COVID Code Consolidation, Spanish-Language Options, RSV Highlight Looming Code Changes

COVID Code Consolidation, Spanish-Language Options, RSV Highlight Looming Code Changes

This past Friday, the American Medical Association (AMA) announced the much-anticipated release of the 2024 CPT® code set; however, there’s a bit of a catch. 

The code set is only available on the AMA’s Intelligent Platform to those in the healthcare industry that are licensed to use the CPT standard data file.

The big reveal of the 230 additions, 49 deletions, and 70 revisions will take place during the virtual AMA CPT Symposium over the course of three days, from Nov. 15-17.  

For those of us who have pre-ordered our CPT books, now we must wait patiently for them to ship, which typically occurs by the end of October or first week of November.

The AMA shared a few of the changes in a press release.

For those who speak Spanish, the AMA has included Spanish descriptors for its 11,163 procedures and services in order to bridge the language gap that currently exists, and to make healthcare more inclusive to those who speak Spanish.

One of the major changes for 2024 is the consolidation of more than 50 codes used to report COVID-19 vaccines, along with the approval of provisional codes 91318-91322 used for the reporting of the monovalent vaccine products from Moderna and Pfizer. Once the monovalent vaccines are approved by the U.S. Food and Drug Administration (FDA), these provisional codes will be effective.

Another notable addition is code 90480, which will be used to report COVID-19 vaccine administration, which replaces all previously approved product-specific vaccine administration codes (which will in turn negate some of the troublesome reporting errors).                                                                                                                                                                            Also, we will have five new CPT codes for reporting Respiratory Syncytial Virus, commonly known as RSV, which, per the AMA, will lead to “better tracking, reporting, and analysis that supports data-driven planning and allocation.”

Next, the AMA provides a glimpse into the evaluation and management (E&M) revisions, which are clarifications that were sought out by Centers for Medicare & Medicaid Services (CMS). 

First, the CPT editorial panel removed the time ranges from the office and other outpatient codes 99202-99215 in order to align with the format with the rest of the E&M codes.

Next, per the AMA, we will have a definition to determine the “substantive portion” of a split and/or shared E&M service between a physician and non-physician practitioner. It will be interesting to see if the definition has any impact when CMS releases the Medicare Physician Fee Schedule proposed rule for 2025.

Lastly, CPT will provide clearer instructions for codes 99234-99236, which are used when reporting hospital inpatient or observation care with admission and discharge services, when the patient stay spans two calendar dates. 

The AMA keeps the remaining changes close to their vest. Now, we sit and patiently wait for November.

About the Author:

Angela Jordan serves as executive vice president for Calm Waters AI. She oversees the development and implementation of ChartPal, a service that provides physicians and non-physician practitioners with coding and documentation reviews to inform customized education to improve documentation accuracy and compliance. 

Jordan brings three decades of medical coding, documentation, and compliance experience to her position. She has been a national member of the AAPC since 2000 and a member of AAPC’s National Advisory Board. She is a frequent presenter and lecturer on coding and compliance topics at national conferences and symposiums.  

Immediately prior to joining Calm Waters AI, Jordan served as senior manager, Advisory Solutions for Dallas-based Ventra Health, where she provided coding and compliance education and audit and litigation support for the organization’s clients. She holds credentials as a Certified Professional Coder (CPC), a Certified Professional Medical Scribe (CPMS) and Certified Obstetrics Gynecology Coder (COBGC).

Facebook
Twitter
LinkedIn

Angela Jordan, CPC, CPMS, COBGC

Angela Jordan serves as executive vice president for Calm Waters AI. She oversees the development and implementation of ChartPal, a service that provides physicians and non-physician practitioners with coding and documentation reviews to inform customized education to improve documentation accuracy and compliance. Jordan brings three decades of medical coding, documentation, and compliance experience to her position. She has been a national member of the AAPC since 2000 and a member of AAPC’s National Advisory Board. She is a frequent presenter and lecturer on coding and compliance topics at national conferences and symposiums. Immediately prior to joining Calm Waters AI, Jordan served as senior manager, Advisory Solutions for Dallas-based Ventra Health, where she provided coding and compliance education and audit and litigation support for the organization’s clients. She holds credentials as a Certified Professional Coder (CPC), a Certified Professional Medical Scribe (CPMS) and Certified Obstetrics Gynecology Coder (COBGC).

Related Stories

Leave a Reply

Please log in to your account to comment on this article.

Featured Webcasts

Decoding 2025 OPPS Charge Capture and Coding Complexities: Strategies for Success

Decoding 2025 OPPS Charge Capture and Coding Complexities: Strategies for Success

Prepare your organization for the 2025 OPPS updates with expert insights from Tiffani Bouchard, CCS, CRCR, a Revenue Integrity Professional with over 30 years of experience. This webcast will address critical challenges in charge capture and coding, providing clarity on APC policies, C-APC packaging, exclusions, and payer-specific requirements. Attendees will learn actionable strategies to ensure compliance, optimize reimbursement, and mitigate risks of claim denials. Gain the knowledge needed to implement updates effectively, educate your team, and maintain seamless revenue cycle operations in the face of evolving OPPS complexities.

January 29, 2025
Enhancing Outcomes with CDI-Coding-Quality Collaboration in Acute Care Hospitals

Enhancing Outcomes with CDI-Coding-Quality Collaboration in Acute Care Hospitals

Join Angela Comfort, DBA, MBA, RHIA, CDIP, CCS, CCS-P, as she presents effective strategies to strengthen collaboration between CDI, coding, and quality departments in acute care hospitals. Angela will also share guidance on implementing cross-departmental meetings, using shared KPIs, and engaging leadership to foster a culture of collaboration. Attendees will gain actionable tools to optimize documentation accuracy, elevate quality metrics, and drive a unified approach to healthcare goals, ultimately enhancing both patient outcomes and organizational performance.

November 21, 2024
Comprehensive Inpatient Clinical Documentation Integrity: From Foundations to Advanced Strategies

Comprehensive Outpatient Clinical Documentation Integrity: From Foundations to Advanced Strategies

Optimize your outpatient clinical documentation and gain comprehensive knowledge from foundational practices to advanced technologies, ensuring improved patient care and organizational and financial success. This webcast bundle provides a holistic approach to outpatient CDI, empowering you to implement best practices from the ground up and leverage advanced strategies for superior results. You will gain actionable insights to improve documentation quality, patient care, compliance, and financial outcomes.

September 5, 2024

Trending News

Featured Webcasts

Navigating the 2025 Medicare Physician Fee Schedule: Key Changes and Strategies for Success

Navigating the 2025 Medicare Physician Fee Schedule: Key Changes and Strategies for Success

The 2025 Medicare Physician Fee Schedule brings significant changes to payment rates, coverage, and coding for physician services, impacting practices nationwide. Join Stanley Nachimson, MS., as he provides a comprehensive guide to understanding these updates, offering actionable insights on new Medicare-covered services, revised coding rules, and payment policies effective January 1. Learn how to adapt your practices to maintain compliance, maximize reimbursement, and plan for revenue in 2025. Whether you’re a physician, coder, or financial staff member, this session equips you with the tools to navigate Medicare’s evolving requirements confidently and efficiently.

January 21, 2025
Patient Notifications and Rights: What You Need to Know

Patient Notifications and Rights: What You Need to Know

Dr. Ronald Hirsch provides critical details on the new Medicare Appeal Process for Status Changes for patients whose status changes during their hospital stay. He also delves into other scenarios of hospital patients receiving custodial care or medically unnecessary services where patient notifications may be needed along with the processes necessary to ensure compliance with state and federal guidance.

December 5, 2024
Navigating the No Surprises Act & Price Transparency: Essential Insights for Compliance

Navigating the No Surprises Act & Price Transparency: Essential Insights for Compliance

Healthcare organizations face complex regulatory requirements under the No Surprises Act and Price Transparency rules. These policies mandate extensive fee disclosures across settings, and confusion is widespread—many hospitals remain unaware they must post every contracted rate. Non-compliance could lead to costly penalties, financial loss, and legal risks.  Join David M. Glaser Esq. as he shows you how to navigate these regulations effectively.

November 19, 2024
Post Operative Pain Blocks: Guidelines, Documentation, and Billing to Protect Your Facility

Post Operative Pain Blocks: Guidelines, Documentation, and Billing to Protect Your Facility

Protect your facility from unwanted audits! Join Becky Jacobsen, BSN, RN, MBS, CCS-P, CPC, CPEDC, CBCS, CEMC, and take a deep dive into both the CMS and AMA guidelines for reporting post operative pain blocks. You’ll learn how to determine if the nerve block is separately codable with real life examples for better understanding. Becky will also cover how to evaluate whether documentation supports medical necessity, offer recommendations for stronger documentation practices, and provide guidance on educating providers about documentation requirements. She’ll include a discussion of appropriate modifier and diagnosis coding assignment so that you can be confident that your billing of post operative pain blocks is fully supported and compliant.

October 24, 2024

Trending News

Happy National Doctor’s Day! Learn how to get a complimentary webcast on ‘Decoding Social Admissions’ as a token of our heartfelt appreciation! Click here to learn more →

CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24