CPT Code updates

2024 CPT Code Updates: Webinar Highlights Changes | AMN Healthcare

The American Medical Association (AMA) has released changes to the Current Procedural Terminology (CPT) 2024 code set, used when billing for medical services and procedures. The CPT Editorial Panel added 230 codes, deleted 49 codes and revised 70 codes.

Webinar Highlights Key CPT Changes for 2024

Dee Mandley, senior manager quality at AMN Healthcare Revenue Cycle Solutions, reported on many of these changes for 2024 in a recent webinar, which is now available for download. This informative session is ideal for medical coders and others in healthcare information management.

Mandley recommended selecting the code that accurately identifies the procedures or service provided, but if a specific code does not exist, the provider should report it as an unlisted code with clear documentation to support the modification or extenuating circumstances that led to the selection of an unlisted code. Unlisted codes can be reported with category I or category III codes.  

AMA made no updates to the integumentary or digestive system surgical codes.

Time Instructions For Medical Coders

Time measurement reporting differs depending on the code being used. If the midpoint on a measurement of time has passed, the coder rounds up to the next unit of time, except for evaluating and management services with total time designations. For instance, 31 minutes would be reported as one hour and 91 minutes would be two hours.

Time-based service codes cannot be counted if the time is associated with a concurrent service. If a disruption in service occurs, that will create a new initial service.

Evaluation and Management (E&M) Services

The AMA released a few 2024 CPT coding updates to the E&M section.

One of those changes is new guidelines for split or shared visits, with time going to the provider who spent the most amount of time, reported Mandley during the AMN webinar.

With Medical Decision Making (MDM), the code takes into consideration the number and complexity of problems and the risk of complications. The amount and complexity of the data component is used in formulating a plan.

“The majority of this substantive portion would go to the provider who made or approved the management plan and takes responsibility,” Mandley said. “He or she is considering the risks.”

Multiple E&M Services on the same date represents a new section in the guidelines. It applies to inpatient, observation or skilled nursing care services. For a per-day service on the same day, a single service is reported. MDM would be aggregated for the day and the time spent is added for the day.

But when there are multiple encounters in different settings or facilities, time cannot be added when reporting more than one primary E&M code. Transferring a patient from a regular bed to intensive care is considered a single encounter but moving to a nursing facility or a different hospital would be a multiple encounter.

If emergency department (ED) services are not reported, the time spent on E&M in the ED can be added with time on E&M in the inpatient or observation bed. When a patient is discharged, both facilities can report separate time for E&M. More details are provided in the webinar.

AMA also revised codes for E&M based on time spent in office and other outpatient visits, in skilled nursing facilities and hospitals. New E&M Add-On Codes were created for pelvic exams.  

2024 Coding Updates For Surgeries and Procedures

Musculoskeletal Surgeries

Several codes were created for vertebral tethering, which straighten the vertebra over time as a child grows, correcting scoliosis. AMA revised lumbar tethering codes and added a new code for revisions, including when performed with thoracoscopy.

“It can be reported with anterior instrumentation codes,” Mandley said.

AMA also added new codes for percutaneous sacroiliac arthrodesis and revised the description of the bunionectomy codes to add hallux valgus.    

Respiratory Surgeries

New codes were created for nasal or sinus endoscopic surgeries, with different codes for procedures performed with radiofrequency or cryoablation of the posterior nasal nerve. It is performed to treat chronic rhinitis. A modifier is needed if performed unilaterally.

The 2024 CPT coding updates include several codes introduced to bill for phrenic nerve stimulation systems or diaphragm pacing, including insertion, removal, repositioning or replacements.

Additionally, four codes were added for therapy activation of the phrenic nerve stimulation system, which can be used 30 days after insertion.

Urinary Surgeries

AMA created a new code for cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug coated balloon catheter for urethral stricture or stenosis for men, including fluoroscopy, when performed, Mandley reported.

Gynecological Surgeries

One code was added for transcervical ablation of uterine fibroids, including intraoperative ultrasound guidance and monitoring, and radiofrequency, which does not require anesthesiology.

Nervous System Surgeries

AMA revised and added codes for skull-mounted cranial neurostimulator pulse generators or receivers, including craniectomy or craniotomy, when performed with direct or inductive coupling, which refers to how the current is passed, Mandley reported. It is used as a treatment for chronic conditions, such as epilepsy.

“There were some new codes for some new technology, where they are using integrated neurostimulator devices,” Mandley said. “Notice the add-on code for each additional electrode array.”

Spinal electrode cords were added for insertion or replacement of percutaneous electrode arrays, she added.   

Eye Injections

AMA added one new code for a suprachoroidal space injection of a pharmacologic agent. That it is the space between the sclera and the choroid.  

Medical Code Changes

A new add-on code was created for a percutaneous transluminal coronary lithotripsy. It is a category I code, which can be reported with angioplasty, atherectomy, stents or thrombolysis.

The 2024 CPT coding updates also include five add-on codes for venography for congenital heart defects, with different codes pertaining to specific heart defects.

Category III Codes

Category III codes refer to temporary codes and are used for data collection, with new technologies and always end in the letter “T.”

2024 changes include a revision and addition of two codes for noncontact near-infrared spectroscopy, which is often used in wound care clinics. Each additional site requires a code. 

Wireless cardiac stimulators also received revised and new codes. Caval valve implantation to treat tricuspid regurgitation has two new codes.

“There are very specific guidelines regarding when you can and can't report diagnostic cath codes with this procedure,” Mandley said, advising medical coders to “check the section notes out.”

The AMA created a new, all-inclusive code for Esophagogastroduodenoscopy (EGD) with an intragastric bariatric balloon. The balloon stays in place for about six months. The provider should not also report the EGD.

Neurostimulation for bladder dysfunction received revised codes and four new codes, for insertion or replacement of the system and revision or removal. The codes specify subcutaneous and subfascial placement.

New codes are now in place for right atrial leadless pacemakers. These new codes for insertion, removal, replacement and programming are for use solely with these single-chamber pacemakers. If the right atrial leadless pacemaker is associated with a dual chamber device, different codes are to be used. In addition, the new codes cannot be reported for the cardiac catheterization, unless the procedure is being done for a different reason.

The CPT Editorial Panel also introduced criteria for telemedicine services, including benefits of telecommunication and meeting in-person appointment requirements. 

To learn more about the 2024 CPT coding updates, including the code numbers, watch AMN Healthcare’s free webinar.