2024 CPT Code Changes: What to Know and How to Prepare
The latest updates to the American Medical Association’s Current Procedural Terminology (CPT)® code set are fast approaching, and health information (HI) professionals should start preparing now for the revisions, say coding experts.
The AMA’s 2024 CPT code set was unveiled in September, and it includes 230 additions, 49 deletions, and 70 revisions among its 11,163 codes, according to the AMA.
One of the most notable changes for 2024 is the consolidation of more than 50 codes that streamline the reporting of COVID-19 immunizations.
An important caveat with COVID-19 codes is that they change depending on the dosage and are also manufacturer-specific, says Kim Huey, an Alabaster, AL-based independent coding and reimbursement consultant.
“You really need to look at which vaccine you are getting from the vendor and make sure your providers get documentation as to whether it’s [the patient’s] first dosage or the additional dosage,” Huey says. “And pay attention to the patient’s age. All of those are changes that we don’t have with any of the other vaccines.”
The AMA’s CPT panel also approved codes (91318-91322) to identify monovalent vaccine products from Moderna and Pfizer for immunization against COVID-19. In addition, a new vaccine administration code (90480) was approved for reporting the administration of any COVID-19 vaccine for any patient, replacing all past approved product-specific vaccine administration codes.
If coders are not sure about the specifics of a certain vaccine product, they should discuss it with their providers or get the product label or box to ensure they are clear on the details, Huey advises.
“There’s just a lot of little moving parts with COVID-19 vaccine [codes],” Huey adds. “But hopefully, the folks that are generally doing these have gotten pretty agile with this area because this has been a moving target since mid-2020.”
New Codes for Reporting RSV Immunizations
Among the CPT changes are also five new codes created to report product-specific RSV immunizations (90380, 90381, 90683, 90679, and 90678) for “better tracking, reporting and analysis that supports data-driven planning and allocation,” according to the AMA.
Revisions that clarify the reporting of evaluation and management (E/M) services were also added, stemming from clarifications sought by the Centers for Medicare and Medicaid Services (CMS). The revisions include:
- Removal of time ranges from office or other outpatient visit codes (99202-99205, 99212-99215) and aligned format with other E/M codes;
- A definition to determine the “substantive portion” of a split/shared E/M visit in which a physician and a non-physician practitioner work jointly to furnish all the work related to the visit; and
- Instructions for reporting hospital inpatient or observation care services and admission and discharge services for the use of codes 99234-99236 when the patient stay crosses over two calendar dates.
Huey said the E/M revisions boil down to some tweaks with modified language, but that they don’t change how the codes are used. Even so, it’s essential that HI professionals and coders examine the new wording to ensure they understand what’s different.
“Too often, we go and look for a new code, and we don’t look at what guidelines changed or what code definitions or parentheticals changed,” she says. “Those are in green writing. They don’t have the red dot to show it’s a new code, but something about that code changed. We miss that sometimes.”
Overall, Huey says the CPT changes for the upcoming year are primarily minor when compared with previous years. HI professionals and coders should use this “break” to refine their work and deepen their understanding of past modifications.
“The last couple years have been pretty tough with some of the documentation changes,” she says. “I don't see anything huge this year that’s going to require that as much. I think [2024] is a chance to hone what we're already doing.”
Alicia Gallegos is a freelance healthcare writer based in the Midwest.