2021 CPT Code Updates
It’s the most wonderful time of the year…annual CPT code updates! Who doesn’t love a good code update, right? Well, for 2021, AMA gives the people what they want with the release of 329 changes to CPT as outlined below and all changes going into effect January 1, 2021.
· 206 new codes
· 54 code deletions
· 69 code revisions
Keep reading to get a peek at some of the significant changes in 5 of the main sections of CPT.
Evaluation and Management
The hottest CPT code update this year is of course, the changes made to evaluation and management codes for office and other outpatient visits (99201-99215). AMA made its first major changes in more than 25 years to codes and guidelines from this section of CPT. The revisions are designed to make documenting and coding, new and established outpatient office visits, simpler and more flexible and to reduce administrative burden.
Revisions to E/M office visit codes include:
· Eliminating the key components of history and physical exam from code selection
· Code selection based on medical decision making or total time (Physician’s choice)
· Guidelines and code descriptions updated with additional details
The URL below is a link to an AMA webpage with tools and resources to aid with the transition to using the revised E/M codes. https://www.ama-assn.org/practice-management/cpt/cpt-evaluation-and-management
Although the Surgery section is the largest section of CPT there were only 11 new codes added for 2021. However, significant updates were made to code descriptions, with revisions to provide clarification about extent of procedure, and several other codes were deleted or otherwise revised. Additionally, major revisions were made to the breast repair and reconstruction section with extensive changes to the guidelines and code descriptions. Listed below are some examples.
The language added to the description (shown in bold here for illustration purposes) of code 29822 clarifies the extent of work represented by a surgical shoulder arthroscopy that is specified as limited.
· 29822 Arthroscopy, shoulder, surgical; debridement, limited, 1 or 2 structures (eg, humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anchor complex, labrum, articular capsule, articular side of the rotator cuff, bursal side of the rotator cuff, sub-acromial burse, foreign body[ies])
The edits made to code 19342 simplify the description, making it easier for the coder to decide when it is appropriate to assign this code.
· 19342 Delayed insertion or replacement of breast prosthesis following mastopexy, mastectomy, or in reconstruction, implant on separate day from mastectomy.
Changes to the Radiology section for 2021 were minimal. Notable modification include the addition of a new code for CT scans of the thorax, without contrast, to screen for lung cancer, 71271, and deletion of code 76970 Ultrasound study follow-up (specify).
Pathology and Laboratory
Major updates to Pathology and Laboratory include the addition of new codes related to combating the COVID-19 public health emergency. Several codes to report testing for SARS-CoV-2 have been released periodically since April 2020 which will become permanent parts of the CPT code classification on January 1, 2021. Other codes released in 2020 and valid for use in 2021 will not be published in the CPT codebook until 2022.
Significant additions to Path and Lab include a substantial number of new codes, 80+, that were added to the Proprietary Laboratory Analyses (PLA) section of CPT. Additions to this section include the release of the 5 PLA codes listed below which are related to testing for SARS-CoV-2.
· 0202U to report the BioFire® Respiratory Panel 2.1 test (Publication 2021)
· 0223U, 0224U, 0225U and 0226U for detection of SARS-CoV-2 (Publication 2022)
· 0240U detection of SARS-CoV-2, Influenza A and Influenza B (Publication 2022)
· 0241U detection of SARS-CoV-2, Influenza A and Influenza B and RSV (Publication 2022)
The full list of COVID-19 related path and lab codes which are new for 2021 and their descriptions can be downloaded from this link to the AMA website: https://www.ama-assn.org/practice-management/cpt/covid-19-cpt-coding-and-guidance
The Medicine section of codes saw impactful updates in several areas.
The Medicine section was also affected by the addition of new codes to report COVID-19 related services (some with publication dates in 2021 and some in 20220), specifically the addition of two codes to report coronavirus vaccines (91300, 91301) and four codes to report their administration (0001A, 0002A, 0011A, 0012A). The addition of these new codes, necessitated updates to the immunization administration guidelines that direct how to report these codes correctly.
For more information on the new CPT codes for COVID-19 immunizations, visit this link: https://www.ama-assn.org/practice-management/cpt/covid-19-cpt-vaccine-and-immunization-codes
Diabetes Screening and Care
New code 92229 allows providers to report point of care automated analysis and reporting of retinal imaging for detection or monitoring of disease. The technology underlying this code allows diabetic patients improved access to screening for diabetic retinopathy by bringing the analysis into the primary care setting through point of care testing.
Continuous Cardiac Monitoring
Eight new codes, 93241, 93242, 93243, 93244, 93245, 93246, 93247, 93248, as well as new guidelines, were added to the Cardiovascular Monitoring Services range of codes. These codes are used to report continuous cardiac monitoring and detection and will replace Category III codes 0295T, 0296T, 0297T and 0298T. These codes allow reporting of external EKG recordings for more than 40 hours and up to 7 days or for more than 7 and up to 15 days.
CPT 2021 has many additions, revisions and deletions In addition to the updates covered here. So, to be prepared to put your best coding foot forward come January 1st, be sure to pull out your new CPT book and take some time to look at the code and guidelines changes that affect your day to day code assignments the most.
View the AMA press release for CPT Code Updates Here.
For more coding resources, visit MRA’s coding solutions page here.