Release of New HCPCS Codes Creates Spur to Action for Providers

The new Healthcare Common Procedural Coding System (HCPCS) codes were released on Nov. 6. These codes include supplies, medications, implants, surgeries, etc. The latest release contained 553 changes and updates to the coding system, including the following:

1. 343 additions;
2. 5 coverage and long description changes;
3. 50 long description changes;
4. 18 discontinued codes;
5. 7 coverage changes;
6. 126 payment changes; and
7. 4 short description changes.

With this release, it is important to begin to familiarize yourself with the new codes, deletions, and changes.

For charge description master (CDM) coordinators, the following tasks are imperative:

1. Review the new codes with the appropriate departments to determine if each should be included as of Jan. 1. Also, ask yourselves: do the new codes impact any supplies or implants?
2. Review discontinued codes to determine if you need to inactivate line items.
3. Update the codes with the description payment changes.
4. Update descriptions that were changed, as appropriate.

For the coding staff:

1. Review new codes for procedures that may be performed. Research CPT® Assistant for guidance on new procedures.
2. Review coverage changes for impact on medical necessity. 

The coverage changes may be shared with the ancillary departments and physician offices to promote documentation for medical necessity. It is best to get the documentation when the test/procedure has been ordered and before it has been performed.

These changes are effective for Jan. 1, 2024, so we have time to prepare. Remember to reach out to others in the revenue cycle if you have any questions.