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January 19, 2024

Medicare Coding Updates 2024: A Comprehensive Guide

When it comes to medical billing services – the important thing to note is that the healthcare industry is constantly evolving. With this evolution comes the need for yearly Medicare coding updates. The CPT (Current Procedural Terminology) code set is updated and published annually by AMA – American Medical Association. These updates are essential to capture the broader range of care services accurately.

Why are CPT coding updates important?
2024’s CPT code set updates will bring significant changes, reflecting the rapid pace of health technology and medical science innovation. Our comprehensive guide explains:

2024 coding updates.
The global significance of the new updates.
Implications for patient and healthcare providers.
List of changes in the 2024 CPT code set.
Challenges and opportunities associated with Medicare coding updates of 2024.

Overview of Medicare Coding Updates 2024

The current 2024 CPT codes set comes with extensive revisions, as AMA has announced 349 editorial changes, to be exact. The changes include 49 deletions, 230 additions, along with 70 revisions. The 2024 Medicare coding updates have increased the number of codes to 11,163. The new qualitative updates aim to enhance the CPT codes’ clarity and usability.

A Comprehensive Look at New and Revised Codes for 2024

Before we explore the implications of Medicare coding updates, let’s look into the following:

New COVID-19 Codes

Moderna and Pfizer’s monovalent COVID vaccines’ new specified codes are marking a significant update. The codes “91318-91322” will now facilitate precise reporting and tracking of COVID-19 vaccinations, an essential facet of the ongoing pandemic management.

RSV Immunization (90380-90381, 90683, 90679, and 90678)

New RSV immunization codes include:

90380-90381
90683
90679
90678

These new CPT coding updates reflect the latest advancements in RSV prevention. The codes effective from July 17, 2023, are evidence of the CPT code set’s unique ability to morph around emerging healthcare needs

Modifications to E/M Codes

Modifications to the E/M codes, including the 99202-99205 and 99212-99215, will simplify the coding process. These changes have removed the time ranges and introduced definitions for determining the substantive portion of shared/split E/M visits.

Oncology and Hematology Code Updates

Medicare coding updates for 2024 come with revisions to several oncology and hematology codes, including:

0269U
0271U
0272U, etc.

All these coding updates shall enhance the specificity and accuracy of coding procedures for these complex branches of medical care.

Deletion of Outdated Codes

The current removal of codes includes the following:

99441-99443
0404T-0775T

-is a part of the latest Medicare coding updates and a testament to CPT’s continuing effort to remove the less relevant or outdated codes. This is done by ensuring that the code set remains reflective and current to modern healthcare practices.

List of Changes inside Medical Coding Updates CPT 2024 Code Set

Below is a complete list of 2024 coding updates, including the CPT codes 2024, which have been deleted and changed according to the latest update:

Changed CPT Codes

The list of CPT code sets that are placed with the current updated CPT codes of 2024:

99217-99220 – For the hospital observation services, which are now replaced by new codes 99315-99318.
99241 – For the office consultation, which is now replaced by new CPT codes: 99315-99318
99251 – For the Inpatient consultation, which is replaced by the new codes 99315-99318

Deleted CPT Codes

Below is a list of codes that were deleted with the latest Medicare coding updates:

Laparoscopy codes – 49652-49657.
Hospital observation services – 99217-99220
Office consultation – 99241
Inpatient consultation – 99251
Nursing facility services – 99318
Custodial care codes (for new and established patients in a rest home, domiciliary, or home care plan) – 99324-99328
Custodial care codes for the established and new patients of nursing facilities – 99334-99337
Domiciliary, home care plan oversight, or rest home – 99339-99340
New patients’ home visits – 99343
Prolonged services add-on codes – 99354-99357

PLA CPT Coding Updates

AMA has brought the following changes to the CPT PLA codes, including:

New Additions

0420U-0438U, are a series of newer PLA CPT codes for proprietary laboratory analyses for illnesses, including:

Revisions to PLA CPT Codes

0351U is the revision of the code descriptor for:

1. Tyrosinemia Follow-Up Panel
2. Self-Collect
3. Blood Spot
4. Mayo Clinic
5. Laboratory Developed Test

-all for including specific information regarding the test.

0356U is the revision of the code descriptor specifically for chronic kidney disease (Nephrology). It is for including more specific information regarding the test and for adding the term quantitative.

Deletions in PLA CPT Codes

0066U, which was for:

1. Parsagen Diagnostics, Inc.,
2. PartoSureTM Test
3. Parsagen Diagnostics, Inc.,

In addition to all of these changes coming from the latest Medicare coding updates, the CPT PLA code is also getting the much-needed update. The update shall include a newer duplicate PLA test symbol and a parenthetical note to code 0345U. Furthermore, the update also aims to correct the abbreviation of CAD to CHD – specifically for coronary heart disease in Descriptor code 0401U.

Additional Changes to the CPT 2024 Code Set

The new hospital observation services codes 99315-99318 emphasize patient-centered care, considering time and resources.
Office consultation codes 99315-99318 now evaluate complexity and time spent, ensuring personalized healthcare solutions.
Inpatient consultation codes 99315-99318 adapt to patient needs, accounting for case complexity and time invested.
Custodial care codes 99324-99337 are eliminated, streamlining coding for enhanced clarity and efficiency.
Home visits with the new patient code 99343 are removed, reflecting evolving healthcare practices.
Prolonged services add-on codes 99354-99357 are now bidding farewell, simplifying billing and documentation processes.

Implications of Medicare Coding Updates for Healthcare Providers and Patients

2024 Medicare coding updates will significantly affect patients and healthcare providers alike. For healthcare professionals, staying up-to-date with the coding changes and updates is essential for ensuring accuracy in medical billing. That is in addition to ensuring compliance with the insurance regulations. The CPT coding updates also impact how the medical services are reported, documented, and reimbursed – highlighting the need for continuous adaptation and education for changing medical coding practices.

Introduction of Spanish Descriptors

For patients, specifically those belonging to the Latin community, adding Spanish language descriptors is an important step for a more inclusive healthcare system in the US. This change will address a crucial barrier to healthcare access and comprehension. Additionally, introducing Spanish descriptors will help Spanish-speaking patients better understand their care, allowing them to take an active part in it.

Challenges and Opportunities Arising from 2024's Medicare Coding Updates

The CPT coding updates for 2024 will surely bring in many benefits; however, these will also present multiple challenges. Like each year, the healthcare providers will have to spend time and resources training their staff on the new revisions and codes. Like always, this transition period can be demanding; however, it lets healthcare organizations review and improve their billing and coding processes.
The consolidation of the COVID-19 vaccine codes and the introduction of the new RSV immunization codes highlight the CPT code’s receptiveness to the current healthcare challenges. These changes combined will simplify the medical coding process and improve the reporting and tracking of vital public health data.
Adapting to the new Medicare coding updates will present challenges, specifically for small-scale healthcare practices with limited resources. Staying current with frequent changes necessitates continuous training for staff and updates to the billing systems.

The solution?

Solutions include:

Investing in medical coding education
Usage of updated software tools
Outsourcing medical billing services to third-party providers.

These steps combined can help reduce billing and coding errors and ensure compliance. Collectively, these solutions will benefit both the healthcare providers and patients.

Conclusion

CPT codes are primarily used in the USA; however, the Medicare coding updates have global implications. Many healthcare systems and countries consider the CPT system a model – for developing their coding standards. For example, adding Spanish language descriptors inside the 2024 CPT coding updates is a significant step for inclusivity. It can, additionally, influence international coding practices. Moreover, as global health challenges like COVID-19 necessitate a globally coordinated response, consistency in international medical coding systems becomes vital for reporting, tracking, and managing health issues across borders.