Reimbursement News

2022 CPT Code Set Released, Streamlines Medical Coding for COVID-19

AMA released the 2022 CPT code set, which includes new medical coding and documentation standards for COVID-19 vaccinations, among other updates.

AMA releases 2022 CPT code set

Source: American Medical Association

By Jacqueline LaPointe

- The new 2022 Current Procedural Terminology (CPT) code set aims to streamline medical coding and documentation of COVID-19 vaccinations, among other updates.

The code set released today by the American Medical Association (AMA) provides an annual update to CPT codes, including the addition of new codes developing during the COVID-19 pandemic. AMA reported that the 2022 CPT code set incorporates 12 vaccine-specific codes that “are the model for efficiently reporting and tracking immunizations and administrative services against the coronavirus (SARS-CoV-2).”

“Data-driven planning and resource allocation is vital for effective immunization programs that will bring the coronavirus pandemic to an end,” Gerald E. Harmon, MD, president of the AMA, said in an announcement today. “Correlating each coronavirus vaccine and dosing schedule with its own unique CPT code has provided necessary analytical advantages to help track, allocate and optimize resources for immunization programs across the United States.”

AMA first unveiled vaccine-specific codes in November 2020 in preparation for emergency use authorizations from the Food and Drug Administration (FDA). FDA later authorized the use of three COVID-19 vaccines from Pfizer and BioNTech, Moderna, and Johnson & Johnson, respectively.

Just recently, FDA also granted full approval to the vaccine from Pfizer and BioNTech and plans to roll out a third dose of the vaccine to patients to boost immunity. The agency plans to do the same for the Moderna vaccine when the company submits data showing the efficacy of a booster shot.

AMA has released vaccine-specific codes, including those for the administration of third doses, before FDA authorizations or approvals to help providers prepare for medical coding and documentation. The codes are now also part of the 2022 CPT code set, according to the recent announcement.

The 2022 CPT code set includes other changes, which total 405 in total this year. The changes include 249 new codes, 63 deletions, and 93 revisions.

“The CPT code set continues to see growth in new and novel areas of medicine with 43 [percent] of editorial changes tied to new technology services described in Category III CPT codes and the continued expansion of the Proprietary Laboratory Analyses (PLA) section of the CPT code set,” AMA stated in the announcement.

AMA also said the coding changes reflect medical coding demands of innovative care delivery, such as digital health, precision medicine, and augmented intelligence. For example, the Association announced the addition of five new codes in the 2022 CPT code set (98975, 98976, 98977, 98980, 98981) to support innovation in digital medicine services. The codes can be used to report therapeutic remote monitoring, which has become extremely popular during the COVID-19 pandemic.

The codes also expand on remote physiologic monitoring codes that were created in 2020 (99453, 99454, 99457, 99458), AMA stated.

Additionally, AMA highlighted new codes for principal care management. The codes (99424, 99425, 99426, 99427) will enable physicians and qualified healthcare professionals to code care management services for a patient with a complex chronic condition.

“Medicare policy for principal care management services has been evolving and the new CPT codes, along with revisions to existing CPT codes for care management, better align with Medicare guidelines,” AMA stated. “These CPT changes add to nearly a decade of coding content work that respond to the reporting needs of physicians and others who help manage the chronic conditions of America’s aging population.”

Providers can learn more about new CPT codes using the 2020 code set’s appendix. Among other items, the new appendix offers a taxonomy for digital medicine services “that supports increased awareness and understanding of approaches to patient care through the multifaceted digital medicine services available for reporting in the CPT code set.”

AMA will also host two virtual events in November, the Outpatient CDI Workshop and the CPT and RBRVS 2022 Annual Symposium.

2022 CPT codes and their descriptors can be imported directly into healthcare software solutions using the downloadable CPT 2022 Data File.