T Transcatheter tricuspid valve annulus reconstruction with implantation of adjustable annulus reconstruction device, percutaneous approach 0569T Transcatheter tricuspid valve repair, percutaneous approach; initial prosthesis 0570T Transcatheter tricuspid valve repair, percutaneous approach; each additional prosthesis during same session (List separately in addition to code for primary procedure) 33361 Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; percutaneous femoral artery approach 33362 Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; open femoral artery approach 33363 Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; open axillary artery approach 33364 Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; open iliac artery approach 33365 Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; transaortic approach (eg, median sternotomy, mediastinotomy) 33366 Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; transapical exposure (eg, left thoracotomy) 33367 Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; cardiopulmonary bypass support with percutaneous peripheral arterial and venous cannulation (eg, femoral vessels) (List separately in addition to code for primary procedure) 33368 Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; cardiopulmonary bypass support with open peripheral arterial and venous cannulation (eg, femoral, iliac, axillary vessels) (List separately in addition to code for primary procedure) 33369 Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; cardiopulmonary bypass support with central arterial and venous cannulation (eg, aorta, right atrium, pulmonary artery) (List separately in addition to code for primary procedure) 33390 Valvuloplasty, aortic valve, open, with 92986 Percutaneous balloon valvuloplasty; aortic valve cardiopulmonary bypass; simple (ie, valvotomy, debridement, debulking, and/or simple commissural resuspension) 33391 Valvuloplasty, aortic valve, open, with cardiopulmonary bypass; complex (eg, leaflet extension, leaflet resection, leaflet reconstruction, or annuloplasty) 33405 Replacement, aortic valve, with cardiopulmonary bypass; with prosthetic valve other than homograft or stentless valve 33406 Replacement, aortic valve, with cardiopulmonary bypass; with allograft valve (freehand) 33410 Replacement, aortic valve, with cardiopulmonary bypass; with stentless tissue valve 33411 Replacement, aortic valve; with aortic annulus enlargement, noncoronary sinus 33412 Replacement, aortic valve; with transventricular aortic annulus enlargement (Konno procedure) 33413 Replacement, aortic valve; by translocation of autologous pulmonary valve with allograft replacement of pulmonary valve (Ross procedure) 33420 Valvotomy, mitral valve; closed heart 33422 Valvotomy, mitral valve; open heart, with cardiopulmonary bypass 33425 Valvuloplasty,