Widely-used billing codes have been updated for 2024, including new ones for respiratory syncytial virus (RSV) vaccines and medications, and new Spanish translations.
The American Medical Association (AMA) last week released the Current Procedural Terminology (CPT) 2024 Code Set. The update included 349 editorial changes, including 230 additions, 49 deletions and 70 revisions. With more than 11,100 codes in use, the CPT system continues "to grow and evolve with the rapid pace of innovation in medical science and health technology," AMA said.
The AMA said the CPT update includes five new codes created to report product-specific RSV products (90380, 90381, 90683, 90679, and 90678) for better tracking, reporting and analysis that supports data-driven planning and allocation, AMA said.
There's been a flurry of new US vaccines and drugs to address RSV, a highly contagious virus that can cause infections of the lungs and breathing passages.
The Food and Drug Administration (FDA) in May granted the first US approval of an RSV vaccine to Arexy, manufactured by GSK. The FDA cleared it for prevention of lower respiratory tract disease caused by RSV in adults age 60 years and older.
In June, Pfizer won FDA approval of Abrysvo, another vaccine meant to protect adults older than 60 years from RSV. The following month, the FDA approved nirsevimab (Beyfortus, AstraZeneca/Sanofi), for the prevention of RSV in neonates and infants entering their first RSV season, and in children up to 24 months of age who remain vulnerable to severe RSV disease through their second RSV season. (As Medscape previously reported, this is not a vaccine, but a monoclonal antibody used for prevention. There has been confusion on this issue in part because monoclonal antibodies are often used for treatment rather than prevention.)
The FDA also has approved Abrysvo for use in pregnant individuals.
In addition, new CPT codes aim to streamline COVID-19 immunizations reporting. A new code (90480) was approved for reporting the administration of any COVID-19 vaccine for any patient. New provisional codes (91318-91322) will identify monovalent vaccine products from Moderna and Pfizer for immunization against COVID-19.
These provisional codes will be effective for use when the monovalent vaccine products from Moderna and Pfizer receive FDA approval, AMA said.
More Codes Explained In Spanish
The 2024 update includes more code descriptions in Spanish. Many hospitals, health plans and medical offices already incorporate CPT descriptors in English-language medical documents, insurance forms, price sheets, and patient portals. This expansion is intended to help patients who may not read English well or at all.
"Providing approximately 41 million Spanish speaking individuals in the United States with an easy-to-understand description of medical procedures and services can help build a more inclusive healthcare environment, where language is no longer a barrier and patients can actively engage in their own care," Lori Prestesater, AMA's senior vice president of health solutions, said in a statement.
In addition, the 2024 update includes clarifications sought by the Centers for Medicare & Medicaid Services about the reporting of evaluation and management (E/M) services. The revisions include:
Removal of time ranges from office or other outpatient visit codes (99202-99205, 99212-99215) and format alignment with other E/M codes
Definition of the "substantive portion" of a split/shared E/M visit in which a physician and a non-physician practitioner work jointly to furnish all the work related to the visit
Instructions for reporting hospital inpatient or observation care services and admission and discharge services for the use of codes 99234-99236 when the patient stay crosses over two calendar dates
Kerry Dooley Young is a freelance journalist based in Washington, D.C. Follow her on Mastodon and Threads as @kerrydooleyyoung.
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Cite this: CPT Updates for 2024 Include New RSV Vaccines, Spanish Translation - Medscape - Sep 14, 2023.