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Each year, the American Medical Association (AMA) releases updates to the Current Procedural Terminology (CPT®) code set. Staying current isn’t just about compliance—it’s about ensuring your practice is accurately and optimally reimbursed for the services you provide.
Here’s a breakdown of the critical 2024 CPT code updates you need to implement.
Major Themes for 2024:
This year’s changes heavily reflect the evolving healthcare landscape, with significant updates in digital health, prolonged services, and psychiatry.
Key Additions to Know:
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- New & Revised Prolonged Service Codes: The complex prolonged service codes (99417, 99418) have been deleted. For 2024, use:
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- 99417: Prolonged outpatient evaluation and management (E/M) service beyond total time.
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- G2212: New Code for prolonged inpatient or nursing facility E/M service beyond total time.
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- Critical: Ensure your billing team understands the new time thresholds and reporting rules.
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- New & Revised Prolonged Service Codes: The complex prolonged service codes (99417, 99418) have been deleted. For 2024, use:
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- Digital Health Expansion: The “Category III” telehealth codes are now permanent “Category I” codes, solidifying the role of remote care.
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- 98980, 98981: Remote therapeutic monitoring (RTM) service codes have been revised for clarity.
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- Continue to use 99453, 99454, 99457, 99458 for remote physiologic monitoring (RPM).
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- Digital Health Expansion: The “Category III” telehealth codes are now permanent “Category I” codes, solidifying the role of remote care.
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- Psychiatry Code Overhaul: The psychiatric evaluation and management codes (90791, 90792) have been deleted and replaced with new codes that align with the E/M office visit structure (based on medical decision making or time).
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- 90885, 90887: New codes for psychiatric diagnostic evaluation.
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- 90889, 90890: New codes for interactive complexity.
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- Psychiatry Code Overhaul: The psychiatric evaluation and management codes (90791, 90792) have been deleted and replaced with new codes that align with the E/M office visit structure (based on medical decision making or time).
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- Maternal Care Services: New codes have been added for comprehensive postpartum care and cesarean delivery bundles to better reflect current clinical practice.
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- Other Notable New Codes:
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- 0604T, 0605T: Transcervical uterine artery embolization.
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- 0651T: Ablation of malignant prostate tissue using high-intensity focused ultrasound (HIFU).
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- Other Notable New Codes:
Important Revisions & Deletions:
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- Review changes to vaccine administration codes (90460, 90461).
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- Codes for hydration (90760, 90761) have been deleted.
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- Pay close attention to revised descriptors for many surgery and radiology codes.
Action Steps for Your Practice:
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- Update Your Systems: Ensure your EHR, practice management, and billing software have been updated with the 2024 code set.
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- Educate Your Team: Provide mandatory training for both clinicians and coders. Accurate documentation drives accurate coding.
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- Review Superbills: Update all patient-facing superbills and encounter forms immediately.
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- Consult Your Biller: Work with your in-house or outsourced billing team to understand the impact on your most common services.
Conclusion:
Failing to implement CPT updates can lead to claim denials, delayed payments, and lost revenue. Proactive adaptation is key to a smooth and profitable revenue cycle in 2024.
Need help navigating the 2024 coding changes? Our certified medical coders and billing specialists are always up-to-date on the latest regulations. Partner with us to ensure your coding is accurate, compliant, and optimized for maximum reimbursement.
