The American Medical Association’s (AMA’s) 2020 update of the CPT code set comprises 394 code changes, including 248 new codes, 71 deletions, and 75 revisions. A thorough understanding of these changes is important for correct coding and reimbursement for the services represented by these codes. Coders in reliable medical billing and coding companies stay up-to-date on annual code changes and are well-positioned to help physicians report services and procedures correctly.
The 2020 CPT code changes, which come into effect on January 1, were made based on broad input from physicians, medical specialty societies and the greater health care community. Here are the highlights and implications of the updates:
- 6 new CPT codes to report e-visits: Electronic visits (e-visits) help patients who would otherwise find it difficult to pay for medical care or have to travel long distances. Digital health tools address this concern by allowing patients and physicians to communicate asynchronously and outside of office settings. In 2020, there are 6 new CPT codes for reporting a range of digital health services including e-visits through secure patient portal messages.
- 99421, 99422 and 99423 describe patient-initiated digital communications with a physician or other qualified health professional
- 98970, 98971 and 98972 represent patient-initiated digital communications with a nonphysician health professional
- 2 new codes for home blood-pressure monitoring: Also spurred by the popularity of digital health tools, new codes 99473 and 99474 will allow reporting self-measured blood pressure monitoring. Tracking blood pressure at home helps patients take an active role in the process and enables physicians to better diagnose and treat hypertension.
Commenting on the new codes for digital health services, AMA President Patrice A. Harris, MD, MA said, “With the advance of new technologies for e-visits and health monitoring, many patients are realizing the best access point for physician care is once again their home….The new CPT codes will promote the integration of these home-based services that can be a significant part of a digital solution for expanding access to health care, preventing and managing chronic disease, and overcoming geographic and socioeconomic barriers to care.”
- Updates for health and behavior assessment and intervention services: New codes 96156, 96158, 96164, 96167, and 96170, and add-on codes 96159, 96165, 96168, and 96171 for health and behavior assessment and intervention services will replace six older codes. According to the AMA, this update is intended to “more accurately reflect current clinical practice that increasingly emphasizes interdisciplinary care coordination and teamwork with physicians in primary care and specialty settings.”
- Significant enhancements for reporting long-term electroencephalographic (EEG) monitoring services (95700-95726):Monitoring the electrical activity of the brain is critical to diagnose epilepsy. Four older codes have been deleted to make way for 23 new codes for long-term electroencephalographic (EEG) monitoring services. According to the AMA, the new codes provide better clarity around the services reported by a technologist, a physician, or another qualified health care provider.
Other approved CPT changes for 2020 according to a March 2019 AAPC article include:
- A new code to report a quadrivalent inactivated-adjuvanted influenza virus vaccine
- Deletion of cardiac device evaluation code 93299 Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results
- A new category III code to report an assay of cancer stem cell
- Two new category III codes to report autologous cellular implant
- A new category III code to report evacuation of meibomian glands
- Addition of two category III codes to report transcervical bilateral permanent fallopian tube occlusion and the separate introduction of saline for confirmation of occlusion via sonosalpingingraphy
- Deletion of codes 21296 Reduction of masseter muscle and bone (eg, for treatment of benign masseteric hypertrophy); intraoral approach and 43401 Transection of esophagus with repair, for esophageal varices due to low utilization
Companies that provide coding and medical billing services review the changes to codes as well as reporting instructions as they are announced. With legible, complete and accurate clinical documentation, expert AAPC-certified coders can help physicians report the correct codes and ensure proper reimbursement for their services.