When it comes to code system updates, changes to the Current Procedural Terminology (CPT) codes are some of the most important to stay on top of. With their close link to billing and reimbursement needs, falling behind can quickly impact your organization’s bottom line. Below, we’re highlighting five major takeaways from this year’s updates – with a link to more in-depth coverage for those who want to learn more.
- CPT’s 2023 edition includes approximately 10,969 codes – reflecting 225 additions, 75 deletions, and 93 revisions. There are also multiple revisions and additions to the CPT guidelines.
- As COVID-19 vaccine guidelines evolved to include a second booster dose and inoculations for the pediatric population, coding structures have also matured. The 2023 guide includes seven new product codes and 20 administration codes – with the addition of an adult booster only code – as well as specific pediatric population codes for patients aged 5-11 years, six months to 4 years, and six months to 5 years.
- Similarly, the 2023 edition addresses new, emerging concerns related to monkeypox and smallpox. With respect to monkeypox, the Centers for Disease Control and Prevention (CDC) has aligned with the World Health Organization’s (WHO’s) terminology change from monkeypox to Mpox. A new code for laboratory testing, 87593, and two new codes related to mpox and smallpox vaccines, 90611 and 90622, were added to this year’s manual.
- There are two new codes for bariatric surgery – specifically esophagogastroduodenoscopy (EGD) with bariatric balloon. Code 43290 indicates EGD with deployment of an intragastric bariatric balloon(s), while 43291 denotes EGD with removal of intragastric bariatric balloon(s).
- Finally, a new code 30469 indicating repair of nasal valve collapse with radiofrequency codifies a procedure that has been performed since 2017. However, the procedure’s recent, increasing frequency indicates a clinical need for a designated procedure code.
For an in-depth look at the code set adjustments, watch IMO’s on-demand webinar, Highlights from the 2023 CPT code set update, featuring coding experts June Bronnert and Shelly Jude.
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