Not grandmother’s CPT: code set evolves amid pandemic, salary challenges

Mark Synovec, MD, chairs the editorial board of the CPT, which is responsible for maintaining what is sometimes called “the language of medicine”, the current procedural terminology (CPT®) code set. The editorial board, he said, has acted nimbly to adapt to the rapidly evolving challenges of the pandemic, digital health and more.

“We are not your grandmother’s CPT,” said Dr Synovec, also chairman of the Topeka pathology group, chairman of the pathology section of the branch council of the AMA Specialty and Service Society and speaker at AMA Specialty and Service Society. opening during the CPT.® and RBRVS Annual Symposium 2022. The event took place again virtually due to the COVID-19 pandemic.

There have been 405 changes in total to the CPT code set for 2022, including 249 codes added, 63 codes deleted and 93 revised codes, noted Dr Synovec. Also new is a streamlined process to quickly develop codes related to COVID-19 and post them on WADA’s website for immediate use.

These include 12 new and 40 revised codes for diagnostic tests and 28 vaccine related codes which have been conveniently compiled into an appendix (PDF) of the CPT code set. “The CPT Vaccine Coding Caucus got up to the minute to get them through the process,” said Dr Synovec.

Symposium presentations are available on request by registering at

Part of WADA’s COVID-19 CPT Guide, the “Find Your COVID-19 Vaccine CPT Codes” resource

helps you determine the correct combination of CPT codes for the type and dose of vaccine you are administering.

Learn more about how CPT codes keep pace with COVID-19 vaccine development.

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Another COVID-19 code developed by the CPT Editorial Board and assigned by the AMA / Specialty Society RVS Update Committee (RUC) was 99072. This code could be used for billing for supplies, equipment and additional clinical staff time in addition to that typically included in office or outpatient services performed during a public health emergency (PHE) due to infectious diseases transmitted through the respiratory tract.

The CPT code came into effect in September 2020. The Centers for Medicare & Medicaid Services (CMS), however, consider these additional expenses to be a “bundled service” and, so far, do not cover the 99072 as a separate payment to the. Medicare title.

The RUC continues to urge CMS to immediately implement and pay for CPT code 99072 to recognize the increased expense due to infection control practices required to immunize and safely care for patients during PHE.

CMS officials, in the 2022 Medicare Physician Payment Schedule, said “we appreciate comments from commentators and will consider those comments in the context of potential future regulation.”

Gift Tee, director of the practitioner services division of CMS Hospital and Ambulatory Policy Group, presented at the symposium and focused on the changes included in the 2022 schedule and acknowledged upcoming Medicare payment cuts. CMS was required by law to make the pay cuts and that Congress should pass legislation to avoid those pay cuts, he explained.

For example, a 3.75% increase in Medicare physician payments is slated for 2021. “This is a legal provision that CMS does not have the power to change,” Tee said.

Without action from Washington, a 9.75% reduction in Medicare physician payments will take effect Jan. 1, 2022. Join other physicians and take action to reverse these cuts and protect access to care.

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New CPT codes for coronavirus vaccines: what you need to know

Virtual attendees asked about improvements to CMS policies regarding shared or shared Assessment and Management (M / M) visits, and billing questions relating to office, clinic or clinic ownership. the hospital where the services were provided.

“The documentation in the medical record should identify the two people who made the visit,” Tee said. “The person providing the substantial part must sign and date the medical file. “

Physicians who work as Medicare Contract Medical Directors (CMDs) participated in a question-and-answer session of the symposium and offered their advice on billing and documentation regarding these visits.

Gary Oakes, MD, a CMD with Noridian Healthcare Solutions, advised simply recording what was done for the patient, by whom and how long it took so that if another doctor needed to take over, he or she it can pick up where the previous one left off.

“This is really what we’re looking for,” said family physician Dr Oakes. Her recurring tip: “Tell the story of what you did today for this patient.

Likewise, Laurence Clark, MD, also CMD at Noridian, said not to hang on to the property of the facility where the care was being provided.

“You should be basing yourself on what it really is – if it’s an office, it’s an office,” said Dr. Clark, an internist. “If the hospital owns it, it’s still an office.

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