by Aimee L. Wilcox, CPMA, CCS-P, CST, MA, MT
Dec 5th, 2023
Current Procedural Terminology (CPT) code set is updated annually and published a few months prior to implementation to ensure ample time to prepare for the required changes. The number of text and code revisions, deletions, and additions changes from year to year, so the amount of work required to be prepared for the changes on January 1st of the following year can be anywhere from minimal to extensive.
To assist in preparing for the changes, the AMA hosts the AMA Annual Symposium in November where the CPT changes are presented by members of the CPT Editorial Panel and guest speakers representing Medicare speak to the changes being implemented in the Final Rule. This year there are 349 editorial changes, which when reviewed, demonstrate the AMA’s determination to keep pace with the innovations in medical science, health technology, and artificial intelligence used to support healthcare data and decision making.
Over the past few years there have been extensive changes to the Evaluation and Management (E/M) services; however, changes this year are minimal, with the addition of an add-on code (+) for a pelvic examination that is only reportable when performed during an E/M encounter and code description changes to the section of Office or Other Outpatient E/M services (99202-99205 and 99212-99215) for reporting codes based on time. In the example noted below, the code description change was made to remove the time range to standardize these code descriptions.
|2023 Code Description
|2024 Code Description
|When using time for code selection, 15-29 minutes of total time is spent on the date of the encounter.
|When using total time on the date of the encounter, for code selection, 15 minutes must be met or exceeded
Additional changes include:
- Major revisions to Appendix S, which defines the various forms of artificial intelligence for categorization of the many innovations being introduced into healthcare decision making.
- Deletion of Appendix Q, which has likely been used more than any other Appendix in the past three years, as it contains a crosswalk to coding COVID-19 vaccines by manufacturer, patient age, and type of vaccine.
- An extensive revision of the reporting guidelines for Immunization Administration for Vaccines/Toxoids and Vaccines, Toxoids (see Medicine section), with the introduction to the new monovalent COVID-19 vaccines by manufacturer with a single administration code, unique to COVID-19 vaccines.
- The first ever FDA-approved immune globulin product for the prevention of respiratory syncytial virus (RSV).
- A couple of Category III codes have graduated to become Category I codes
Another important update this year is the addition of a new subsection in the E/M guidelines defining the “substantive portion” of a split or shared visits, where in the facility setting, a physician and a nonphysician practitioner share or split the performance of the key components (history, exam, medical decision making) of a patient’s E/M encounter. Previously, guidance related to split or shared services were listed under the “Guidelines for Selecting Level of Service Based on Time.” This has been a highly anticipated change in reporting guidelines, as the definition of “substantive portion” is changing and may be significantly impactful to nonphysician practitioners as well as for reimbursement. Special attention should be given to this definition change and understanding how it will impact coding and reimbursement.
To learn more about the 2024 CPT coding updates, join us for our next FREE webinar "2024 CPT Code Changes", where we will discuss the coming changes and how to best prepare for them. Webinar is scheduled for Thursday, Dec 7th @ 10:15 AM PT, 11:15 AM MT, 12:15 PM CT, 1:15 PM ET. Click HERE to join us.