Updated Cpt Codes
Adnan Qamar
Transforming Healthcare Operations | Proven Expert in Streamlining Medical Billing, Credentialing, and Enrollment Processes | Driving Efficiency and Revenue Growth in Hospital and Health Services Management
The American Medical Association (AMA) has released updates to the Current Procedural Terminology (CPT) code set for 2024, which affect the billing process for medical services and procedures. These changes include the introduction of 230 new codes, the removal of 49 codes, and revisions to 70 existing codes.
Key Changes for 2024
Time Reporting Guidelines
For accurate time reporting, coders must now round up to the next unit of time once the midpoint has passed, except for evaluation and management (E&M) services with specific total time designations. For instance, 31 minutes should be reported as one hour, while 91 minutes should be reported as two hours. It’s important to note that time-based service codes cannot include time spent on concurrent services. Any disruption in service requires starting a new initial service.
Evaluation and Management (E&M) Services
The 2024 CPT updates include significant changes to E&M coding. New guidelines for split or shared visits dictate that time should be attributed to the provider who spent the most time on the service. Medical Decision Making (MDM) now factors in the number and complexity of problems and the risk of complications. The MDM code also considers the complexity of data used to formulate a plan. Most of the MDM weight is assigned to the provider responsible for or approving the management plan.
New rules for multiple E&M services on the same date consolidate MDM and time into a single report for services performed on the same day. However, time cannot be combined for multiple primary E&M codes when services occur in different settings or facilities. For example, transferring a patient from a regular bed to intensive care counts as a single encounter, while moving to a different hospital or nursing facility counts as separate encounters. Additionally, time spent in an emergency department can be added to time spent in inpatient or observation care, but both facilities can report separate times if the patient is discharged.
Surgical and Procedural Code Updates
·???????? Musculoskeletal Surgeries: New codes have been introduced for vertebral tethering procedures, which straighten vertebrae to correct scoliosis as a child grows. The AMA also revised lumbar tethering codes and added a new code for revisions performed with thoracoscopy. New codes are available for percutaneous sacroiliac arthrodesis, and bunionectomy codes have been updated to include hallux valgus.
·???????? Respiratory Surgeries: The 2024 update includes new codes for nasal or sinus endoscopic surgeries, with separate codes for procedures involving radiofrequency or cryoablation of the posterior nasal nerve. These procedures are used to treat chronic rhinitis. New codes have been added for phrenic nerve stimulation systems, including insertion, removal, repositioning, and replacements, as well as therapy activation of these systems.
·???????? Urinary Surgeries: A new code has been created for cystourethroscopy that includes mechanical urethral dilation and drug delivery via a drug-coated balloon catheter for treating urethral stricture or stenosis in men.
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·???????? Gynecological Surgeries: One new code has been added for transcervical ablation of uterine fibroids, which includes intraoperative ultrasound guidance and radiofrequency, without requiring anesthesia.
·???????? Nervous System Surgeries: Revised and new codes have been introduced for skull-mounted cranial neurostimulator devices and spinal electrode arrays. These codes cover craniectomy or craniotomy procedures performed with direct or inductive coupling for treating chronic conditions like epilepsy.
·???????? Eye Injections: A new code has been added for suprachoroidal space injections of pharmacologic agents, targeting the space between the sclera and choroid.
Medical Code Changes
A new add-on code has been introduced for percutaneous transluminal coronary lithotripsy, which can be used with angioplasty, atherectomy, stents, or thrombolysis. Additionally, five new add-on codes are available for venography related to congenital heart defects, each tailored to specific heart defects.
Category III Codes
Category III codes are temporary codes used for data collection and end in "T." For 2024, revisions and new codes include those for noncontact near-infrared spectroscopy, used in wound care clinics, and for wireless cardiac stimulators. New codes also cover caval valve implantation for treating tricuspid regurgitation and neurostimulation for bladder dysfunction, specifying subcutaneous and sub fascial placements. An all-inclusive code for Esophagogastroduodenoscopy (EGD) with an intragastric bariatric balloon has been introduced, eliminating the need to report the EGD separately. New codes for right atrial leadless pacemakers cover insertion, removal, replacement, and programming for these single-chamber devices.
Telemedicine Services
The CPT Editorial Panel has introduced new criteria for telemedicine services. These criteria emphasize the benefits of telecommunication while outlining requirements for in-person appointments.
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Dee Mandley, Senior Manager Quality at AMN Healthcare Revenue Cycle Solutions, discussed these updates in a recent webinar. This session, available for download, is particularly useful for medical coders and healthcare information management professionals seeking detailed insights into the 2024 CPT code changes.