2024 CPT Code Changes – Read this Important Update!

2024 CPT Code Changes and Important Updates - PracticeForces

The Current Procedural Terminology (CPT)* code set by the American Medical Association (AMA) undergoes annual updates. In 2024, a significant number of updates pertain to time-based codes, potentially influencing the reporting timeframe. There are 230 additions, 49 deletions, and 70 revisions, all effective January 1, 2024. This post outlines the pertinent coding changes ( new, revised, and deleted CPT codes in 2024 for E/M, COVID-19, gastroenterology, cardiology, neurology, orthopedics, podiatry, respiratory, urology, eye practices,  pathology and laboratory, and gynecology.

Note: Deletions are shown as crossed text, and changes are shown as underlined text.

Evaluation and Management

What’s Changed

For 2024, CPT® has decided to remove the time ranges from both the new and established office/outpatient E/M codes and replace them with a single total time amount.

▲99202 Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 15 -29 minutes of total time is spent on the date of the encounter minutes must be met or exceeded.

▲99203 Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 30-44 minutes of total time is spent on the date of the encounter minutes must be met or exceeded.

▲99204 Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 45 -59 minutes of total time is spent on the date of the encounter minutes must be met or exceeded.

▲99205 Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 60 -74 minutes of total time is spent on the date of the encounter minutes must be met or exceeded.

▲99212 Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 10 –19 minutes of total time is spent on the date of the encounter minutes must be met or exceeded.

▲99213 Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 20 -29 minutes of total time is spent on the date of the encounter minutes must be met or exceeded.

▲99214 Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 30-39 minutes of total time is spent on the date of the encounter minutes must be met or exceeded.

▲99215 Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 40-54 minutes of total time is spent on the date of the encounter minutes must be met or exceeded.

▲99306 Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 45 – 50 minutes must be met or exceeded.

▲99308 Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and a low level of medical decision-making. When using total time on the date of the encounter for code selection, 15 20 minutes must be met or exceeded.

Critical care is a threshold time. Must have complete 30-minute time increments

Add on: Visit complexity
+G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient’s single, serious condition or a complex condition.

G2211 Documentation requirements not available– No definition of ‘serious’ condition
• Can not be used if modifier -25 is appended to E/M
• Not appropriately reported when the care furnished during the O/O E/M visit is discrete, routine, or time-limited.  Examples: treatment of a simple virus, seasonal allergies, new onset GERD, treatment of a fracture, and/or when the billing provider has not taken responsibility for or does not plan to take responsibility for ongoing medical care for that particular patient with
consistency and continuity over time.

The relationship between the patient and the practitioner determines when the add-on should
be billed.  Can be used for treatment of acute conditions by practitioner who provides ongoing care; continuing focal
point for all health care services, that the patient needs and the patient sees this provider to be evaluated for sinus congestion. The inherent complexity of G2211 is not in the clinical condition, but rather the cognitive load of the continued responsibility of being the focal point for all needed services for the patient.

The 2024 national Medicare allowable for G2211 is $16.05.

Split/Shared Visits
• If code is selected using time, then the professional who spends the majority of time on the date of the encounter reports the service– Will have to document time using the appropriate format. If MDMis used, the individual who approves the care plan for the problems addressed and takes responsibility related to management risk performs the substantive portion of the visit.  If data are used, only the person who performs an independent interpretation or discussion of management or test interpretation may use these categories.– This is not just documenting test result.

Peer- Specialist

Principal Illness Navigation: Peer Support G0140, G0146
• Time-based services – threshold time. G0140/6 Peer support; person-centered assessment performed to understand better the individual context of the serious, high-risk condition– Certified or trained auxiliary personnel, including a certified peer specialist.

Lived experience, especially in substance use and behavioral health areas; training is not as clinically focused as compared to a support person for an oncology program.
• Peer support requirements – most states have specific standards for individuals to be a peer support specialist. States that do not have codified standards and because it is behavioral health-oriented are required to be trained in accordance with SAMHSA standards.

COVID-19

What’s Changed

▲ 91304 Severe Acute Respiratory Syndrome Coronavirus 2 (Sars-Cov-2) (Coronavirus Disease [Covid19]) Vaccine, Recombinant Spike Protein Nanoparticle, Saponin-Based Adjuvant, preservative free, 5 Mcg/0.5 Ml Dosage, For Intramuscular Use

What’s Been Deleted

AMA deleted the following COVID-19-related codes on Nov. 1, 2023. These codes appear in the 2024 CPT® code book because it went to print before these code changes were finalized.

0001A 0034A 0072A 0104A 0151A 91303 91314

0002A 0041A 0073A 0111A 0154A 91305 91315

0003A 0042A 0074A 0112A 0164A 91306 91316

0004A 0044A 0081A 0113A  0171A 91307 91317

0011A 0051A 0082A 0121A  0172A 91308

0012A 0052A 0083A 0124A 0173A 91309

0013A 0053A  0091A 0134A 0174A 91310

0021A 0054A 0092A 0141A  91300 91311

0022A 0064A 0093A 0142A 91301 91312

0031A  0071A 0094A 0144A 91302 91313

What’s unchanged

  • 90480: Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, single dose.
  • 91316 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID19]) vaccine, mRNA-LNP, spike protein, bivalent, preservative free, 10 mcg/0.2 mL dosage, for intramuscular use.
  • 91318 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, 3 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use.
  • 91319 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, 10 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use.
  • 91320 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, 30 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use.
  • 91321 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, 25 mcg/0.25 mL dosage, for intramuscular use.
  • 91322 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, 50 mcg/0.5 mL dosage, for intramuscular use.

Specialty 1: Gastroenterology

What’s Changed

▲64590 – Insertion or replacement of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, direct or inductive coupling requiring pocket creation and connection between electrode array and pulse generator or receiver.

▲64595 Revision or removal of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, with detachable connection to electrode array.

What’s been deleted

0386U Gastroenterology (Barrett’s esophagus), P16, RUNX3, HPP1, and FBN1 methylation analysis, prognostic and predictive algorithm reported as a risk score for progression to high-grade dysplasia or esophageal cancer.

What’s unchanged

  • 0398U Gastroenterology (Barrett’s esophagus), P16, RUNX3, HPP1, and FBN1 DNA methylation analysis using PCR, formalin-fixed paraffin-embedded (FFPE) tissue, algorithm reported as risk score for progression to high-grade dysplasia or cancer.
  • 0430U Gastroenterology, malabsorption evaluation of alpha-1-antitrypsin, calprotectin, pancreatic elastase and reducing substances, feces, quantitative
  • 0813T Esophagogastroduodenoscopy, flexible, transoral, with volume adjustment of intragastric bariatric balloon
  • 0369U Infectious agent detection by nucleic acid (DNA and RNA), gastrointestinal pathogens, 31 bacterial, viral, and parasitic organisms, and identification of 21 associated antibiotic-resistance genes, multiplex amplified probe technique.

Specialty 2: Cardiology

What’s Changed

▲0308U Cardiology (coronary artery disease [CAD]), analysis of 3 proteins (high sensitivity [hs] troponin, adiponectin, and kidney injury molecule-1 [KIM-1]) with 3 clinical parameters (age, sex, history of cardiac intervention), plasma, algorithm reported as a risk score for obstructive CAD.

Three new codes were added for epicardial ultrasound for congenital heart disease. When all components are performed, including the placement and manipulation of the transducer, image acquisition, interpretation, and report, use new code 76987. When the provider only performs the placement, manipulation of the transducer, and image acquisition, use new code 76988. When the provider performs only the interpretation and report, use 76989.

CPT® 2024 includes eight new codes for the phrenic nerve stimulation system. Introductory guidelines and parentheticals are also added. The new codes are:

  • 33276 is for the insertion of the pulse generator and stimulating leads and generator initial analysis with diagnostic mode activation.
  • +33277 is an add-on code for the insertion of transvenous sensing lead.
  • 33278 is for the removal of the pulse generator and lead(s).
  • 33279 is for the removal of only the leads.
  • 33280 is for the removal of only the pacemaker.
  • 33281 is for the repositioning of the lead(s).
  • 33287 is for the removal and replacement of the pulse generator.
  • 33288 is for the removal and replacement of the lead(s)

What’s Unchanged

  • 0019M cardiovascular disease, plasma, analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk population.
  • 76988 Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only.
  • 76989 Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only.
  • 76987 Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report

0377U cardiovascular disease, quantification of advanced serum or plasma lipoprotein profile, by nuclear magnetic resonance (NMR) spectrometry with report of a lipoprotein profile (including 23 variables).

0401U Cardiology (coronary heart disease [CHD]), 9 genes (12 variants), targeted variant genotyping, blood, saliva, or buccal swab, algorithm reported as a genetic risk score for a coronary event

0415U cardiovascular disease (acute coronary syndrome [ACS]), IL-16, FAS, FASLigand, HGF, CTACK, EOTAXIN, and MCP-3 by immunoassay combined with age, sex, family history, and personal history of diabetes, blood, algorithm reported as a 5-year (deleted risk) score for ACS

  • 76987 Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation, and report
  • 76988 Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only
  • 76989 Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only.
  • 93584 Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart (List separately in addition to code for primary procedure)
  • 93585 Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (List separately in addition to code for primary procedure)
  • 93586 Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (List separately in addition to code for primary procedure)
  • 93587 Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate vein) (List separately in addition to code for primary procedure) Medicine
  • 93588 Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena cava) (List separately in addition to code for primary procedure.
  • 0793T Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance.

What’s been deleted

  The code for pelvimetry, 74710, is deleted.   

New code 75580 was added to describe a noninvasive estimate of coronary fractional flow reserve (FFR) derived from augmentative software analysis of the data set from a coronary computed tomography angiography. A diagnostic intraoperative thoracic aorta ultrasound is described by new code 76984.

Interventional Cardiology
• +93972 Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure)
• Frequently described in practice as “IntraVascular Lithotripsy (IVL)” • Used to treat heavily calcified coronary arteries
that will not dilate with traditional techniques. • An alternative to coronary rotational atherectomy or orbital atherectomy
• Patient may have:– Multiple prior layers of stent, now in-stent restenosis– Multiple layers of under-expanded stents due to vessel
rigidity.
• Balloon is bulky so may have to pre-dilate vessel • IVL balloon inflated to 2-6 ATM, 10 pulses, deflate, repeat for up to 80 total pulses.

Specialty 3: Neurology

What’s been deleted

  • 0404T Transcervical uterine fibroid(s) ablation with ultrasound guidance, radiofrequency
  • 0424T Insertion or replacement of neurostimulator system for treatment of central sleep apnea; complete system (transvenous placement of right or left stimulation lead, sensing lead, implantable pulse generator).
  • 0425T Insertion or replacement of neurostimulator system for treatment of central sleep apnea; sensing lead only.
  • 0426T Insertion or replacement of neurostimulator system for treatment of central sleep apnea; stimulation lead only .
  • 0427T Insertion or replacement of neurostimulator system for treatment of central sleep apnea; pulse generator only .
  • 0428T Removal of neurostimulator system for treatment of central sleep apnea; pulse generator only.
  • 0429T Removal of neurostimulator system for treatment of central sleep apnea; sensing lead only .
  • 0430T Removal of neurostimulator system for treatment of central sleep apnea; stimulation lead only.
  • 0431T Removal and replacement of neurostimulator system for treatment of central sleep apnea, pulse generator only.
  • 0432T Repositioning of neurostimulator system for treatment of central sleep apnea; stimulation lead only.
  • 0433T Repositioning of neurostimulator system for treatment of central sleep apnea; sensing lead only .
  • 0434T Interrogation device evaluation implanted neurostimulator pulse generator system for central sleep apnea.
  • 0435T Programming device evaluation of implanted neurostimulator pulse generator system for central sleep apnea; single session.
  • 0436T Programming device evaluation of implanted neurostimulator pulse generator system for central sleep apnea; during sleep study.
  • 0768T Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, subsequent treatment, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve.
  • 0769T Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, subsequent treatment, including noninvasive electroneurographic localization (nerve conduction localization), each additional nerve (List separately in addition to code for primary procedure).

What’s Changed

▲0766T Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, initial treatment, with identification and marking of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve

▲0767T Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, initial treatment, with identification and marking of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; each additional nerve (List separately in addition to code for primary procedure).

▲63685 Insertion or replacement of spinal neurostimulator pulse generator or receiver, direct or inductive coupling, requiring pocket creation and connection between electrode array and pulse generator or receiver

▲63688 Revision or removal of implanted spinal neurostimulator pulse generator or receiver, with detachable connection to electrode array

▲64590 Insertion or replacement of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, direct or inductive coupling requiring pocket creation and connection between electrode array and pulse generator or receiver

▲64595 Revision or removal of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, with detachable connection to electrode array.

61889 Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when
performed, with direct or inductive coupling, with connection to depth and/or cortical strip electrode array(s). • Cranial-mounted IPG can handle two electrodes. • Cortical strip electrode usually on surface of the brain.
• Responsive neurostimulator (Chronic EEG recordings– Stimulation in response to abnormal EEG patterns).

61891 – Revision or replacement of skull the mounted cranial neurostimulator pulse generator with connection to depth and/or cortical strip electrode array(s).
• 61892 – Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed.

What’s Unchanged

  • 0358U Neurology (mild cognitive impairment), analysis of β-amyloid 1-42 and 1-40, chemiluminescence enzyme immunoassay, cerebral spinal fluid, reported as positive, likely positive, or negative.
  • 0393U Neurology (eg, Parkinson disease, dementia with Lewy bodies), cerebrospinal fluid (CSF), detection of misfolded α-synuclein protein by seed amplification assay, qualitative.
  • 0399U Neurology (cerebral folate deficiency), serum, detection of anti-human folate receptor IgGbinding antibody and blocking autoantibodies by enzyme-linked immunoassay (ELISA), qualitative, and blocking autoantibodies, using a functional blocking assay for IgG or IgM, quantitative, reported as positive or not detected.
  • 0784T Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging guidance, when performed
  • 0785T Revision or removal of neurostimulator electrode array, spinal, with integrated neurostimulator
  • 0786T Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed
  • 0787T Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator
  • 0788T Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (Hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detection algorithms, closed-loop parameters, and passive parameters, when performed by a physician or other qualified health care professional, spinal cord or sacral nerve, 1-3 parameters Category III Codes
  • 0789T Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (Hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detection algorithms, closed-loop parameters, and passive parameters, when performed by a physician or other qualified health care professional, spinal cord or sacral nerve, 4 or more parameters.

Specialty 4: Orthopedic

What’s Changed

CPT® 2024 adds three new codes for anterior thoracic vertebral body tethering. This technique is an alternative to traditional spinal fusion surgery, which involves fusing together the vertebrae to stabilize the spine, eliminating motion in the fused segments. Anterior vertebral body tethering is considered a less invasive option that allows for continued spinal growth and movement. This procedure is performed on patients with scoliosis. Introductory guidelines and parenthetical guidance are also added for the following codes:

  • 22836 is for anterior thoracic vertebral body tethering when performed for up to seven vertebral segments.
  • 22837 is for anterior thoracic vertebral body tethering when performed for eight or more vertebral segments.
  • 22838 is for the revision, replacement, or removal of the thoracic vertebral body tethering.

A new code for sacroiliac joint arthrodesis, 27278, was added to report the placement of an intra-articular stabilization device using a minimally invasive technique that does not transfix the joint.

What’s been deleted

  • 0508T Pulse-echo ultrasound bone density measurement resulting in indicator of axial bone mineral density, tibia.
  • 0775T Arthrodesis, sacroiliac joint, percutaneous, with image guidance, includes placement of intra-articular implant(s) (eg, bone allograft[s], synthetic device[s])

What’s Unchanged

  • 0815T Ultrasound-based radiofrequency echographic multi-spectrometry (REMS), bone-density study and fracture-risk assessment, 1 or more sites, hips, pelvis, or spine.
  • 27278 Arthrodesis, sacroiliac joint, percutaneous, with image guidance, including placement of intra-articular implant(s) (eg, bone allograft[s], synthetic device[s]), without placement of transfixation device.

Specialty 5: Podiatry

What’s Changed

▲28296 Correction, hallux valgus with (bunionectomy), with sesamoidectomy, when performed; with distal metatarsal osteotomy, any method.

▲28295 Correction, hallux valgus with (bunionectomy), with sesamoidectomy, when performed; with proximal metatarsal osteotomy, any method.

▲28297 Correction, hallux valgus with (bunionectomy), with sesamoidectomy, when performed; with first metatarsal and medial cuneiform joint arthrodesis, any method.

▲28298 Correction, hallux valgus with (bunionectomy), with sesamoidectomy, when performed; with proximal phalanx osteotomy, any method.

▲28299 Correction, hallux valgus with (bunionectomy), with sesamoidectomy, when performed; with double osteotomy, any method.

Specialty 6: Respiratory Practices

New CPT codes

Two new codes were created for the destruction of the posterior nasal nerve during a nasal/sinus endoscopy.

  • Code 31242 was added to report the procedure performed using radiofrequency ablation.
  • Code 31243 was added to report the procedure performed using cryoablation

Specialty 7: Urology Practices

CPT 52284 describes cystourethroscopy with mechanical urethral dilation and urethral therapeutic drug delivery using a drug-coated balloon catheter for urethral stricture or stenosis in a male patient. The procedure includes fluoroscopy.

64597 insertion or replacement of percutaneous array, peripheral nerve, with integrated neurostimulator, including imaging guidance,
when performed, each additional electrode array.

64596 insertion or replacement of percutaneous array, peripheral nerve, with integrated neurostimulator, including imaging guidance,
when performed, the initial electrode array.

64590 Insertion or replacement of a peripheral, sacral, or gastric neurostimulator pulse generator or receiver, direct or inductive, requiring pocket creation and connection between electrode array and pulse generator or receiver.

Specialty 8: Eye Practices

New CPT code: New code 67516 describes the injection of a pharmacologic agent in the suprachoroidal space. The medication is reported separately.

Specialty 9: Pathology and Laboratory

New and revised CPT codes

Codes 81171, 81172, 81243, 81244, 81403, 81404, 81405, 81406, and 81407 were revised to replace “mental retardation” with “intellectual disability.”

Also, in this section, you’ll find six new genomic sequence analysis panel codes for solid organ neoplasms:

  • 81457 is for interrogation for sequence variants; DNA analysis, microsatellite instability.
  • 81458 is for interrogation for sequence variants; DNA analysis, copy number variants, and microsatellite instability.
  • 81459 is for interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements.
  • 81462 is for cell-free nucleic acid (e.g., plasma) interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants, and rearrangements.
  • 81463 is for cell-free nucleic acid (e.g., plasma) interrogation for sequence variants; DNA analysis, copy number variants, and microsatellite instability.
  • 81464 is for cell-free nucleic acid (e.g., plasma) interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements.
  • New multianalyte assays with algorithmic analyses (MAAA) code 81517 was added for liver fibrosis and liver-related clinical events within five years.
  • New code 82166 describes the chemistry test for anti-mullerian hormone (AMH).
  • Three new immunology codes were created for acetylcholine receptors (AChR): 86041 describes when the procedure includes the binding antibody; 86042 describes when the procedure includes the blocking antibody; and 86043 describes when the procedure includes the modulating antibody.
  • New code 86366 describes testing for muscle-specific kinase (MuSK) antibodies. New code 87523 was added for hepatitis D. New code 87593 describes orthopoxvirus (e.g., monkeypox virus, cowpox virus, vaccinia virus) testing.
  • There are also many new proprietary laboratory analyses (PLA) codes. These codes describe PLAs provided by either a single laboratory or licensed/marketed to multiple providing laboratories.

Specialty 10: Gynecology

+99459 Pelvic exam 
• Practice expense only
• Accounts for extra resources in pelvic exams– Endometrial biopsy, LEEP, IUD insertion and other similar services already include the practice expense; do NOT report when other services are done at the same time.  May be added to problem-oriented E/M and
preventive services.

58580 Transcervical RF ablation of uterine fibroids, including the US. Not a hysteroscopic procedure, not endometrial ablation.
• RF –removal without excision– Myomectomy can be morbid – lot of blood loss.
• Placed through the cervix and provides intracavitary US guidance
• Note parentheticals.

HIPEC Hyperthermic Intraperitoneal chemotherapy
• 96547 – first 60 minutes
• 96548 – each additional 30 minutes
• Time is not part of usual pre-, intra-, and post procedural work assoc with primary procedure.– Pre-operative counseling for patients who may need these types of services is not included in these codes. Pre-op counseling could be included in the preoperative counseling for the primary procedure.– See parentheticals for included and excluded work– The mid-point rule for time applies to these codes.

HIPEC – time-based
• Primary (radical) procedure is completed, and the abdomen is superficially closed.
• Time starts with the placement of additional sites for catheters, the incision(s) for catheters, and probe
placement.
• Chemo is immediately added following procedure.
• Time while chemo is administered and agent dwell time is included.
• NOT an implanted catheter or port (96446) for later chemo admin.

58674 Laparoscopic RF fibroid ablation

58661 – clarified as a unilateral procedure. – Structures mean fallopian tube or portion thereof or ovary or portion thereof.

Please note that the purpose of this article is to provide a general overview and does not cover all the modifications made to the CPT codes for 2024.  Here’s the link to order the 2024 edition. Also, the PracticeForces team is here to assist you with any clarifications you may have. You can submit your queries here. Contact us.

Content reference: 2023 AAPC

 

Parul Garg, CEO and co-founder of PracticeForces, has significantly contributed to the growth of over 1,000 U.S. medical practices through her expertise in medical billing and coding since the company’s inception in 2003. With a background in Computer Science and an MBA in Human Resources, her leadership and AAPC-certified coding skills have been pivotal in managing the company’s operations effectively.

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