Samuel A. Collins
question: Have any of your Current Procedural Terminology (CPT) codes changed this year?
Current Procedural Terminology (CPT) codes are codes that describe services provided to patients, from tests, treatments, x-rays, and more. Some years may see notable changes, such as 2021, when ratings and ratings were completely revamped. Management Services (E&M). Let’s take a look at the changes that apply to acupuncturists in 2024.
Billing based on time
In 2024, office visit codes 99202-99205 and 99212-99215 were revised to remove the minute time “range” from each code. Instead, clinicians billing based on time must meet or exceed a single “minimum time threshold.” This revision now indicates a minimum time that must be completed or exceeded.
For example, 99202 indicates that the minimum time that must be met or exceeded is 15 minutes, and the range of 15 to 29 minutes is no longer indicated. This makes it clear that the time required is minimal. This time includes in-person as well as activities that are part of the test. This may occur before or after face-to-face time with the patient.
The updated coding instructions are as follows: As a special note, code 99201 is of course gone and 99202 is now the lowest level for new patients. Her 99211 in an established patient also does not change and has no time element. Each code now simply indicates a minimum amount of time that must be met or exceeded.
Code 99202-99205
99202 Office or other outpatient visits for new patient evaluation and management. This requires a medically appropriate medical history and/or examination. Frank Medical decision making. If the total time on the encounter date is used for code selection, 15 minutes must be met or exceeded.
99203 Office or other outpatient visits for new patient evaluation and management. This requires a medically appropriate medical history and/or examination. low level Refers to medical decision making. If the total time on the encounter date is used for code selection, half an hour must be met or exceeded.
99204 Office or other outpatient visits for new patient evaluation and management. This requires a medically appropriate medical history and/or examination. medium level Medical decision making. If the total time on the encounter date is used for code selection, 45 minutes must be met or exceeded.
99205 Office or other outpatient visits for new patient evaluation and management. This requires a medically appropriate medical history and/or examination. advanced Medical decision making. If the total time on the encounter date is used for code selection, 60 minutes must be met or exceeded.
Code 99212-99215
(Remember, 99211 has not changed. An office or other outpatient visit for the evaluation and management of an established patient, which may not require the presence of a physician or other qualified health care professional. there is.)
99212 Office or other outpatient visits for the evaluation and management of established patients requiring a medically appropriate history and/or examination. Frank Medical decision making. If the total time on the encounter date is used for code selection, 10 minutes must be met or exceeded.
99213 Office or other outpatient visits for the evaluation and management of established patients requiring a medically appropriate history and/or examination. low level Medical decision making. If the total time on the encounter date is used for code selection, 20 min must be met or exceeded.
99214 Office or other outpatient visits for the evaluation and management of established patients requiring a medically appropriate history and/or examination. medium level Medical decision making. If the total time on the encounter date is used for code selection, half an hour must be met or exceeded.
99215 Office or other outpatient visits for the evaluation and management of established patients requiring a medically appropriate history and/or examination. advanced Medical decision making. If the total time on the encounter date is used for code selection, 60 minutes must be met or exceeded.
Note that if you are using time to select E&M services, it is essential to document the specific time in your notes. If the code selection is based on a medical decision, there is no requirement that a minimum time be met. However, more complex ones often take longer.
Other considerations
There are no changes to acupuncture coding or services. Remember that time is a required element, not just an insertion point. This is true whether you have one set or multiple sets. Each set requires its own face time and insertion point.
There were no changes to the physical drug code. However, reviews from major carriers show that acupuncture providers often do not accurately document timed services. This is the number one reason why acupuncturists are subject to review and refunds if not documented.
Time must follow the 8-minute rule and document the total number of minutes spent in-person or round-trip time. Most carriers seem to prefer and want the time to be documented with a “from” and “to”. For example, instead of just 20 minutes, specify 20 minutes from 9:15 to 9:35.
Editor’s note: Have questions about billing? Email Sam at sam@hjrossnetwork.com. By submitting, you confirm that your question may be the subject of a future column.
