Navigating Change: What You Need to Know About the CPT 2024 Updates

Highcare RCM

The healthcare landscape continually evolves, and so do the CPT codes used to describe medical procedures and services. The 2024 annual update brings several significant changes, reflecting advancements in medical science and technology. Here’s an overview of some pivotal updates:

The 2024 CPT update comprises 349 editorial changes, featuring 230 additions, 49 deletions, and 70 revisions. This underscores the dynamic nature of healthcare innovations, with 11,163 codes now available for various medical procedures and services

E&M Guidelines

Time-Based Coding:

The concept of time in new and established office/outpatient E/M codes has undergone a transformation. The update removes time ranges, replacing them with a single total time amount, now a requisite for code compliance. It’s important to note that while the description for time has changed, the CPT® 2023 E/M code level guidelines remain unaffected.

Split (or Shared) Visits:

Determining which team member reports the visit is based on calculating the substantive portion of the encounter:

  • If code selection relies on total time, the professional who spends the majority or more than half of the face-to-face or non-face-to-face time performing the service reports it.
  • Alternatively, if a practice codes the visit based on medical decision-making (MDM), the practitioner handling the problems addressed and risk portions of the visit reports the service.

Hospital Inpatient, Observation, Admission, and Discharge Services:

The guidelines for hospital inpatient or observation care services, as well as admission and discharge services, entail specific nuances:

  • Services such as hospital inpatient care, observation care, and nursing facility services are considered on a per-day basis, consolidating multiple visits occurring within a single calendar date in the same setting into a single reported service.
  • When employing MDM for code level selection, the aggregated MDM throughout the calendar date is utilized. When using time for code level selection, the time is summed over the course of the day based on reporting time guidelines.
  • Transfers between different designated facilities or levels of care may not necessarily constitute a new stay or a transfer to a different facility, depending on specific criteria.
  • When a physician or other Qualified Healthcare Professional (QHP) offers subsequent E/M services and doesn’t report ED sets but reports a different E/M service (e.g., hospital inpatient or observation care services), the time spent in the ED can contribute to the total time calculation for that encounter date.

Pelvic examination:

CPT® 99459 is a code specifically covering direct practice expenses. It allows billing alongside E/M services when practitioners conduct a pelvic exam as part of an E/M service provided to patients.

Surgery

Musculoskeletal System:

Additions: 22836 – 22838

These codes mark a significant stride in vertebral body tethering at the thoracic level, offering a less invasive option for spinal growth and movement in patients with scoliosis.

Revised Code: 28292, 28295 – 28299

Codes Specifically focusing on hallux valgus correction “with bunionectomy,” refining the code language for clarity and precision.

Respiratory System:

Additions: 31242 – 31243

Introducing codes for the destruction of the posterior nasal nerve during nasal/sinus endoscopy, expanding options for addressing related conditions.

Cardiovascular System:

Additions: 33276 – 33281, 33287 – 33288

A significant addition for the phrenic nerve stimulation system, facilitating reporting for insertion, repositioning, replacement, and removal of the pulse generator, leads, and pacemaker.

Urinary System:

Addition: 52284

A code dedicated to reporting cystourethroscopy with mechanical urethral dilation and urethral therapeutic drug delivery, aiding in managing urethral stricture or stenosis in male patients.

Female Genital System:

Addition: 58580

Describing Transcervical radiofrequency ablation of uterine fibroid(s), offering a focused approach to address this condition.

Nervous System:

Additions: 61889, 61891 – 61892

Introducing codes for reporting the insertion, revision, and replacement of skull-mounted cranial pulse generator or receiver, improving specificity in documentation.

Additions: 64596 – 64598

Added for the insertion, replacement, revision, or removal of the percutaneous electrode array of a peripheral nerve with an integrated neurostimulator, offering more granularity in reporting.

Revised Codes: 63685, 63688, 64590, 64595

Detailed revisions emphasizing sacral procedures and refining requirements for various spinal neurostimulator-related procedures.

Eye and Ocular Adnexa:

Addition: 67516

Introduced to report the injection of a pharmacologic agent in the suprachoroidal space, addressing specific ocular conditions.

Radiology

Addition: 75580

Added to describe a non-invasive estimate of coronary fractional flow reserve (FFR) derived from augmentative software analysis of the data set from a coronary computed tomography angiography.

Addition: 76984

This code is now available to report the service diagnostic intraoperative thoracic aorta ultrasound.

Addition: 76987 – 76988

These codes are added specifically to report intraoperative epicardial cardiac ultrasound for congenital heart disease.

Deletion: 74710

This code has been removed from the coding structure.

Medicine

Addition: 90380 – 90381

Added for respiratory syncytial virus (RSV) treatment in the immune globulins subsection. Designed specifically for monoclonal antibody administration in seasonal doses.

Addition: 90480

Replaces all previously approved specific vaccine administration codes. Encompasses the administration of any COVID-19 vaccine for both pediatric and adult patients, now inclusive of counseling.

Addition 91318 – 91320, 91321 – 91322

New codes added based on patient age groups for Pfizer and Moderna vaccines, enhancing accuracy in reporting.

Addition: 93150 – 93153

Added to describe therapy activation, programming, and system interrogation for the phrenic nerve stimulation system.

Addition: +93584 – +93588

Add on codes created for venography procedures related to congenital heart defects. These codes cover catheter placement, radiological supervision, and interpretation.

 

This overview provides insight into the major updates within the 2024 CPT code set. However, it’s crucial to refer to the complete set of updates for comprehensive understanding and accurate coding practices.

Tagged: CPT Coding Changes, Medical Coding, E&M Guideline, CPT 2024, Surgery Codes Updates, Radiology Codes Updates, Pathology and laboratory Codes Updates, Covid Vaccine Codes, Covid  Medicine Codes Updates, Healthcare Technology

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