The document outlines the 2024 changes to CPT coding, emphasizing updates for inpatient, emergency, nursing facility, home services, prolonged services, split/shared visits, telehealth, and specific procedures. Key modifications include the introduction of new codes, changes in reporting requirements, and adjustments to existing codes across various medical services. Additionally, it details updated guidelines for telehealth and specific vaccination codes for SARS-CoV-2, reflecting current healthcare practices.

1. CPT Changes 2024
Lynn M. Anderanin
CPC, CPMA, CPB, CPC-I, CPPM, COSC
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2. Inpatient and Observation
• Modifier 25 can be reported on these codes to identify subsequent
services to another visit at another site of service on the same day
• Discharge services can only be reported by the discharging provider
• 99221-99223- First encounter with the patient who has not received
any professional services from the provider or other provides of the
exact same specialty and subspecialty who belongs to the same group
• If using time, this is reported by calendar date. Continuous service
over two calendar days is reported on one calendar date.
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3. Emergency Services- 99282-99285
• Time cannot be used to determine level
• 99281 is now equivalent to 99211. Description says this service does
not require the presence of a physician or QHP.
• Can be reported with critical care on the same day
• 99242-99245 can be reported for consultations performed in the ED
• Appropriate modifier(s) should be used for services not completed or
part of a surgery practice (e.g. 52,53,54,55,56)
• 99202-99215 should be used to report ED visits performed for
physician convenience
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4. Nursing Facilities-99304-99316
• Used for services at nursing and skilled nursing facilities
• Also use for psychiatric treatment center and immediate care facility
for patients with intellectual disabilities.
• Performed by principal provider (admitting provider) overseeing the
care of the patient.
• “Multiple morbidities requiring intensive management” added to high
risk for nursing facility visits.
• Discharge services require a provider “face-to-face” with the patient
on the date of discharge
• 99318 is replaced by 99307-99310
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5. Home or Residence Services
99341,99342,99344,99345,99347-99350
• Includes domiciliary, rest home, custodial care service, and home care
plan oversight services
• Some domiciliary services will be reported with 99347,99491,or
99492
• Travel time is not included
• Prolonged service code is 99417
• 99343 is replaced by 99341,99342,99344, or 99345
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6. Prolonged Services
• Add on codes 99417, 99418
• Can be used if there is more than one provider involved with the
patient
• Primary codes- 99205, 99215, 99223, 99233, 99236, 99245, 99255,
99306, 99310, 99345, 99350, 99483
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7. Split or Shared Visits
• Provider that performs substantive portion if time is used
• For Medical Decision Making
• Whomever performs the problems addressed at the encounter and the risk of
complications for the patient
• In order to use data reviewed and analyzed because the history of the patient
by an independent historian or the ordering of tests do not need to be
performed by the provider, in order to use this as an element the provider
must perform an independent interpretation of test(s) or the discussion of a
plan or test interpretation must be performed by the reporting provider
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8. Telehealth
• Health and well-being coaching- 2024
• Social Determinants of Health Risk Assessment- permanent
• Accepting that patient can be in their home- paid at non-facility rate
• Adding applicable providers- qualified occupational therapists, qualified
physical therapists, qualified speech-language pathologists, and qualified
audiologists
• Define direct supervision to permit the presence and immediate availability
of the supervising practitioner through real-time audio and video
interactive telecommunications through December 31, 2024
• COVID-19 PHE for Medicare telehealth services at least until the end of
2024
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9. Phrenic Nerve Stimulation
• 33276 Insertion of pulse generator and stimulating lead(s)
• +33277 Insertion of transvenous sensing lead
• 33278 Removal of pulse generator and lead(s)
• 33279 Removal of transvenous lead(s) only
• 33280 Removal of pulse generator only
• 33281 Repositioning of lead(s)
• 33287 Removal and replacement of pulse generator
• 33288 Removal and replacement of lead(s)
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10. Chemistry, Immunology, and Microbology
• 82166 AMH Antu-mullerian hormone
• 86041 AChR receptor: binding antibody
• 86042 Blocking antibody
• 86043 Modulating antibody
• 87523 Nucliec acid to detect infectious agent detection of hepatitis D
quantification, when performed
• 87593 Orthopoxvirus
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11. SARS-CoV-2 Vaccinations
• 0121A IM injection SARS-CoV-2 vaccine, mRNA-LNP, bivalent spike
protein, preservative free, 30mcg/0.3ml dosage, tris-sucrose
formulation, single dose
• 0151A IM injection SARS-CoV-2 vaccine, mRNA-LNP, bivalent spike
protein, preservative free, 10mcg/0.2ml dosage, diluent
reconstituted, tris-sucrose formulation, single dose
• 0171A IM injection SARS-CoV2 vaccine, mRNA-LNP, bivalent spike
protein, preservative free, 3mcg/0.2ml dosage, diluent reconstituted,
tris-sucrose formulation, first dose
• 0172A second dose
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12. Thank You!!!
Register Now
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