CPT, Medicare, and E/M Coding: Stay Informed with 2024 Updates

2024 Healthcare Essentials: A Triple Session on CPT Coding, Medicare, and E/M Updates for 2024

SESSION 1- CPT Coding Updates for 2024 | SPEAKER NAME: Jill M. Young

Webinar Description

Each year the AMA releases revisions, deletions and additions to its CPT® coding book. There are 153 new codes for 2024.  Included in the new codes are several in the Surgery subsections such as the Musculoskeletal, Respiratory, Cardiovascular, Urinary, Female Genital and Nervous Systems. There are also new codes in the Radiology section as well as the Pathology and Laboratory sections.   Several of the new codes are Category III codes that are being “upgraded” to Category I codes or regular CPT® codes.

The 2024 edition of CPT® also has 349 editorial changes scattered throughout the book along with 49 deleted and 70 revised codes.  Some of the revisions are in unlisted codes, those ending in 99 that are found in sections throughout The CPT® book.

Most noteworthy is the CPT®’s definition of split shared visits.  The AMA has opened up a bit of a can of worms in this by offering entirely new scenarios for split shared visits that digress significantly from the ones that CMS has. Joined this webinar to know more about the code changes.

Webinar Objectives

Each year practices need to be aware and understand the implications of the coding changes that are released.   A code in 2023 that was appropriate for use, may not be in 2024 because of a new code, revised guidelines or a revision in the text of the code itself.  Lost revenue can easily occur in these situations because of mis-coding and the need to appeal.  This session will walk the listener through the changes released for 2024 and give them a better understanding of the codes.  This will give them better options in making sure their code assignment is compliant.

Webinar Agenda

Starting with the new definition CPT® has for split shared visits, a brief discussion of how it varies from CMS’ will ensue.  Then the presenter will go through the various sections of the CPT® book, making note of not only new codes but changes in language and changes in guidelines. 

Webinar Highlights

• Split shared visits and CPT®’s new guidelines for them
• Revisions to the guidelines for unlisted services found throughout the CPT® book
• Revisions to the time intervals for Office and Other Outpatient services, what do you need to change in your practice model
• Category  III codes deleted that are now Category I CPT® codes
• CPT®’s policies for telehealth in 2024
• Other new codes

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SESSION 2- E/M Coding Updates | SPEAKER NAME: Lynn M. Anderanin

Webinar Description

Ensuring Adequate Documentation to Prevent Denials and Penalties

In recent years, the Evaluation and Management (E&M) section of CPT® has undergone significant transformations, and the year 2024 is no exception. With a focus on enhancing efficiency in documentation and simplifying the process, revisions are set to address concerns surrounding the latest documentation guidelines. Additionally, a new CPT® code is being introduced within the E&M section, offering opportunities for providers. Furthermore, changes are in the works for the CMS Physicians Fee Schedule Final rule in 2024, particularly impacting E&M services delivered via telehealth, now that the Public Health Emergency has concluded.

Webinar Objectives

• Exploring the Significance of E&M Codes in Various Physician Specialties
• Understanding the Determination of Service Levels Through Medical Documentation Review
• Analyzing the Flexibility in Choosing Methods for Each Patient
• Examining Reimbursement Variations Across Service Levels
• Addressing Recent Changes and Common Concerns in E&M Coding
• Highlighting the Role of Insurance Audits in Detecting Fraud and Abuse, and Their Impact on Reimbursement and Penalties

Webinar Agenda

• Exploring the Changes in E&M Coding Requirements
• Identifying Necessary Documentation Adjustments
• Ensuring Documentation Adequacy for Code Compliance
• Emphasizing the Role of Education and Knowledge Sharing for Staff
• Understanding the Importance of Accurate and Comprehensive Documentation

Webinar Highlights

• Revisions to many codes by clarifying the requirements when time is the chosen method
• Description changes for shared/split visits
• Can we now report multiple E&M visits on the same day?
• New guidelines related to codes in which to determine the level of service is time.
• Inpatient and observation guideline changes
• Addition of guidelines and tables for the prolonged service with direct contact
• The first year of an E&M code as an add on for pelvic examinations

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SESSION 3- Medicare Updates | SPEAKER NAME: Jill M. Young

Webinar Description

Beyond the Basics: Uncovering the Hidden Impact of PFS Final Rule on Medicare Practices

The release of the Final Rule for the Medicare Physician Fee Schedule 2024 is a pivotal moment, offering crucial insights for the upcoming year's services. This comprehensive rule outlines the changes that Medicare/CMS intends to make to HCPCS (and CPT) codes, encompassing policies, procedures, and code modifications. Recognizing the appropriate codes for 2024 is vital for offices preparing for the new year, as it involves not only potential additions to the PFS but also alterations in code descriptors aligned with CMS/Medicare-defined policies and procedures. Notably, there are ongoing Public Health (PHE) flexibilities under the Medicare Diabetes Prevention Program (MDPP) Expanded Model. Despite the conclusion of PHE in 2023, 2024 will see CMS/Medicare defining "exceptions" or "allowances" to the MDPP program.

In this informative session led by Jill M. Young, CEMA, CPC, CEDC, CIMC, participants will gain valuable tips on efficiently searching and accessing information within the extensive 2,000+ pages of the final rule document. Jill will share her personal insights, uncovering hidden gems of information within the rule to enhance participants' understanding of the upcoming changes.

Webinar Objectives

The Physician Fee Schedule (PFS) final rule is a powerful document that is often overlooked in an office educating itself for the upcoming year. Within this document, Medicare establishes and updates its distinct set of policies and procedures. Failure to identify specific changes affecting Medicare patients can lead to issues such as inaccurate billing and coding, overlooked modifiers, and, ultimately, revenue loss. Attending this session, participants will gain insights into solutions for potential challenges in 2024 concerning Medicare patients. Notably, the discussion will focus on the impactful Visit Complexity Add-On code, a code not universally applicable to all physicians. CMS/Medicare provides precise guidance on the appropriate usage and frequency of this code, making this discussion crucial for all participants.

Webinar Highlights

• Adoption of the Office and other Evaluation & Management Visit Complexity add on code
• Behavioral Health Services updates
• Updates to codes and policies for Telehealth Service
• New allowances and codes for Caregiver Training Services
• Social Determinants of Health (SDOH) Risk Assessment
• Community Health Integration (CHI) and Principal Illness Navigation (PIN) services
• Continuing Public Health (PHE) flexibilities under the Medicare Diabetes Prevention Program (MDPP) Expanded Model

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