AMA CPT Codes Updates for 2022 That Will Affect Medical Billing Services

by | Dec 28, 2021 | Blog, Medical Coding | 0 comments

Each year, the American Medical Association makes updates to the CPT code set. The 2022 CPT code set has 405 editorial changes, including 249 new codes, 63 deletions and 93 revisions. As a reliable medical billing and coding company, we keep close track of these changes to help healthcare providers report patient encounters using the right codes for claims submission and reimbursement.

Focus on COVID-19 Vaccine-specific Codes

A major highlight of the 2022 CPT code set are a series of 15 vaccine-specific codes that the AMA considers “the model for efficiently reporting and tracking immunizations and administrative services against the coronavirus (SARS-CoV-2)”.Each coronavirus vaccine and dosing schedule is correlated with its own unique CPT code.

The new CPT codes that the AMA introduced over the past year clinically distinguish each coronavirus vaccine for better tracking, reporting and analysis that supports data-driven planning and allocation. Streamlining medical coding and documentation of COVID-19 vaccinations has helped optimize resources for immunization programs across the United States.

In November 2021, the AMA approved 28 Category I vaccine-specific codes: 0001A, 0002A, 0003A, 0004A, 0011A, 0012A, 0013A, 0021A, 0022A, 0031A, 0034A, 0041A, 0042A, 0051A, 0052A, 0053A, 0054A, 0064A, 0071A, 0072A, 91300, 91301, 91302, 91303, 91304, 91305, 91306, and 91307.A closer look at these codes:

  • Pfizer-BioNTech COVID-19 Vaccine CPT 91300, 0001A, 0002A, 0003A, 0004A
  • Moderna COVID-19 Vaccine CPT 91301, 0011A, 0012A, 0013A
  • AstraZeneca COVID-19 Vaccine CPT 91302, 0021A, 0022A
  • Janssen COVID-19 Vaccine CPT 91303, 0031A 0034A
  • Novavax COVID-19 vaccine CPT 91304 – 0041A, 0042A
  • Pfizer’s modified formulation CPT code 91305, 0051A, 0052A, 0053A, 0054A
  • Moderna COVID vaccine 91306 and 0064A
  • Pfizer COVID-19 vaccine and immunization administration for the tris-sucrose pediatric (i.e., 5 through 11 years of age)CPT code 91307, 0071A, and 0072A

The 2022 CPT code set features a vaccine code finder resource that physicians and medical coding service providers can use to identify the appropriate CPT code combination for the type and dose of COVID-19 vaccine provided to each patient. It also includes an appendix for one-stop access to all the codes for COVID-19 vaccine reporting.

Other 2022 CPT Updates

The editorial changes to the CPT code set are based on the coding demands of digital health, precision medicine, augmented intelligence, and other aspects of a modern health care system. Other updates made to the CPT code set for 2022 include:

  • Addition of five new CPT codes (98975, 98976, 98977, 98980, 98981) to report therapeutic remote monitoring. These codes expand on the remote physiologic monitoring codes (99453, 99454, 99457, 99458) created in 2020.
  • Four new codes for principal care management (99424, 99425, 99426, 99427) to enable physicians and qualified healthcare professionals to report care management services for a patient with a complex chronic condition.
  • A new appendix that provides a taxonomy for digital medicine services that “supports increased awareness and understanding of approaches to patient care through the multifaceted digital medicine services available for reporting in the CPT code set”.

COVID-19 Coding and Documentation – Significance of Reliable Medical Billing Support

A 2020 survey conducted through the Healthcare Financial Management Association’s (HFMA) Pulse Survey program showed that confusion over COVID-19 coding and claim requirements is one of the top impacts the pandemic has had on revenue cycle operations.

This is hardly surprising as new codes are being constantly developed to ensure accurate documentation and billing of COVID-19 care. Over the last two years, new ICD procedure codes related to the virus were created and many changes were made to the CPT and HCPCS code sets related to COVID-19 and related conditions and procedures. In addition to new codes and reimbursement policies, telehealth implementations and social distancing protocols due to COVID-19 impacted all healthcare organizations. To ensure accurate claims submission providers also need diligently adhere to the coding and billing regulations of government agencies like the Centers for Medicare and Medicare services (CMS) and the Centers for Disease Control and Prevention (CDC), as well as the American Medical Association (AMA) and other official organizations.

Companies providing medical coding and medical billing services have helped healthcare facilities deal with these challenges. Their teams stay up to date with the code changes and train to help physicians document and bill for the new services amid the frequent policy and regulation changes. As physicians focus on providing the best care for their patients, they can partner with a reliable medical billing and coding company to successfully handle the complexities of billing and coding and optimize revenue cycle management.

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