Revenue Cycle and Coding

Some 2024 CPT Code Revisions

There are 16 revisions in the pathology/laboratory section, making this section the area with the highest number of revisions. The Category III CPT code section has 13 revisions, followed by a tie between the Evaluation and Management (E/M) and surgery sections with 10 revisions. An overview of some of the changes in these areas and other department areas are discussed below.

Evaluation and Management (E/M) Updates

The Evaluation and Management section has 10 revisions.

Office or other outpatient Services

CPT codes 99202-99205, and 99212-99215 are being revised to update the time requirements. The time requirement is changed from removing the time range to now reflecting that a total time minimum must be met or exceeded to report the evaluation.

New Patient E/M
Code2024 Short Description (Total Time – Minimum)2023 Short Description
99202OFFICE O/P NEW SF 15 MINOFFICE O/P NEW SF 15-29 MIN
99203OFFICE O/P NEW LOW 30 MINOFFICE O/P NEW LOW 30-44 MIN
99204OFFICE O/P NEW MOD 45 MINOFFICE O/P NEW MOD 45-59 MIN
99205OFFICE O/P NEW HI 60 MINOFFICE O/P NEW HI 60-74 MIN
Established Patient E/M
Code2024 Short Description (Total Time – Minimum) 2023 Short Description
99212OFFICE O/P EST SF 10 MINOFFICE O/P EST SF 10-19 MIN
99213OFFICE O/P EST LOW 20 MINOFFICE O/P EST LOW 20-29 MIN
99214OFFICE O/P EST MOD 30 MINOFFICE O/P EST MOD 30-39 MIN
99215OFFICE O/P EST HI 40 MINOFFICE O/P EST HI 40-54 MIN

Nursing Facility Services

Nursing facility services CPT codes 99306 and 99308 are also revised to update the time requirements.

Surgery Updates

There are 10 revised surgery codes.  Six codes describing hallux rigidus correction procedures with implant are revised to include “with” bunionectomy in the description instead of “(bunionectomy)”. This change impacts CPT codes 28292 – 28299.

In the nervous system, two codes for spinal neurostimulator pulse generator or receiver insertion, replacement, and revision or removal are revised.

Code2024 Long Description2023 Long Description
63685Insertion or replacement of spinal neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiverInsertion or replacement of spinal neurostimulator pulse generator or receiver, direct or inductive coupling
63688Revision or removal of implanted spinal neurostimulator pulse generator or receiver, with detachable connection to electrode arrayRevision or removal of implanted spinal neurostimulator pulse generator or receiver

Two codes revised for peripheral, sacral, or gastric neurostimulator pulse generator or receiver insertion/replacement/revision/removal.

Laboratory Updates

Code2024 Long Description2023 Long Description
64590Insertion or replacement of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiverInsertion or replacement of peripheral or gastric neurostimulator pulse generator or receiver, direct or inductive coupling
64595Revision or removal of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, with detachable connection to electrode arrayRevision or removal of peripheral or gastric neurostimulator pulse generator or receiver

There are 16 codes revised in the Laboratory section.  A few of these are mentioned below.

Molecular Pathology

Molecular pathology procedure codes 81403 – 81407 are being revised to update and replace examples listed in the code descriptor.

Genomic Sequencing Procedures

Codes 81445, 81449, 81450, 81451, 81455 and 81456 are being revised to remove “Targeted” genomic sequence analysis panel and to remove the specific gene examples within the description to allow other applications and to simplify the description.

PLA Updates

There are 2 revised PLA codes.

Code2024 Long Description2023 Long Description
0351UInfectious disease (bacterial or viral), biochemical assays, tumor necrosis factor-related apoptosis inducing ligand (TRAIL), interferon gamma-induced protein-10 (IP-10), and C-reactive protein, serum, or venous whole blood, algorithm reported as likelihood of bacterial infectionInfectious disease (bacterial or viral), biochemical assays, tumor necrosis factor-related apoptosis-inducing ligand (TRAIL), interferon gamma-induced protein-10 (IP-10), and C-reactive protein, serum, algorithm reported as likelihood of bacterial infection
0356UOncology (oropharyngeal or anal), evaluation of 17 DNA biomarkers using droplet digital PCR (ddPCR), cell-free DNA, algorithm reported as a prognostic risk score for cancer recurrenceOncology (oropharyngeal), evaluation of 17 DNA biomarkers using droplet digital PCR (ddPCR), cell-free DNA, algorithm reported as a prognostic risk score for cancer recurrence

Medicine Updates

Four CPT codes are revised in the medicine section.

Chemotherapy Administration and Other Highly Complex Drug or Highly Complex Biologic Agent Administration

CPT code 96446 is revised to remove the word “indwelling” and replaced it with “implanted”, clarifying administration via an implanted port.

Special Dermatological Procedures

CPT Codes 96920-96922 are revised to add “Excimer” to the description and remove “inflammatory skin disease”, specifying these services are for reporting excimer laser treatment for psoriasis.

Category III Code Updates

This section has 13 revised codes. These changes include:

  • CPT 0517T – 0520T have both long and short description updates to add clarity of the pulse generator components.
  • CPT 0587T – 0590T revisions include specifying these services are for bladder dysfunction.
  • CPT 0656T – 0657T is revised adding “Anterior lumbar or thoracolumbar” vertebral body tethering to the long descriptions making these services for both lumber and thoracolumbar treatment.
  • Initial Treatment” is removed from CPT 0766T – 0767T.

2024 HCPCS Updates

343 New HCPCS codes

74 Discontinued codes

193 Revisions (Description/Payment/Coverage Change)

2024 HCPCS January Update

Medicare Program – Addition of JZ Modifier

Effective July 1, 2023, providers and suppliers are required to report the JZ modifier on all claims that bill for drugs from single-dose containers that are separately payable under Medicare Part B when there are no discarded amounts. Additional billing guidelines and answers to frequently asked questions are available on the CMS website.

Medicare Program – Discarded Drugs and Biologicals – JW Modifier and JZ Modifier Policy Frequently Asked Questions

https://www.cms.gov/medicare/medicare-fee-for-service-payment/hospitaloutpatientpps/downloads/jw-modifier-faqs.pdf

Billing and Coding: JW and JZ Modifier Billing Guidelines

https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=55932

COVID/RSV Code Updates:

Final Rule

2024 Centers for Medicare and Medicaid Services (CMS) Final Rule

News

Access the Legal Guide

You are not currently logged in.








» Lost your Password?

Legal Guide Access Instructions

NHIMA Members (Free):

Your username is your AHIMA ID (without any leading zeros if applicable) and your password is your last name (case-sensitive). If you do not know your AHIMA ID number, then please contact AHIMA.

Non-Members ($125):

You will be granted access after payment has been received.  Your username is your email address and your password is your last name (case-sensitive).