CPT codes serve as the universal language of medicine, facilitating accurate reporting and billing for medical services. The CPT codes are updated to properly represent changes in medical practices, technology, and procedures. The CPT code set is updated annually by the CPT Editorial Panel, the Centers for Medicare and Medicaid Services (CMS), and the American Medical Association (AMA). These changes, which are usually made available a long time in advance of their deployment, are essential for guaranteeing precision and transparency in medical coding and billing procedures.
The CPT version as of 2024 has 349 changes, comprising 230 additions, 49 deletions, and 70 revisions. It is important that you understand these modifications and stay informed. Let’s examine those updates for 2024 in detail.
Understanding CPT Codes and the Importance of Updates
Before getting into the details of the 2024 CPT code modifications, it’s important to understand the basics of CPT codes and the reasons behind their frequent updates. The American Medical Association (AMA) created, maintains, and owns the copyright of CPT codes, which are a standardized method for reporting medical services and procedures. New codes are added to reflect new services as they arise, old codes are updated to reflect modifications to medical procedures, and out-of-date codes are eliminated when healthcare practices change. Annual updates guarantee that the code set, which has hundreds of codes in use, is up to date and in line with the changing needs of healthcare delivery.
Significant Changes in the 2024 CPT Code Set
COVID-19 and Immunization Codes
In 2024, the most recent developments are widely discussed in the field of healthcare coding, particularly with regard to COVID-19 immunizations. The CPT Editorial Panel has released new provisional codes, 91318 through 91322, especially for the most recent monovalent vaccinations from major companies Moderna and Pfizer. These are not simply figures; they are keys that enable healthcare providers to record and report COVID-19 immunizations more easily. Furthermore, 90480, a complete vaccination administration code, has been approved. The COVID-19 vaccine administration procedure is now more streamlined and uniformly reported across different healthcare settings thanks to the replacement of all previous vaccine-specific administration codes with one new one. This modification is a result of a continuous attempt to adjust to the changing pandemic environment and related immunization plans.
RSV Immunization Codes
The 2024 CPT code set includes five new codes (90380, 90381, 90683, 90679, and 90678) in response to progress made against respiratory syncytial virus (RSV), a serious respiratory infection. These codes are designed particularly to improve RSV vaccination paperwork and analysis. The use of these codes is a vital step in enhancing the healthcare system’s ability to allocate resources and plan using data, especially when it comes to the management, assessment, and prevention of RSV. This addition underscores the CPT’s commitment to keeping pace with medical innovations and ensuring that emerging treatments and preventive measures are accurately and efficiently coded.
Revisions to Evaluation and Management (E/M) Codes
The evaluation and management (E/M) codes will undergo a number of changes in the 2024 update, with the goal of streamlining the coding procedures for both new and existing patients as well as care provided in nursing facilities. These changes simplify the coding system, making it easier to understand and use in clinical situations. These modifications are expected to improve coding accuracy by clarifying the requirements and criteria for each code, which will enable improved patient care management and more accurate E/M service billing procedures.
Hematology and Oncology Code Revisions
Updates to some oncology and hematology codes are part of the most recent CPT code set change and are effective from October 1, 2023. These changes involve changes to these codes’ descriptions, reflecting the continuous advancement of medical knowledge and treatment approaches in these fields. These codes have been updated by the CPT Editorial Panel to guarantee their continuous applicability and conformity to modern medical procedures and technological advancements. This is essential to guaranteeing correct billing and documentation in these specialty areas of medicine, which frequently see quick breakthroughs and developments.
Deletion of Outdated Codes
Several codes that are no longer relevant or often used have been removed from the CPT 2024 code set in keeping with its goal to represent the changing nature of medical knowledge and technology. This covers, among other things, the codes related to telephone management and assessment services. As part of a continuous effort to ensure the CPT code set is current and free of redundancy, these codes are being removed. In addition to ensuring that the codes appropriately represent modern medical procedures and services, this method streamlines the coding system for healthcare professionals.
A Detailed Look at New and Revised Codes
New COVID-19 Codes:
- 90480: Administration of single-dose COVID-19 vaccine via intramuscular injection for all ages.
- 91318 (Pfizer): COVID-19 mRNA-LNP vaccine (3 mcg/0.2 mL dosage) for children aged 6 months through 4 years.
- 91319 (Pfizer): COVID-19 mRNA-LNP vaccine (10 mcg/0.2 mL dosage) for children aged 5 through 11 years.
- 91320 (Pfizer): COVID-19 mRNA-LNP vaccine (30 mcg/0.3 mL dosage) for individuals aged 12 years and older.
- 91321 (Moderna): COVID-19 mRNA-LNP vaccine (25 mcg/0.25 mL dosage) for children aged 6 months through 11 years.
- 91322 (Moderna): COVID-19 mRNA-LNP vaccine (50 mcg/0.5 mL dosage) for individuals aged 12 years and older.
RSV Immunization Innovations:
- 90380: Seasonal dose of monoclonal antibody for respiratory syncytial virus (RSV), 0.5 mL dosage, intramuscular use.
- 90381: Seasonal dose of monoclonal antibody for RSV, 1 mL dosage, intramuscular use.
- 90678: Bivalent RSV vaccine (preF, subunit) for intramuscular use.
- 90679: Adjuvanted recombinant RSV vaccine (preF, subunit) for intramuscular use (effective May 2023).
- 90683: mRNA lipid nanoparticle RSV vaccine for intramuscular use (effective Jan. 1, 2024).
Musculoskeletal System
New codes for anterior thoracic vertebral body tethering include:
- 22836: Anterior thoracic vertebral body tethering for up to seven vertebral segments.
- 22837: Anterior thoracic vertebral body tethering for eight or more vertebral segments.
- 22838: Revision, replacement, or removal of thoracic vertebral body tethering.
New code for sacroiliac joint arthrodesis:
- 27278: Percutaneous placement of intra-articular stabilization device into the sacroiliac joint using a minimally invasive technique.
- Revision of hallux valgus correction codes (28292-28299) to specify procedure as “with bunionectomy”.
Surgery codes:
Cardiovascular System
- 8 new codes (33276-33288) for phrenic nerve stimulation system
Urinary System
- 52284: Cystourethroscopy with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis (male), including fluoroscopy
Female Genital System
- 58580: Transcervical radiofrequency ablation of uterine fibroid(s) with intraoperative ultrasound guidance and monitoring
Nervous System
New codes for skull-mounted cranial pulse generator or receiver procedures:
- 61889: Insertion
- 61891: Revision or replacement
- 61892: Removal
Revision of nervous system surgery codes:
63685, 63688, 64590, and 64595
Radiology
- 75580: Noninvasive estimate of coronary fractional flow reserve (FFR) derived from augmentative software analysis of data set from coronary computed tomography angiography
- 76984: Diagnostic intraoperative thoracic aorta ultrasound
- 76987, 76988, and 76989: Epicardial ultrasound for congenital heart disease
Deleted code:
74710: Pelvimetry
Implications for Healthcare Providers
Healthcare providers must pay close attention to and adjust to the revisions to the 2024 CPT code set in order to maintain correct billing and compliance with insurance laws. These improvements have an impact on reporting and reimbursement procedures for healthcare services in addition to the coding and documentation procedures. In order to prevent potential compliance problems, claim denials, and coding errors, healthcare practitioners need to remain up to date on these developments. To maintain competence and compliance in navigating the changing world of healthcare billing and payment, ongoing education and training in medical coding procedures are crucial.
Implications for Patients
The inclusion of Spanish language descriptors in the CPT code set represents a monumental step towards more inclusive healthcare, particularly for patients in the Latinx community. This change addresses a critical barrier to healthcare access and comprehension, allowing Spanish-speaking patients to better understand and engage with their medical care. Healthcare professionals may increase patient knowledge of medical processes and services, improve communication with Spanish-speaking patients, and ultimately encourage better health outcomes by using language-specific descriptions. By ensuring that every patient receives the treatment they require in a way that is suitable for their language and culture, this initiative demonstrates a commitment to diversity, equity, and inclusion in the delivery of healthcare.
Frequently Asked Questions
CPT codes, or Current Procedural Terminology codes, are a standardized system used to report medical procedures and services. They are updated annually to reflect changes in medical practices, technologies, and regulations, ensuring accuracy and compliance in medical billing and coding.
The 2024 CPT code set includes 349 modifications, comprising additions, deletions, and revisions, effective January 1, 2024.
Some key changes include revisions to evaluation and management (E/M) codes, updates to specific procedure codes in various medical specialties, and the addition of new codes for emerging technologies and treatments.
Healthcare providers need to stay current with the 2024 CPT code changes to ensure accurate documentation, coding, and billing practices. Failure to comply with these changes may result in claim denials, reimbursement delays, and potential compliance issues.
The 2024 CPT code changes aim to improve the accuracy and specificity of medical coding, which can lead to better documentation of healthcare services and more transparent billing practices. Additionally, the inclusion of Spanish language descriptors promotes inclusivity and accessibility for Spanish-speaking patients, enhancing their understanding and engagement with their medical care.
