Code and fee preview: Take a first look at CPT code changes coming your way in 2021

Why This Topic Matters

These proposed updates affect commonly reported services and may require software, documentation, and workflow preparation before the effective date. Reviewing the scope early helps organizations plan for CPT migration, E/M reporting changes, and code-set replacements that can affect claim submission and payment.

Article Sections

1. 2021 E/M update

   Overview of proposed office E/M reporting updates for 2021, including changes to documentation and code selection for office visit services.

2. Category III migration

   Summary of new and transitioning Category III CPT code activity described in the proposed rule, including broader movement toward Category I reporting.

3. Existing CPT codes replaced

   Discussion of selected existing CPT codes that are being replaced or updated in connection with procedure bundling and code-set revisions.

4. G codes replaced

   Coverage of planned replacements for selected G codes and related descriptor updates affecting diagnostic imaging and chronic care services.

5. New tests

   Preview of newly created test-related codes described in the proposed rule, including respiratory and vestibular testing services.