COVID Code Consolidation, Spanish-Language Options, RSV Highlight Looming Code Changes

COVID Code Consolidation, Spanish-Language Options, RSV Highlight Looming Code Changes

This past Friday, the American Medical Association (AMA) announced the much-anticipated release of the 2024 CPT® code set; however, there’s a bit of a catch. 

The code set is only available on the AMA’s Intelligent Platform to those in the healthcare industry that are licensed to use the CPT standard data file.

The big reveal of the 230 additions, 49 deletions, and 70 revisions will take place during the virtual AMA CPT Symposium over the course of three days, from Nov. 15-17.  

For those of us who have pre-ordered our CPT books, now we must wait patiently for them to ship, which typically occurs by the end of October or first week of November.

The AMA shared a few of the changes in a press release.

For those who speak Spanish, the AMA has included Spanish descriptors for its 11,163 procedures and services in order to bridge the language gap that currently exists, and to make healthcare more inclusive to those who speak Spanish.

One of the major changes for 2024 is the consolidation of more than 50 codes used to report COVID-19 vaccines, along with the approval of provisional codes 91318-91322 used for the reporting of the monovalent vaccine products from Moderna and Pfizer. Once the monovalent vaccines are approved by the U.S. Food and Drug Administration (FDA), these provisional codes will be effective.

Another notable addition is code 90480, which will be used to report COVID-19 vaccine administration, which replaces all previously approved product-specific vaccine administration codes (which will in turn negate some of the troublesome reporting errors).                                                                                                                                                                            Also, we will have five new CPT codes for reporting Respiratory Syncytial Virus, commonly known as RSV, which, per the AMA, will lead to “better tracking, reporting, and analysis that supports data-driven planning and allocation.”

Next, the AMA provides a glimpse into the evaluation and management (E&M) revisions, which are clarifications that were sought out by Centers for Medicare & Medicaid Services (CMS). 

First, the CPT editorial panel removed the time ranges from the office and other outpatient codes 99202-99215 in order to align with the format with the rest of the E&M codes.

Next, per the AMA, we will have a definition to determine the “substantive portion” of a split and/or shared E&M service between a physician and non-physician practitioner. It will be interesting to see if the definition has any impact when CMS releases the Medicare Physician Fee Schedule proposed rule for 2025.

Lastly, CPT will provide clearer instructions for codes 99234-99236, which are used when reporting hospital inpatient or observation care with admission and discharge services, when the patient stay spans two calendar dates. 

The AMA keeps the remaining changes close to their vest. Now, we sit and patiently wait for November.

About the Author:

Angela Jordan serves as executive vice president for Calm Waters AI. She oversees the development and implementation of ChartPal, a service that provides physicians and non-physician practitioners with coding and documentation reviews to inform customized education to improve documentation accuracy and compliance. 

Jordan brings three decades of medical coding, documentation, and compliance experience to her position. She has been a national member of the AAPC since 2000 and a member of AAPC’s National Advisory Board. She is a frequent presenter and lecturer on coding and compliance topics at national conferences and symposiums.  

Immediately prior to joining Calm Waters AI, Jordan served as senior manager, Advisory Solutions for Dallas-based Ventra Health, where she provided coding and compliance education and audit and litigation support for the organization’s clients. She holds credentials as a Certified Professional Coder (CPC), a Certified Professional Medical Scribe (CPMS) and Certified Obstetrics Gynecology Coder (COBGC).

Facebook
Twitter
LinkedIn

Angela Jordan, CPC, CPMS, COBGC

Angela Jordan serves as executive vice president for Calm Waters AI. She oversees the development and implementation of ChartPal, a service that provides physicians and non-physician practitioners with coding and documentation reviews to inform customized education to improve documentation accuracy and compliance. Jordan brings three decades of medical coding, documentation, and compliance experience to her position. She has been a national member of the AAPC since 2000 and a member of AAPC’s National Advisory Board. She is a frequent presenter and lecturer on coding and compliance topics at national conferences and symposiums. Immediately prior to joining Calm Waters AI, Jordan served as senior manager, Advisory Solutions for Dallas-based Ventra Health, where she provided coding and compliance education and audit and litigation support for the organization’s clients. She holds credentials as a Certified Professional Coder (CPC), a Certified Professional Medical Scribe (CPMS) and Certified Obstetrics Gynecology Coder (COBGC).

Related Stories

Leave a Reply

Please log in to your account to comment on this article.

Featured Webcasts

The Cost of Ignoring Risk Adjustment: How HCCs Impact Revenue & Compliance

The Cost of Ignoring Risk Adjustment: How HCCs Impact Revenue & Compliance

Stop revenue leakage and boost hospital performance by mastering risk adjustment and HCCs. This essential webcast with expert Cheryl Ericson, RN, MS, CCDS, CDIP, will reveal how inaccurate patient acuity documentation leads to lost reimbursements through penalties from poor quality scores. Learn the critical differences between HCCs and traditional CCs/MCCs, adapt your CDI workflows, and ensure accurate payments in Medicare Advantage and value-based care models. Perfect for HIM leaders, coders, and CDI professionals.  Don’t miss this chance to protect your hospital’s revenue and reputation!

May 29, 2025
I050825

Mastering ICD-10-CM Coding for Diabetes and it’s Complications: Avoiding Denials & Ensuring Compliance

Struggling with ICD-10-CM coding for diabetes and complications? This expert-led webcast clarifies complex combination codes, documentation gaps, and sequencing rules to reduce denials and ensure compliance. Dr. Angela Comfort will provide actionable strategies to accurately link diabetes to complications, improve provider documentation, and optimize reimbursement—helping coders, CDI specialists, and HIM leaders minimize audit risks and strengthen revenue integrity. Don’t miss this chance to master diabetes coding with real-world case studies, key takeaways, and live Q&A!

May 8, 2025
2025 Coding Clinic Webcast Series

2025 ICD-10-CM/PCS Coding Clinic Update Webcast Series

Uncover critical guidance. HIM coding expert, Kay Piper, RHIA, CDIP, CCS, provides an interactive review on important information in each of the AHA’s 2025 ICD-10-CM/PCS Quarterly Coding Clinics in easy-to-access on-demand webcasts, available shortly after each official publication.

April 14, 2025

Trending News

Featured Webcasts

Medicare Advantage 2026: Navigating New Rules, Denial Protections & SDoH Shifts

Medicare Advantage 2026: Navigating New Rules, Denial Protections & SDoH Shifts

Stay ahead of Medicare Advantage’s 2025-2026 regulatory changes in this critical webcast featuring expert Tiffany Ferguson, LMSW, CMAC, ACM. Learn how new CMS rules limit MA plan denials, protect hospitals from retroactive claim reopenings, and modify Two-Midnight Rule enforcement—plus key insights on omitted SDoH mandates and heightened readmission scrutiny. Discover actionable strategies to safeguard revenue, ensure compliance, and adapt to evolving health equity priorities before the June 2025 deadline. Essential for hospitals, revenue cycle teams, and compliance professionals navigating MA’s shifting landscape.

May 28, 2025
Navigating the 3-Day & 1-Day Payment Window: Compliance, Billing, and Revenue Protection

Navigating the 3-Day & 1-Day Payment Window: Compliance, Billing, and Revenue Protection

Struggling with CMS’s 3-Day Payment Window? Join compliance expert Michael G. Calahan, PA, MBA, CCO, to master billing restrictions for pre-admission and inter-facility services. Learn how to avoid audit risks, optimize revenue cycle workflows, and ensure compliance across departments. Critical for C-suite leaders, providers, coders, revenue cycle teams, and compliance teams—this webcast delivers actionable strategies to protect reimbursements and meet federal regulations.

May 15, 2025
Audit-Proof Your Wound Care Procedures: Expert Insights on Compliance and Risk Mitigation

Audit-Proof Your Wound Care Procedures: Expert Insights on Compliance and Risk Mitigation

Providers face increasing Medicare audits when using skin substitute grafts, leaving many unprepared for claim denials and financial liabilities. Join veteran healthcare attorney Andrew B. Wachler, Esq., in this essential webcast and master the Medicare audit process, learn best practices for compliant billing and documentation, and mitigate fraud and abuse risks. With actionable insights and a live Q&A session, you’ll gain the tools to defend your practice and ensure compliance in this rapidly evolving landscape.

April 17, 2025
Utilization Review Essentials: What Every Professional Needs to Know About Medicare

Utilization Review Essentials: What Every Professional Needs to Know About Medicare

Dr. Ronald Hirsch dives into the basics of Medicare for clinicians to be successful as utilization review professionals. He’ll break down what Medicare does and doesn’t pay for, what services it provides and how hospitals get paid for providing those services – including both inpatient and outpatient. Learn how claims are prepared and how much patients must pay for their care. By attending our webcast, you will gain a new understanding of these issues and be better equipped to talk to patients, to their medical staff, and to their administrative team.

March 20, 2025

Trending News

Happy National Doctor’s Day! Learn how to get a complimentary webcast on ‘Decoding Social Admissions’ as a token of our heartfelt appreciation! Click here to learn more →

CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24