New CPT code sets can pose challenges for medical coding companies, so we want to provide you with an overview of the new CPT codes that are being introduced for 2022.
This will help you evaluate your use of medical coding services and decide whether you should consider leveraging medical coding companies to keep up with future changes in the code set.
This code set includes 405 changes in total. In response to the COVID-19 pandemic, the code set has seen multiple updates that you will benefit from reviewing and evaluating as you develop your medical coding strategy.
Benefits of Keeping Your Medical Coding Services Up with CPT Changes
With all the changes and disruption that COVID-19 has brought with it, organizations like yours should consider the benefits of rethinking your approach to CPT updates, possibly revisiting the option to outsource medical coding. This is an option to help you adjust to changes without placing additional burden on your staff.
Also, keep in mind that changes to the code set usually come with a learning period in which your coders and billers will make more mistakes than usual. This could have a negative impact on your denial rates, slow down claim processing, and ultimately impact cash flows. Some of these potential mistakes include [1]:
- Unbundling CPT codes when one code will capture payment for all the component parts of a procedure
- Upcoding, such as for the highest-level evaluation-and-management, which could get you flagged for potential fraud
- Not checking the National Correct Coding Initiative (NCCI) edits when you are reporting multiple codes
New Codes for 2022 and Your Medical Coding Services
This year’s update includes 249 new codes, 63 that have been eliminated and 93 that have been revised.
COVID-19 Vaccine Codes
The 2022 code set included 12 vaccine-specific codes to help report and track immunizations and administrative services associated with SARS-CoV-2 as efficiently as possible. The president of the American Medical Association (AMA) has stressed the importance of these codes in generating accurate data to address the pandemic,
“Data-driven planning and resource allocation is vital for effective immunization programs that will bring the coronavirus pandemic to an end. Correlating each coronavirus vaccine and dosing schedule with its own unique CPT code has provided necessary analytical advantages to help track, allocate, and optimize resources for immunization programs across the United States.” [2]
These codes were first introduced for use in November 2020 to distinguish each vaccine and dosing and were available before public availability of the vaccines themselves. To help you navigate these codes, the AMA offers a COVID-19 vaccine CPT code finding tool [3]. The tool allows you to go through prompts to find codes for first, second, and third doses as well as boosters.
Digital Care Services
Digital medicine has been exploding in recent years, placing new demands on coders and billers, which might be a reason you might want to outsource medical coding or research more medical coding companies. The 2022 code set includes a unique educational guide to support users. It has a new appendix that provides a taxonomy for digital medicine service. This appendix supports awareness and understanding of new approaches to patient care that occur in the digital medicine space.
The five new codes, 98975, 98976, 98977, 98980, 98981, will be available for reporting of therapeutic remote monitoring, which saw increased use during the pandemic.
Care Management Protocols
The CPT editorial panel also added codes for principal care management, making coding more complex and possibly encouraging you to consider researching medical coding companies. These codes are 99424, 99425, 99426, 99427. They allow your physicians and other qualified health professionals to report care management services. This is for use for patients with one complex condition and comes as Medicare policies for principal care management services have evolved, revising existing CPT codes for care management and bringing coding in alignment with Medicare guidelines. This work has been going on for nearly 10 years to support the need of physicians and other providers who are integral in helping manage the chronic conditions that are so common in America’s growing population of seniors.
Add Your Input on Medical Coding Services
The CPT Editorial Panel is currently looking for new perspectives from organizations like yours as they expand the vocabulary of medicine [4].
The panel holds multiple meetings a year and is currently planning expansion from 17 members to 21. They are looking to increase their expertise, specifically to reflect the growth of digital health, diagnostic precision medicine, and augmented intelligence. The positions will be open to:
- Physicians nominated by a medical specialty society
- A nominee from a medical specialty society or an organization that represent private healthcare insurers
- A member of an at-large organization
This is an opportunity to get new voices into the conversation around medical coding and impact your medical coding service experiences for years to come.
If you’d like to learn more, the AMA will be hosting two virtual events, the Outpatient CDI Workshop and the CPT and RBRVS 2022 Annual Symposium in November. And if you’d like to learn more about your options to outsource medical coding, start here.
References
[1] K. B. O’Reilly, “8 medical coding mistakes that could cost you,” American Medical Association, 14 July 2021. Available: https://www.ama-assn.org/practice-management/cpt/8-medical-coding-mistakes-could-cost-you.
[2] J. LaPointe, “2022 CPT Code Set Released, Streamlines Medical Coding for COVID-19,” RevCycleIntelligence, 7 September 2021. Available: https://revcycleintelligence.com/news/2022-cpt-code-set-released-streamlines-medical-coding-for-covid-19.
[3] American Medical Association, “Find your COVID-19 Vaccine CPT® Codes,” 2021. Available: https://www.ama-assn.org/find-covid-19-vaccine-codes.
[4] A. Robeznieks, “New voices, perspective sought as CPT Editorial Panel expands,” American Medical Association, 24 September 2021. Available: https://www.ama-assn.org/about/cpt-editorial-panel/new-voices-perspective-sought-cpt-editorial-panel-expands.
