As healthcare continues to evolve in response to technological innovation and changing patient expectations, coding professionals are at the forefront of documenting that transformation. The CPT® 2025 code set, released by the American Medical Association (AMA), reflects a clear shift toward the integration of artificial intelligence (AI), digital medicine, and remote monitoring services in mainstream clinical care.
With 270 new codes, 112 deletions, and 38 revisions, this year’s update is not just a refresh, it is a roadmap for the future of healthcare delivery.
Over the past several years, we have seen digital therapeutics (DTx), and monitoring tools emerge as novel, pilot-stage solutions to fill gaps in chronic disease management. In 2025, these tools have taken center stage, and CPT is catching up to clinical practice.
New codes have been added to support the following:
As more clinicians embrace these digital-first approaches, coding professionals and documentation specialists must ensure these services are correctly reflected in the medical record to support accurate billing, clinical outcomes tracking, and compliance with payer policies.
One of the most anticipated updates in CPT 2025 is the inclusion of codes that reflect AI-assisted diagnostic services, particularly in fields like radiology and pathology. These codes acknowledge that AI is not just a background tool, but an active participant in clinical decision-making.
However, these services bring unique documentation and coding challenges. For instance:
New CPT descriptors now explicitly require coding professionals to identify the level of automation and provider input, creating a demand for more nuanced documentation from clinicians. Coding professionals must be trained to recognize when AI is involved and ensure the record meets the payer requirements regarding human oversight and clinical validation.
As coding expands into these high-tech territories, the importance of documentation integrity cannot be overstated. Payers are rapidly updating policies to determine how and when these services qualify for reimbursement. Inconsistent documentation can lead to denials, audits, or overpayments, especially when AI or digital therapeutics are involved.
Organizations should proactively undertake the following:
CPT 2025 marks a new chapter in the evolution of clinical documentation. As services become increasingly virtual, intelligent, and remote, coding professionals are no longer just gatekeepers of reimbursement, they are strategic partners in healthcare innovation.
Coding professionals must remain agile, informed, and connected to both clinical and operational teams. This year’s changes highlight the importance of continuing education, interdisciplinary collaboration, and real-time adaptation to ensure organizations are ready to support and sustain digital health transformation.
CPT 2025 isn’t just about new codes, it’s about preparing for a future where digital tools, AI, and remote services are not the exception but the expectation. Coding professionals must lead the charge in ensuring that innovation is properly captured, compliant, and connected to the patient story. With the right training and mindset, we can support a system where quality, technology, and documentation work in seamless alignment.
Healthcare has been transitioning toward a more digital, interconnected ecosystem for many years, but the pace and magnitude of current changes represent a fundamental shift.
H.R. 1 doesn’t directly rewrite ICD-10 or CPT, but it does change the environment in which you’re coding. The impact is mostly indirect – through
Please log in to your account to comment on this article.
Accurately determining the principal diagnosis is critical for compliant billing, appropriate reimbursement, and valid quality reporting — yet it remains one of the most subjective and error-prone areas in inpatient coding. In this expert-led session, Cheryl Ericson, RN, MS, CCDS, CDIP, demystifies the complexities of principal diagnosis assignment, bridging the gap between coding rules and clinical reality. Learn how to strengthen your organization’s coding accuracy, reduce denials, and ensure your documentation supports true medical necessity.
Denials continue to delay reimbursement, increase administrative burden, and threaten financial stability across healthcare organizations. This essential webcast tackles the root causes—rising payer scrutiny, fragmented workflows, inconsistent documentation, and underused analytics—and offers proven, data-driven strategies to prevent and overturn denials. Attendees will gain practical tools to strengthen documentation and coding accuracy, engage clinicians effectively, and leverage predictive analytics and AI to identify risks before they impact revenue. Through real-world case examples and actionable guidance, this session empowers coding, CDI, and revenue cycle professionals to shift from reactive appeals to proactive denial prevention and revenue protection.
Sepsis remains one of the most frequently denied and contested diagnoses, creating costly revenue loss and compliance risks. In this webcast, Angela Comfort, DBA, MBA, RHIA, CDIP, CCS, CCS-P, provides practical, real-world strategies to align documentation with coding guidelines, reconcile Sepsis-2 and Sepsis-3 definitions, and apply compliant queries. You’ll learn how to identify and address documentation gaps, strengthen provider engagement, and defend diagnoses against payer scrutiny—equipping you to protect reimbursement, improve SOI/ROM capture, and reduce audit vulnerability in this high-risk area.
Only ICD10monitor delivers what you need: updates on must-know changes associated with the FY26 IPPS, including new ICD-10-CM/PCS codes, CCs/MCCs, and MS-DRGs, plus insights, analysis and answers to your questions from two of the country’s most respected subject matter experts.
As AI reshapes healthcare compliance, the risk of biased outputs and opaque decision-making grows. This webcast, led by Frank Cohen, delivers a practical Four-Pillar Governance Framework—Transparency, Accountability, Fairness, and Explainability—to help you govern AI-driven claim auditing with confidence. Learn how to identify and mitigate bias, implement robust human oversight, and document defensible AI review processes that regulators and auditors will accept. Discover concrete remedies, from rotation protocols to uncertainty scoring, and actionable steps to evaluate vendors before contracts are signed. In a regulatory landscape that moves faster than ever, gain the tools to stay compliant, defend your processes, and reduce liability while maintaining operational effectiveness.
Get clear, practical answers to Medicare’s most confusing regulations. Join Dr. Ronald Hirsch as he breaks down real-world compliance challenges and shares guidance your team can apply right away.
Federal auditors are zeroing in on Inpatient Rehabilitation Facility (IRF) and hospital rehab unit services, with OIG and CERT audits leading to millions in penalties—often due to documentation and administrative errors, not quality of care. Join compliance expert Michael Calahan, PA, MBA, to learn the five clinical “pillars” of IRF-PPS admissions, key documentation requirements, and real-life case lessons to help protect your revenue.
During this essential RACmonitor webcast Michael Calahan, PA, MBA Certified Compliance Officer, will clarify the rules, dispel common misconceptions, and equip you with practical strategies to code, document, and bill high-risk split/shared, incident-to & critical care E/M services with confidence. Don’t let audit risks or revenue losses catch your organization off guard — learn exactly what federal auditors are looking for and how to ensure your documentation and reporting stand up to scrutiny.
Prepare for the 2025 CMS IPPS Final Rule with ICD10monitor’s IPPSPalooza! Click HERE to learn more
Get 15% OFF on all educational webcasts at ICD10monitor with code JULYFOURTH24 until July 4, 2024—start learning today!
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 1 with code CYBER25
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24
