Dec 12, 2023
This is a summary of the new CPT codes and HOPPS changes for CY2024.
The course New CPT Codes and HOPPS Changes for CY2024 is available for purchase on HIAlearn.com. It is approved by both AHIMA and AAPC for 2.5 CEUs. This course goes in depth into the changes with additional descriptions of procedures with photos and explanations to help the coder and auditor better understand these sometimes complicated procedures.
For 2024, there are 230 new CPT codes added, 49 deleted and 70 revised.
Most of the changes were in the Category III section of CPT. 83 Category III codes were added with 32 deletions and 12 revisions. Many of these are surgical procedures so coders are encouraged to review these changes thoroughly. There were also significant additions to the Pathology subsection with 74 additions, 15 deletions and 25 revised codes.
The surgery section, where most coders spend their time had 23 code additions along with 10 revised codes.
Here are some highlights.
Musculoskeletal Sub-Section and Category III
There were 4 codes added and 6 revised. Three new codes were added for insertion, revision of anterior thoracic vertebral body tethering. The codes are divided by up to 7 segments or 8 or more. One Category III code was added for revision of thoracolumbar tethering. The other existing Category III codes for lumbar and thoracolumbar tethering were updated. There is another new code for arthrodesis of SI joint, percutaneous for placement of intra-articular implant(s). This is well described in our course and also compared to similar codes that can be confusing for the coder.
Respiratory Sub-Section
There were 2 codes added. These were for nasal endoscopy with destruction of posterior nasal nerve either by radiofrequency or cryoablation. It treats chronic refractory rhinitis.
Cardiovascular Sub-Section and Category III
There were 8 codes added. These were for various procedures involving a phrenic nerve stimulator system which is inserted into veins to help address respiratory conditions such as severe sleep apnea. Four codes in the medicine section were added for interrogation and programming.
A new medicine section code +92972 was added for percutaneous transluminal coronary lithotripsy replacing 0715T.
There were also several revisions to the introduction notes for pacemaker insertions. This is because there were 10 new Category III codes for various procedures involving LEADLESS DUAL CHAMBER pacemakers from insertion to revision to removal of individual components. These are pacemakers where the generator and electrode are combined into one device and inserted into the heart chambers.
There were also 4 category III codes added for various procedures involving RIGH ATRIAL LEADLESS pacemaker insertion.
Category III codes were added for removal and relocation of the two types of components of wireless cardiac stimulation system for left ventricular pacing.
Five codes in the medicine section were added for venography for congenital defects by vein location.
Two new Category III codes were added for percutaneous and open insertion of SVC/IVC valves for treatment of tricuspid regurgitation.
Finally, category code 0793T was added for transcatheter thermal ablation of nerves innervating pulmonary arteries. This treats pulmonary hypertension.
Urinary/Reproductive Sub-Sections and Category III
There were 2 codes added. One is 52284 for cystoscopy with mechanical urethral dilation with drug coated balloon for treating urethral stricture or stenosis in a male.
Code 58580 was added for transcervical ablation of uterine fibroids. This was old 0404T which was deleted.
Three category III codes were added, two for remote complex uroflowmetry and one for low intensity ESW of corpus cavernosum.
Nervous Sub-Section and Category III
There were 6 codes added and 4 revised. Three codes were created for insertion, revision or removal of a skull mounted cranial neurostimulator. Notes in this section were also updated to describe the difference between traditional “Separate” neurostimulators where there is a generator with separate electrode or lead, an “Integrated” neurostimulators that have the generator within the electrode so only one device is implanted. Several codes were updated in the section to describe that they were separate neurostimulators. And several new Category I codes as well as Category III codes were created for new integrated neurostimulators of various sites such as peripheral, sacral, spinal and posterior tibial. There is no subcutaneous pulse generator with integrated systems.
The neurostimulators and codes are described in detail in our course on the New CPT Codes and HOPPS Changes for CY 2024.
Ocular Sub-Section
One new code 67516 was created for suprachoroidal space injection of pharmacologic agent and a category code 0810T was created for subretinal injection of pharmacologic agent, including vitrectomy and 1 or more retinotomies.
Medicine Section
Two new add on codes were created for HIPEC otherwise known as intraoperative hyperthermic intraperitoneal chemotherapy.
Several other medicine codes were created for low level laser therapy for post op pain reduction, caregiver training without patient present, and many new vaccine codes.
Evaluation and Management Section
There was 1 code added and 10 revised. New instructions were added for Telemedicine Services criteria. The new code is +99459 an add on code for pelvic examination done with another E&M procedure. Both codes are reported.
There are new sections for “Split or Shared Visits” and “ Multiple Evaluation and Management Services on the Same Date” with thorough explanations of how to assign these codes. It is explained that only one QHCP can use the same time period when shared. Both QHCPs cannot bill for the same time. Who can bill when is also explained.
In addition, many of the E&M codes had times updated and re-established with explanation of how to use the new times. The ranges were replaced with a definitive time that must be met or exceeded.
Several “G” codes were established as well for principal illness navigator, SDOH risk assessment and community health integration (SDOH).
Coders must also be aware that there were 553 changes and updates to HCPCS Level II codes.
HOPPS Changes
There were no real big changes for HOPPS for CY2024. There is an overall INCREASE of payment rates of 3.1% for 2024 (3.3% increase reduced by 0.2 percentage point for the productivity adjustment). The Conversion factor for CY2024 is $87.382 for hospital the meet OQE requirements. Two new Comprehensive APCs (C-APCs) were developed, C-APC 5342 (Level 1 Abdominal/Peritoneal/Biliary and Related Procedures) and C-APC 5496 (Level 6 Intraocular APC). Table 2 in the final rule lists the C-APCs for CY 2024.
Payment will no longer be made for C9803 for COVID-19 tests and the code has been deleted.
229 Dental codes (CDT codes) had APCs assigned to them. However, the codes are only paid when strict requirements are met. The requirements are reviewed in our course on HIALearn.
There were 9 codes added to the inpatient only list, but they are all new CPT codes for CY2024.
The information contained in this post is valid at the time of posting. Viewers are encouraged to research subsequent official guidance in the areas associated with the topic as they can change rapidly.
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