Are You Prepared for CPT Code Updates in 2022? They will be implemented on January 1st!

It’s time to start implementing the annual CPT code updates. The code development process lasts the majority of the year, and it was completed and released in September. Because the modifications take effect on January 1 of each New Year, this gives time for electronic systems to implement them, and 2022 has a lot of them.

There are 249 new codes, 63 removals, and 93 revisions in all. Although your medical billing software should already have the coding alterations ready to go, it is still vital for medical practitioners and billing employees to understand what they are because input changes are frequently required to ensure the relevant codes are applied.

COVID-19 Vaccination Now Has More Codes

The SARS-CoV-2 coronavirus remains a key source of novel coding. A series of 15 vaccine-specific codes are included in the 2022 code set. These codes are intended not just to allocate reimbursement for services and vaccines, but also to give a means of reporting and tracking immunizations.

The American Medical Association (AMA) handles the codes, but in this case, it worked with the Centers for Disease Control and Prevention (CDC) to design vaccine coding to document which vaccine was provided and to enable vaccination scheduling, reporting, tracking, and analysis.

Medical billing staff can refer to the AMA’s Guidance, “Find your COVID-19 Vaccine CPT Codes,” for a complete list of vaccine and administration codes for Pfizer, Moderna, AstraZeneca, Janssen, and Novavax.

Unique codes for each vaccine’s first, second, third, and booster doses make tracking and assessing immunization in the American population easier.

COVID-19 Vaccine Coding Is Extensive

Although a booster is often a third dose of a vaccine, there are distinct criteria for the availability and timing of each administration, thus it is critical to document which is being given. This is an excellent example of how coding is utilized for reporting and tracking.

When it was discovered that the effects of the COVID-19 mRNA vaccinations faded over time, “booster” doses for adults were permitted. The booster should be administered at least six months after the last dosage of the vaccine, thus it could be a third or fourth dose, based on whether the person got an additional dose in their initial series.

Regardless of whether it is the third or fourth dosage, the booster six months later is coded with the appropriate vaccine code and the booster administration code, which differs depending on the vaccine.

Another key point to remember is that Pfizer has numerous different vaccination codes. The original formulation is denoted by 91300, whereas the newer formulation containing a tris-sucrose buffer is denoted by 91305. 91307 is the pediatric dose, which has been approved for children aged 5 to 11. Furthermore, separate extra codes are utilized to indicate which dose was administered.

Modifications to Digital Medicine in 2022

The COVID-19 pandemic prompted an urgent need to develop digital medicine, allowing patients to see doctors without being exposed to the virus or transferring it to healthcare workers. Beyond the epidemic, virtual access to medical aid has numerous advantages, and adoption is increasing.

New codes and explanations are being written to accommodate this new venue for service offering, but determining what is and is not permitted can be perplexing. The 2022 CPT code collection includes new codes as well as an appendix that includes the American Medical Association’s taxonomy to explain the types of digital medical services.

CPT Code Modifications in Variety of Fields

In addition to the COVID-19 and digital medicine codes, there are modifications for a variety of specializations. When the revised code set was announced in September, the American Medical Association (AMA) stated that 43 percent of the changes were “related to new technological services listed in Category III CPT Codes and the continuous expansion of the Proprietary Laboratory Analyses (PLA) section.”

The annual editing process is meant to ensure that the coding system stays up with the modern health care system, which includes digital health, precision medicine, and augmented intelligence, as defined by the American Medical Association. This year’s modifications also covered primary care management for patients with severe chronic conditions, as well as a variety of operations.

TMB’s objective is to give the assistance that healthcare providers and labs require to run profitable operations.

Our dedication to accessibility and communication ensures that our clients have access to their financial information as well as our employees, so you are never in the dark regarding the progress of your medical billing.

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