Published: February 2, 2017

CPT changes for 2017: What ENTs Need to Know

There are several Current Procedural Terminology® (CPT) code changes for 2017 applicable to otolaryngologist-head and neck surgeons.  Below is a summary of these changes. If you have any questions regarding CPT code changes for 2017, please contact the Health Policy team.


coding_2017There are several Current Procedural Terminology® (CPT) code changes for 2017 applicable to otolaryngologist-head and neck surgeons.  Below is a summary of these changes. If you have any questions regarding CPT code changes for 2017, please contact the Health Policy team.

What ENTs need to know

As the medical community has come to expect, part of the annual rulemaking process conducted by the Centers for Medicare & Medicaid Services (CMS) includes the annual issuance of new and modified CPT codes, developed by the American Medical Association’s (AMA) Current Procedural Terminology (CPT) Editorial Panel, for the coming year. In addition, CMS includes new, or updated, values (also known as relative value units (RVUs)) for medical services that have undergone review by the American Medical Association’s Relative Update Committee (RUC). CMS has the discretion to accept the RUC’s RVU recommendations for physician work, as well as recommendations for direct practice expense inputs, or it may exercise its administrative authority and elect to assign a different value, or practice expense inputs, for medical procedures paid for by Medicare. The final value, as determined by CMS, is then publicly released in the final Medicare Physician Fee Schedule (MPFS) rule for the following calendar year.

The Academy is an active participant in both the AMA RUC valuation of otolaryngology-head and neck services and the CMS annual rulemaking processes. As part of those efforts, we want to ensure Members are informed and prepared for key changes to CPT codes and valuations related to otolaryngology-head and neck surgery services for CY 2017. The following outlines a list of codes  changed in 2017, including new and revised CPT codes, as well as codes which were reviewed by the AMA RUC in 2017 and could have modified Medicare reimbursement values:

New or modified codes

In CY 2017, changes were made to the following CPT codes and were valued by the AMA RUC:

  • + 0466T-Insertion of chest wall respiratory sensor electrode or electrode array, including connection to pulse generator
  • 0467T-Revision or replacement of chest wall respiratory sensor electrode or electrode array, including connection to existing pulse generator
  • 0468T-Removal of chest wall respiratory sensor electrode or electrode array
  • 31580-Laryngoplasty; for laryngeal web, with indwelling keel or stent insertion
  • 31584-Laryngoplasty; with open reduction and fixation (e.g., plating) of fracture, includes tracheostomy, if performed
  • 31587-Laryngoplasty, cricoid split, without graft placement
  • 31591-Laryngoplasty, medialization; unilateral
  • 31592-Cricotracheal resection
  • 92612-Flexible endoscopic evaluation of swallowing by cine or video recording
  • 92613-Flexible endoscopic evaluation of swallowing by cine or video recording; interpretation and report only
  • 92614-Flexible endoscopic evaluation, laryngeal sensory testing by cine or video recording
  • 92615-Flexible endoscopic evaluation, laryngeal sensory testing by cine or video recording; interpretation and report only
  • 92616-Flexible endoscopic evaluation of swallowing and laryngeal sensory testing by cine or video recording
  • 92617-Flexible endoscopic evaluation of swallowing and laryngeal sensory testing by cine or video recording; interpretation and report only
  • 95144-Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, single dose vial(s) (specify number of vials)
  • 95165-Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy; single or multiple antigens (specify number of doses)

(A November 2016 CPT Assistant article provides clarification on the use of 0466T-0468T.)

In the CY 2017 Medicare Physician Final Rule, CMS published values for the Laryngoplasty and Laryngoscopy codes that the Academy disagreed with. In comments to CMS for the final rule, the Academy presented additional information in hopes of CMS publishing a more appropriate value for these codes in CY 2018.

Codes reviewed by the AMA RUC  in CY 2016

In addition to the creation of several new CPT codes for 2017, a number of existing CPT codes relating to otolaryngology were reviewed by the AMA RUC, and their RUC approved values were submitted to CMS for final determination for the CY 2018 final rule. Members should be prepared for modified relative value units for some, or all, of these procedures in CY 2018. CMS will publish proposed values within the MPFS Proposed rule, typically published the first week of July.  The Academy will monitor the recommended values for these services and comment on Member’s behalf. Final values will be released within the final MPFS which is issued by CMS typically around November 1, of each year. Upon receipt, Academy health policy staff will summarize the final rule and alert Members to any critical changes in reimbursement for any of the following medical procedures. Services which were reviewed include:

  • 30901-Control nasal hemorrhage, anterior, simple (limited cautery and/or packing) any method
  • 30903-Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method
  • 30905-Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial
  • 30906-Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; subsequent
  • 31551-Laryngoplasty; for laryngeal stenosis, with graft, without indwelling stent placement, younger than 12 years of age
  • 31552-Laryngoplasty; for laryngeal stenosis, with graft, without indwelling stent placement, age 12 years or older
  • 31553-Laryngoplasty; for laryngeal stenosis, with graft, with indwelling stent placement, younger than 12 years of age
  • 31554-Laryngoplasty; for laryngeal stenosis, with graft, with indwelling stent placement, age 12 years or older
  • 31572-Laryngoscopy, flexible; with ablation or destruction of lesion(s) with fiber based laser, unilateral
  • 31573-Laryngoscopy, flexible; with therapeutic injection(s) (e.g., chemodenervation agent or corticosteroid, injected percutaneous, transoral, or via endoscope channel), unilateral
  • 31574-Laryngoscopy, flexible; with injection(s) for augmentation (eg, percutaneous, transoral), unilateral
  • 31575-Laryngoscopy, flexible; diagnostic
  • 31576-Laryngoscopy, flexible; with biopsy
  • 31577-Laryngoscopy, flexible; with removal of foreign body(s)
  • 31578-Laryngoscopy, flexible; with removal of foreign lesion(s), non-laser
  • 31579-Laryngoscopy, flexible or rigid telescopic, with stroboscopy
  • 31600-Tracheostomy, planned (separate procedure)
  • 31601-Tracheostomy, planned (separate procedure); younger than two years
  • 31603-Tracheostomy, emergency procedure; transtracheal
  • 31605-Tracheostomy, emergency procedure; cricothyroid membrane
  • 31610-Tracheostomy, fenestration procedure with skin flaps
  • 30140-Resection of turbinate

More from February 2017 - Vol. 36, No. 01