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By Leigh Poland
January 15, 2022
Part One of this three-part blog series on the 2022 CPT code set takes a high-level look at some of the driving factors behind the most noteworthy of the 405 changes taking effect on January 1, 2022.
When the 2022 Current Procedural Terminology (CPT) code set from the American Medical Association (AMA) takes effect on January 1, 2022, it ushers in 405 changes of varying significance. Among these are 249 additions, 63 deletions, and 93 revisions, which we will analyze in this three-part blog series.
Before we start our analysis, let’s briefly revisit why it’s so important that we, as coding professionals, stay current on annual CPT code updates. The short explanation is so we can do our jobs accurately and effectively.
Keeping up with the numerous coding changes issued each year by the AMA is simply not optional – regardless of how difficult it can be in some cases. Accurate coding ensures that facilities, physicians, and organizations have appropriate data to support high-quality patient care, as well as timely and proper reimbursement.
Because of the significant impact CPT codes have on the healthcare organization, staying abreast of changes goes beyond educating coding teams. Physicians and other key clinical staff must be made aware of the key changes and whether they require updates to clinical documentation to ensure coders can code to the highest level of specificity. It is also necessary to ensure all appliable systems and processes are updated, e.g., encoder software, computer-assisted coding tools, physician queries, and superbills.
Proper education and planning on the CPT code updates also results in quicker claim submission, averts claim denials, and prevents regulatory audits from outside agencies.
Among the noteworthy changes in the 2022 CPT code set are the addition of 15 codes specific to COVID-19 vaccines. These were developed by the AMA in consultation with the Centers for Disease Control and Prevention (CDC) to streamline reporting and tracking of the COVID-19 vaccines. The 2022 code set incorporates a series of 15 vaccine-specific codes, building upon the initial codes introduced in November 2020 to clinically distinguish each coronavirus vaccine and dosing schedule.
“Data-driven planning and resource allocation is vital for effective immunization programs that will bring the coronavirus pandemic to an end,” said AMA President Gerald E. Harmon, M.D., in a press release announcing the 2022 code set. “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.”
These changes can be found in the Medicine chapter under “Immunization Administration for Vaccines/Toxoids,” to which the AMA added administration codes 0001A-0042A and vaccine product codes 91300-91304. The AMA also created Appendix Q to assist coders in differentiating and selecting the appropriate SARS-CoV-2 (COVID-19) vaccine product codes and associated administration code(s).
The AMA also offers a vaccine code finder resource to help identify the appropriate CPT code combination for the type and dose of COVID-19 vaccine.
In addition to vaccine-related updates, the AMA regularly expands and enhances the CPT code set to capture emerging procedures, services, and technology and service paradigms. For example, 43% of editorial changes in 2022 are tied to new technology services described in Category III CPT codes. A few notable additions are:
Other editorial changes related to new technology are found in the expansion of the Proprietary Laboratory Analyses (PLA) section of the code set.
Innovations in digital medicine services drove several other changes to the 2022 CPT code set. Among these are five new codes (98975, 98976, 98977, 98980, 98981) to report therapeutic remote monitoring, which expand on the remote physiologic monitoring codes created in 2020.
New time-based CPT codes (99424, 99425, 99426, 99427) were also created under a new heading, Principal Care Management Services. These services focus on establishing, implementing, revising, or monitoring a care plan that is specific to a disease for medical and/or physiological needs that are displayed for a single, complex chronic condition.
The next two installments in this blog series will take a more in-depth look at the CPT code set changes. Part Two takes a deep dive into the changes to the Evaluation and Management and Surgery sections, and Part Three covers changes to the Anesthesia, Pathology and Laboratory, Medicine and Category III sections.
Once you have a deeper understanding of what’s new and different for this year, you’ll need to evaluate how best to implement them into your organization’s coding process. Many find it is most effective and efficient to enlist the assistance of a third-party to help with the heavy lifting.
AGS Health offers multiple solutions to prepare your team further for the CPT code updates. We would love to talk to you further about our tools and services to support your team with the use of the numerous code updates and guidelines. Contact us for more information.
Leigh Poland RHIA, CCS
Leigh has over 20 years of coding experience and has worked in the coding and education realm over the last 20 years. Her true passion is coding education making sure coders are equipped to do their job accurately and with excellence. Academically, Leigh has graduated from Louisiana Tech University with a Bachelor of Science. Leigh has had the opportunity to present many times in the past at the AHIMA, ACDIS, and AAPC National Conventions. She has been a guest speaker on AHIMA webinars and has written several articles that were published in the AHIMA Journal. Leigh has traveled the US and internationally providing coding education.
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