Each new year brings new, revised, and deleted codes and coding guidelines that become effective Jan 1. CPT 2024 includes 230 new codes, 70 revised codes, and 49 deleted codes. Most of the changes are in the sections of Evaluation and Management (E/M) Services, the phrenic nerve stimulation system, lab and pathology, COVID-19 and RSV vaccinations, and Category III codes. With 11,163 codes that describe the medical procedures and services available to patients, the CPT code set continues to grow and evolve with the rapid pace of innovation in medical science and health technology. The 2024 version also aims to improve transparency for patients who speak Spanish with the addition of Spanish-language, consumer-friendly descriptors for more than 11,000 medical procedures and services. Adding the descriptors in Spanish will help CPT users assist patients in the Latinx community.
Evaluation and Management (E/M)
The revisions in E/M services include:
- Removal of time ranges from office or other outpatient visit codes (99202-99205, 99212-99215) and aligned with other E/M codes,
- CPT expanded its definition to determine the “substantive portion” of a split/shared E/M visit in which a physician and a non-physician practitioner work jointly to furnish all the work related to the visit, and
- Instructions for reporting hospital inpatient or observation care services and admission and discharge services for the use of codes 99234-99236 when the patient stay crosses over two calendar dates.
- Two nursing facility codes were revised to change the time for 99306 from 45 minutes to 50 minutes and 99308 from 15 minutes to 20 minutes.
- Addition of CPT code 99459 that covers a female pelvic exam and is listed separately in addition to the code for the primary procedure.This is a practice expense-only code that captures the direct expenses associated with performing a female pelvic exam in a non-facility setting during a preventive medicine service (99381-99397) or an E/M service (99202-99215). As an add-on code, it should be reported only for the same date of service as the codes listed above.
Musculoskeletal System-
Three updated codes for anterior thoracic vertebral body tethering, providing an alternative to traditional spinal fusion. Specifically beneficial for scoliosis patients, the procedure allows continued spinal growth and movement. Updated codes are:
– 22836: Anterior thoracic vertebral body tethering for up to seven vertebral segments.
– 22837: Anterior thoracic vertebral body tethering for eight or more vertebral segments.
– 22838: Revision, replacement, or removal of thoracic vertebral body tethering.
Additionally, code 27278 is introduced for sacroiliac joint arthrodesis employing a minimum intrusive method, emphasizing intra-articular stabilization without joint transfixion.
Respiratory system:
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.
Cardiovascular system:
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).
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Urinary System:
New Code 52284 cystourethroscopy with mechanical urethral dilation urethral therapeutic drug delivery using a drug-coated balloon catheter for urethral stricture or stenosis in a male patient. The procedure includes fluoroscopy.
Female Genital System:
New code 58580 for Transcervical radiofrequency ablation of uterine fibroid(s). The procedure includes intraoperative ultrasound guidance and monitoring.
Nervous System:
Three new codes were created for skull-mounted cranial pulse generator or receiver procedures. The insertion is reported with 61889; revision or replacement is reported with 61891; and the removal is reported with 61892.
Insertion or replacement of a spinal neurostimulator pulse generator or receiver code 63685 was revised to require pocket creation and connection between the array and the pulse generator or receiver.
Revision or removal of the implanted spinal neurostimulator code 63688 was revised to include “with detachable connection to electrode array.”
Code 64590 was revised to include “sacral” and to specify that the procedure requires pocket creation and connection between the electrode array and pulse generator or receiver. Code 64595 was revised to include “sacral” and to specify that the procedure is with a detachable connection to the electrode array.
New code 64596 describes the insertion or replacement of the initial electrode array for the percutaneous electrode array of a peripheral nerve with an integrated neurostimulator. New add-on code +64597 is used with 94596 for each additional electrode array. New code 64598 describes the revision or removal of the neurostimulator electrode array with integrated neurostimulator of a peripheral nerve.
Surgery: Eye and Ocular Adnexa
New code 67516 describes the injection of a pharmacologic agent in the suprachoroidal space. The medication is reported separately.
Radiology
The code for pelvimetry, 74710, was 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.
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.
Pathology and Laboratory
Codes 81171, 81172, 81243, 81244, 81403, 81404, 81405, 81406, and 81407 were revised to replace “mental retardation” with “intellectual disability.”
There are six new genomic sequence analysis panel codes for solid organ neoplasm.
- 81457 is for interrogation of 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.
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. This subsection includes MAAA and genomic sequencing procedures (GSP).
Medicine Section:
COVID-19 – Among the important CPT changes for 2024 is the consolidation of over 50 previous codes that streamline the reporting of immunization for COVID-19. The new codes 91318-91322, are the products from Moderna and Pfizer for immunization against Covid-19. In addition, a new vaccine administration code 90480 replaces all previously approved product-specific vaccine administration codes.
A new vaccine administration code (90480) was approved for reporting the administration of any COVID-19 vaccine for any patient.
Respiratory Syncytial Virus (RSV) – Other additions to the CPT code set respond to product-specific innovations in the prevention of Respiratory Syncytial Virus (RSV) that causes acute respiratory infection in individuals of all age groups. Five new CPT codes have been created to report product specific RSV immunizations (90380, 90381, 90683, 90679, and 90678) for better tracking, reporting, and analysis that supports data-driven planning and allocation.
Five new add-on codes were created for venography for congenital heart defects. All the procedures include catheter placement and radiological supervision and interpretation. New guidelines and parentheticals have also been added:
- +93584 is for the anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart.
- +93585 is for the azygos/hemiazygos venous system.
- +93586 is for the coronary sinus.
- +93587 is for venovenous collaterals originating at or above the heart.
- +93588 is for venovenous collaterals originating below the heart.
Three new codes (97550-97552) were created for caregiver training.
Category III Codes
There are many new Category III codes created for new and emerging technology. Some examples include new add-on codes +0827T, +0856T for digital pathology digitization procedures, 0795T-0804T for dual-Chamber leadless pacemaker, and 0820T, +0821T, and +0822T for continuous monitoring and intervention during psychedelic medication therapy.