CPT 2024 Anticipated Code Changes
Category III codes will be converted to Category I codes in the Current Procedural Terminology (CPT®) 2024 code set, these include dorsal sacroiliac (SI) arthrodesis; coronary fractional flow reserve (FFR) with computerized tomography (CT); coronary intravascular lithotripsy (IVL) interventions; transcervical radiofrequency ablation (RFA) of uterine fibroids; and cardiac intraoperative ultrasound services (IOUS). This article provides an overview of the anticipated changes in 2024.
Revisions will be made within several subsections of the evaluation and management (E/M) section to standardize the rest of the E/M sections of the CPT code set in an effort to decrease providers’ administrative burden of documentation as outlined in Medicare’s 2023 Final Rule. In addition, a new E/M subsection with new guidelines for split or shared services will be created. The new codes will be structured to align with the current E/M office or other outpatient services code structure.
There will be revisions to the reporting guidelines for unlisted service codes for various sections of the CPT 2024 code set to reflect the appropriate use of unlisted codes when reporting with other services.
CPT 2024 CODE SET: NEW CATEGORY I CODES
The new Category I codes will be available on January 1, 2024, and are summarized below.
Transcervical RFA of Uterine Fibroids
Transcervical RFA of uterine fibroids includes intraoperative ultrasound guidance and monitoring, a minimally invasive procedure that includes real-time intrauterine ultrasound guidance for the treatment of symptomatic uterine fibroids (ie, leiomyomas) will be converted from Category III code 0404T to a new Category I code.
Dorsal SI Joint Arthrodesis
Category III code 0775T will be converted to a Category I code to report percutaneous arthrodesis of the SI joint using an intra-articular implant(s) without the placement of a transfixation device across the joint. The new Category I code will enable the reporting of percutaneous intra-articular placement of one or more fusion implants directly into the SI joint under imaging guidance. This is usually performed from a posterior approach.
In contrast, existing code 27279 is used to report the percutaneous placement of a transfixation device, such as a screw, across the SI joint to perform the fusion. This is usually performed from a lateral approach.
Coronary FFR with CT
Codes 0501T-0504T will be converted to a single, new Category I code to report non-invasive estimated coronary FFR derived from augmentative artificial intelligence (AI)
software analysis of coronary CT angiography (CCTA) data.
Coronary IVL Interventions
Coronary IVL is a revascularization technique used to treat heavily calcified coronary arteries using pulsatile sonic pressure waves that pass through soft tissue and selectively interact with highdensity calcium to produce shear stresses that fracture the calcium.
A new Category I add-on code will replace Category III code 0715T to report percutaneous transluminal coronary lithotripsy.
Cardiac IOUS
Cardiac IOUS are used to evaluate cardiovascular structures, provide intraoperative guidance, and provide real-time perioperative surgical decision-making information that may affect the intraoperative strategy (eg, changing cannulation strategies, altering bypass targets, and identifying additional defects).
Four new Category I codes will be available to report cardiac IOUS, which are used primarily in cardiothoracic surgery procedures, including epiaortic ultrasound and congenital epicardial echocardiography.
REVISIONS TO E/M CODES
Additional revisions will be made to the E/M codes in 2024 as part of the work of the AMA/Specialty Society Relative Value Scale (RVS) Update Committee (RUC) to decrease the administrative burden of documentation outlined in Medicare’s 2023 Final Rule.
The following updates will include:
• Time ranges will be removed from the office or other outpatient visit codes for codes 99202-
99205 and 99212-99215 to align with the format of other E/M codes.
• The portion of physician’s services that may be reported for split (or shared) visits will be
defined.
• Reporting instructions will be added for codes 99234-99236 [(hospital inpatient or
observation care services) (including admission and discharge services)] when the duration
of the visit crosses over two calendar dates.
Telemedicine Office Visits
A CPT/RUC Telemedicine Office Workgroup was created to assess and develop appropriate coding guidance for E/M telemedicine office visits performed via audio-visual and audio-only mechanisms.
The workgroup determined that a new E/M subsection with new guidelines for telemedicine services will be established in the CPT 2024 code set.
The new codes will align with the current E/M office or other outpatient services code structure (ie, using time or medical decision-making [MDM]) with separate codes for new and established patient encounters and the addition of a virtual check-in code that could be used to determine whether a patient needs a face-to-face visit.
Codes 99441, 99442, and 99443 will be deleted.
Reporting Guidelines for Unlisted Codes
In 2024, revisions will be made to various sections of the CPT code set that contain unlisted service codes to reflect their appropriate use when reporting with other services.
An unlisted code workgroup was established by the CPT Editorial Panel to evaluate the use of unlisted service codes. The workgroup addressed how unlisted codes are used in conjunction with existing Category I and III codes during the same intervention and whether there is a need for guidance on their appropriate use.
REVISED CODES
The following E/M codes will be revised in the CPT 2024 code set:
99202 Office or other outpatient visits for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision-making. When using time for code selection, 15-29 minutes of total time is spent on the date of the encounter 99203 Office or other outpatient visits for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using time for code selection, 30-44 minutes of total time is spent on the date of the encounter 99204 Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and a moderate level of medical decision making. When using time for code selection, 45-59 minutes of total time is spent
on the date of the encounter 99205 Office or other outpatient visits for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and a high level of medical decision-making. When using time for code selection, 60-74 minutes of total time is spent on the date of the encounter
99212 Office or other outpatient visits for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision-making. When using time for code selection, 10-19 minutes of total time is spent on the date of the encounter
99213 Office or other outpatient visits for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and a low level of medical decision-making. When using time for code selection, 20-29 minutes of total time is spent on the date of the encounter
99214 Office or other outpatient visits for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and a moderate level of medical decision-making. When using time for code selection, 30-39 minutes of total time is spent on the date of the encounter
99215 Office or other outpatient visits for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and a high level of medical decision-making. When using time for code selection, 40-54 minutes of total time is spent on the date of the encounter
99306 Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and a high level of medical decision making. When using the total time on the date of the encounter for code selection, 45 minutes must be met or exceeded
99308 Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and a low level of medical decision-making. When using the total time on the date of the encounter for code selection, 15 minutes must be met or exceeded
DELETED CODES
The codes below will be deleted from the CPT 2024 code set:
99441 Telephone evaluation and management service by a physician or other qualified healthcare professional who may report evaluation and management services provided to an
established patient, parent, or guardian not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24
hours or soonest available appointment; 5-10 minutes of medical discussion
99442 Telephone evaluation and management service by a physician or other qualified healthcare professional who may report evaluation and management services provided to an
established patient, parent, or guardian not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24
hours or soonest available appointment; 11-20 minutes of medical discussion
99443 Telephone evaluation and management service by a physician or other qualified health care professional who may report evaluation and management services provided to an
established patient, parent, or guardian not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24
hours or soonest available appointment; 21-30 minutes of medical discussion
0404T Transcervical uterine fibroid(s) ablation with ultrasound guidance, radiofrequency
0501T Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic
simulation software analysis of functional data to assess the severity of coronary artery disease; data preparation and transmission, analysis of fluid dynamics, and simulated
maximal coronary hyperemia, generation of estimated FFR model, with anatomical data review in comparison with the estimated FFR model to reconcile discordant data, interpretation and report
0502T Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic
simulation software analysis of functional data to assess the severity of coronary artery disease; data preparation and transmission
0503T Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic
simulation software analysis of functional data to assess the severity of coronary artery disease; analysis of fluid dynamics and simulated maximal coronary hyperemia, and
generation of estimated FFR model
0504T Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic
simulation software analysis of functional data to assess the severity of coronary artery disease; anatomical data review in comparison with estimated FFR model to reconcile
discordant data, interpretation, and report
0715T Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure)
0775T Arthrodesis, sacroiliac joint, percutaneous, with image guidance, includes placement of intra-articular implant(s) (eg, bone allograft)
Category III codes will be converted to Category I codes in the Current Procedural Terminology (CPT®) 2024 code set, these include dorsal sacroiliac (SI) arthrodesis; coronary fractional flow reserve (FFR) with computerized tomography (CT); coronary intravascular lithotripsy (IVL) interventions; transcervical radiofrequency ablation (RFA) of uterine fibroids; and cardiac intraoperative ultrasound services (IOUS). This article provides an overview of the anticipated changes in 2024.
Revisions will be made within several subsections of the evaluation and management (E/M) section to standardize the rest of the E/M sections of the CPT code set in an effort to decrease providers’ administrative burden of documentation as outlined in Medicare’s 2023 Final Rule. In addition, a new E/M subsection with new guidelines for split or shared services will be created. The new codes will be structured to align with the current E/M office or other outpatient services code structure.
There will be revisions to the reporting guidelines for unlisted service codes for various sections of the CPT 2024 code set to reflect the appropriate use of unlisted codes when reporting with other services.
CPT 2024 CODE SET: NEW CATEGORY I CODES
The new Category I codes will be available on January 1, 2024, and are summarized below.
Transcervical RFA of Uterine Fibroids
Transcervical RFA of uterine fibroids includes intraoperative ultrasound guidance and monitoring, a minimally invasive procedure that includes real-time intrauterine ultrasound guidance for the treatment of symptomatic uterine fibroids (ie, leiomyomas) will be converted from Category III code 0404T to a new Category I code.
Dorsal SI Joint Arthrodesis
Category III code 0775T will be converted to a Category I code to report percutaneous arthrodesis of the SI joint using an intra-articular implant(s) without the placement of a transfixation device across the joint. The new Category I code will enable the reporting of percutaneous intra-articular placement of one or more fusion implants directly into the SI joint under imaging guidance. This is usually performed from a posterior approach.
In contrast, existing code 27279 is used to report the percutaneous placement of a transfixation device, such as a screw, across the SI joint to perform the fusion. This is usually performed from a lateral approach.
Coronary FFR with CT
Codes 0501T-0504T will be converted to a single, new Category I code to report non-invasive estimated coronary FFR derived from augmentative artificial intelligence (AI)
software analysis of coronary CT angiography (CCTA) data.
Coronary IVL Interventions
Coronary IVL is a revascularization technique used to treat heavily calcified coronary arteries using pulsatile sonic pressure waves that pass through soft tissue and selectively interact with highdensity calcium to produce shear stresses that fracture the calcium.
A new Category I add-on code will replace Category III code 0715T to report percutaneous transluminal coronary lithotripsy.
Cardiac IOUS
Cardiac IOUS are used to evaluate cardiovascular structures, provide intraoperative guidance, and provide real-time perioperative surgical decision-making information that may affect the intraoperative strategy (eg, changing cannulation strategies, altering bypass targets, and identifying additional defects).
Four new Category I codes will be available to report cardiac IOUS, which are used primarily in cardiothoracic surgery procedures, including epiaortic ultrasound and congenital epicardial echocardiography.
REVISIONS TO E/M CODES
Additional revisions will be made to the E/M codes in 2024 as part of the work of the AMA/Specialty Society Relative Value Scale (RVS) Update Committee (RUC) to decrease the administrative burden of documentation outlined in Medicare’s 2023 Final Rule.
The following updates will include:
• Time ranges will be removed from the office or other outpatient visit codes for codes 99202-
99205 and 99212-99215 to align with the format of other E/M codes.
• The portion of physician’s services that may be reported for split (or shared) visits will be
defined.
• Reporting instructions will be added for codes 99234-99236 [(hospital inpatient or
observation care services) (including admission and discharge services)] when the duration
of the visit crosses over two calendar dates.
Telemedicine Office Visits
A CPT/RUC Telemedicine Office Workgroup was created to assess and develop appropriate coding guidance for E/M telemedicine office visits performed via audio-visual and audio-only mechanisms.
The workgroup determined that a new E/M subsection with new guidelines for telemedicine services will be established in the CPT 2024 code set.
The new codes will align with the current E/M office or other outpatient services code structure (ie, using time or medical decision-making [MDM]) with separate codes for new and established patient encounters and the addition of a virtual check-in code that could be used to determine whether a patient needs a face-to-face visit.
Codes 99441, 99442, and 99443 will be deleted.
Reporting Guidelines for Unlisted Codes
In 2024, revisions will be made to various sections of the CPT code set that contain unlisted service codes to reflect their appropriate use when reporting with other services.
An unlisted code workgroup was established by the CPT Editorial Panel to evaluate the use of unlisted service codes. The workgroup addressed how unlisted codes are used in conjunction with existing Category I and III codes during the same intervention and whether there is a need for guidance on their appropriate use.
REVISED CODES
The following E/M codes will be revised in the CPT 2024 code set:
99202 Office or other outpatient visits for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision-making. When using time for code selection, 15-29 minutes of total time is spent on the date of the encounter 99203 Office or other outpatient visits for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using time for code selection, 30-44 minutes of total time is spent on the date of the encounter 99204 Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and a moderate level of medical decision making. When using time for code selection, 45-59 minutes of total time is spent
on the date of the encounter 99205 Office or other outpatient visits for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and a high level of medical decision-making. When using time for code selection, 60-74 minutes of total time is spent on the date of the encounter
99212 Office or other outpatient visits for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision-making. When using time for code selection, 10-19 minutes of total time is spent on the date of the encounter
99213 Office or other outpatient visits for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and a low level of medical decision-making. When using time for code selection, 20-29 minutes of total time is spent on the date of the encounter
99214 Office or other outpatient visits for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and a moderate level of medical decision-making. When using time for code selection, 30-39 minutes of total time is spent on the date of the encounter
99215 Office or other outpatient visits for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and a high level of medical decision-making. When using time for code selection, 40-54 minutes of total time is spent on the date of the encounter
99306 Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and a high level of medical decision making. When using the total time on the date of the encounter for code selection, 45 minutes must be met or exceeded
99308 Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and a low level of medical decision-making. When using the total time on the date of the encounter for code selection, 15 minutes must be met or exceeded
DELETED CODES
The codes below will be deleted from the CPT 2024 code set:
99441 Telephone evaluation and management service by a physician or other qualified healthcare professional who may report evaluation and management services provided to an
established patient, parent, or guardian not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24
hours or soonest available appointment; 5-10 minutes of medical discussion
99442 Telephone evaluation and management service by a physician or other qualified healthcare professional who may report evaluation and management services provided to an
established patient, parent, or guardian not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24
hours or soonest available appointment; 11-20 minutes of medical discussion
99443 Telephone evaluation and management service by a physician or other qualified health care professional who may report evaluation and management services provided to an
established patient, parent, or guardian not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24
hours or soonest available appointment; 21-30 minutes of medical discussion
0404T Transcervical uterine fibroid(s) ablation with ultrasound guidance, radiofrequency
0501T Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic
simulation software analysis of functional data to assess the severity of coronary artery disease; data preparation and transmission, analysis of fluid dynamics, and simulated
maximal coronary hyperemia, generation of estimated FFR model, with anatomical data review in comparison with the estimated FFR model to reconcile discordant data, interpretation and report
0502T Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic
simulation software analysis of functional data to assess the severity of coronary artery disease; data preparation and transmission
0503T Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic
simulation software analysis of functional data to assess the severity of coronary artery disease; analysis of fluid dynamics and simulated maximal coronary hyperemia, and
generation of estimated FFR model
0504T Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic
simulation software analysis of functional data to assess the severity of coronary artery disease; anatomical data review in comparison with estimated FFR model to reconcile
discordant data, interpretation, and report
0715T Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure)
0775T Arthrodesis, sacroiliac joint, percutaneous, with image guidance, includes placement of intra-articular implant(s) (eg, bone allograft)