Sneak Peek at CPT Changes: Part II

October 23, 2023

Last week, we began highlighting some of the key changes in the new CPT codes for 2024. This week, we’ll pick up where we left off, with changes affecting telemedicine visits, reporting of E/M services, and deletions of certain codes you used in 2023. Grab a fresh cup of coffee, and let’s take a look.

Telemedicine Visits

In 2019, coders and physicians began using telehealth codes and have been trying to keep up with changes ever since. The series of codes changed at least three times before the AMA/CMS finally settled on a solid code set for Audio and Audio/Video visits. Now the set is dramatically changing again. Beginning in 2024, you will no longer be able to code or bill for the Audio section (99441-99443), which is being dropped. If you don’t have the Audio/Video section, you cannot bill for any telehealth services.

Changes in Reporting

After CMS sought clarifications on the reporting of evaluation and management (E/M) services, the CPT Editorial Panel made these revisions:

  • Removal of time ranges from office or other outpatient-visit codes 99202–99205 and 99212–99215 and aligned the format with other E/M codes
  • A definition to determine the “substantive portion” of a split or shared E/M visit in which a physician and a nonphysician health professional work together to furnish work related to the visit
  • Instructions for reporting hospital inpatient or observation services and admission and discharge services for using codes 99234–99236 when the patient stay crosses over two calendar dates

For more information: AMA releases the CPT 2024 code set | American Medical Association (ama-assn.org)

 

Proprietary Lab Analyses

Another new code set for 2024 covers PLA (Proprietary Laboratory Analyses). The CPT Editorial Panel revised two codes (0351U, 0356U) and added 19 others (0420U–0438U). Deleted codes are also included in the PLA list. There are 12 pages to review.

For more information:  CPT Proprietary Laboratory Analyses Codes Short Descriptors | AMA (ama-assn.org)

 

Unlisted Service Codes

The CPT 2024 code set includes revisions to various sections that contain unlisted service codes to reflect their appropriate use when reporting with other services. The changes are based on recommendations from a work group that the CPT Editorial Panel established to evaluate unlisted service codes and address how unlisted codes are used with existing Category I and III codes during the same intervention.

 

Deleted Codes

The codes below will be deleted from the CPT 2024 code set:

99441-99443 Telephone evaluation and management service (Telehealth by audio) codes, discussed above
0404T Transcervical uterine fibroid(s) ablation with ultrasound guidance, radiofrequency
0501T-0504T Covering noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation software analysis of functional data to assess the severity of coronary artery disease
0715T Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure)
0775T Arthrodesis, sacroiliac joint, percutaneous, with image guidance, includes placement of intra-articular implant(s) (e.g., bone allograft[s], synthetic device[s]

 

For more information: 051723-CPT-2024-Anticipated-Code-Changes.pdf (acr.org)

 

Got a question about E/M coding? We’d love to hear from you.

Submit your questions by emailing us at coders@calmwatersai.com

 

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Michelle Sergei-Casiano
Michelle Sergei-Casiano
Michelle Sergei-Casiano
CPC, CFPC, CEMC Senior Manager, Regulatory and Coding Compliance coders@calmwatersai.com