For 2024, significant updates will be introduced to ICD-10, CPT, and HCPCS, affecting medical practices, hospitals, and healthcare systems across the country. Medical knowledge, technological advancements, and healthcare practices continue to evolve, so coding systems must keep up. To ensure the accuracy of billing, documentation, and reimbursement, changes are made to the International Classification of Diseases (ICD), Current Procedural Terminology (CPT), and Healthcare Common Procedure Coding System (HCPCS) codes every year.
We will cover the changes you can expect in this newsletter as well as how to navigate these changes.
Overview of 2024 ICD-10, CPT, and HCPCS Coding Changes
ICD-10, CPT, and HCPCS Coding updates for 2024 reflect a continued focus on streamlining documentation, addressing emerging healthcare needs, and improving revenue cycle efficiency. Here’s a high-level summary of what’s coming in each of the three major code sets:
- ICD-10-CM/PCS: New diagnostic codes are being added and existing codes are being revised, aiming to improve diagnosis specificity and accuracy, particularly in mental health, infectious diseases, and substance abuse.
- CPT: The 2024 updates include new codes for digital health services, artificial intelligence (AI)-driven medical tools, and expanded categories for telemedicine and remote monitoring. A number of revisions have also been made in order to simplify complicated procedures and clarify existing codes.
- HCPCS Level II: Several new codes were added, revised, or deleted, reflecting the availability of new drugs, medical devices, durable medical equipment (DME), and biologicals in the healthcare system.
ICD-10-CM and ICD-10-PCS Updates for 2024
ICD-10-CM (diagnosis codes) and ICD-10-PCS (procedure codes) updates for 2024 include adding, revising, and deleting codes in order to better reflect the diagnosis and treatment of medical conditions. To ensure that diagnostic and procedural codes are aligned with current medical practices, the Centers for Disease Control and Prevention (CDC) and the Centers for Medicare & Medicaid Services (CMS) oversee these changes.
Key Changes in ICD-10-CM for 2024
- Mental Health and Substance Use Disorders: It is now possible to capture diagnoses related to mental health conditions, including anxiety disorders, depression, and substance abuse disorders, using a number of new codes. In light of the continuing importance of mental health in public health, these new codes are intended to help diagnose, treat, and track patient outcomes more effectively.
- Infectious Diseases: New codes for viral infections, long-term sequelae of infectious diseases, and emerging diseases have been added to ICD-10-CM, reflecting the ongoing impact of infectious diseases, especially post-COVID-19 complications.
- Neurological Disorders: A variety of neurological conditions have been updated, including Parkinson’s disease, epilepsy, and other movement disorders. These updates can assist in documenting progress and treatment plans more precisely.
- Trauma and Injury: A number of changes were made in trauma and injury codes, particularly in regards to burns, fractures, and poisonings. These revisions aim to enhance specificity, which is crucial for coding associated with emergency room visits, trauma care, and rehabilitation services.
Key Changes in ICD-10-PCS for 2024
- Minimally Invasive Procedures: The ICD-10-PCS update for 2024 includes new codes for advanced laparoscopic and robotic-assisted procedures, reflecting the ongoing shift towards less invasive surgery. Various medical fields, including gynecology and cardiothoracic surgery, are adopting minimally invasive techniques in increasing numbers.
- Imaging and Diagnostic Procedures: New imaging codes are available for specialized MRI, CT scans, and nuclear medicine that employ advanced AI algorithms. These codes reflect advancements in diagnostic technology, particularly in the field of AI-assisted diagnostic tools.
- Expanded Options for Rehabilitation Services: This update also covers physical, occupational, and speech therapy. These updates reflect new treatments, such as virtual rehabilitation and new therapeutic devices that help patients recover from surgeries, strokes, and traumatic injuries.
CPT 2024 Updates
CPT code set updates have been introduced by the American Medical Association (AMA), which oversees them. As healthcare services evolve, telemedicine, remote patient monitoring, and AI-driven diagnostics will be incorporated into these changes.
Key Additions to CPT for 2024
- Telemedicine and Remote Patient Monitoring: CPT updates for 2024 include new codes for remote patient monitoring, digital consultations, and virtual care management as telehealth continues to grow post-pandemic. For healthcare providers to receive appropriate reimbursement, these codes are essential for capturing care provided through virtual platforms.
- AI and Machine Learning Tools: In healthcare, artificial intelligence is increasingly being integrated into diagnostics, treatment planning, and care management, among other notable trends. AI-based diagnostic tools, including imaging analysis and predictive analytics for chronic conditions, have been added to the CPT codes for 2024.
- Procedural Clarifications and Simplifications: Healthcare providers have been updated with procedures codes to simplify documentation requirements and reduce administrative burdens. These include codes for surgical procedures, diagnostic tests, and interventional therapies.
Deletions and Revisions in CPT for 2024
- Deletion of Obsolete Codes: To streamline the code set, a number of outdated codes, particularly those relating to procedures that are no longer commonly used, have been removed. This reduces confusion and prevents coding errors.
- Revised Surgical and Diagnostic Codes: Current medical practices have led to revisions to the surgical and diagnostic codes. For instance, changes made to cardiac procedure codes increase clarity in stent placement and ablation documentation.
HCPCS Level II Updates for 2024
Medicare and Medicaid patients are primarily billed using the Healthcare Common Procedure Coding System (HCPCS), but durable medical equipment (DME), prosthetics, orthotics, and supplies are also coded with this system. Many changes have been made to address the latest healthcare products and therapies in the 2024 updates.
Key HCPCS Updates for 2024
- New Drug and Biologic Codes: HCPCS has developed new codes to accommodate the latest gene therapies, monoclonal antibodies, and advanced cancer treatments, as they enter the market. These codes include the latest gene therapies, monoclonal antibodies, and advanced cancer treatments. In order to ensure proper reimbursement, healthcare providers must learn these new codes.
- Durable Medical Equipment (DME): Several new HCPCS codes have been added to represent updated DME, including advanced prosthetics, orthotic devices, and mobility aids, enabling patients to access the most advanced rehab and home healthcare technologies.
- Codes for Advanced Wound Care: New codes have been introduced for high-tech dressings, bioengineered tissues, and negative pressure wound therapy (NPWT) devices, reflecting advances in wound care products. Patients with chronic wounds or post-surgical recovery needs require these products to improve outcomes.
- Revisions to Existing Codes: In addition to introducing new codes, many existing medical devices, drugs, and biologicals codes have been revised to improve clarity and accuracy.
Preparing Your Practice for 2024 Coding Changes
Maintaining compliance and maximizing reimbursement depends on keeping up with coding updates. Here are some steps healthcare organizations can take to stay on top of the 2024 ICD-10, CPT, and HCPCS coding updates:
- Staff Education and Training: Coders and billing staff should take formal training sessions, webinars, or certification programs to ensure that they are knowledgeable about the latest changes to ICD-10, CPT, and HCPCS.
- Update Coding Software and Tools: Make sure that your system is up-to-date with the new 2024 coding changes by working with your EHR and billing vendors. Automating code updates can help prevent errors and claims processing delays.
- Review and Audit Current Practices: Audit your current coding and medical billing practices to identify areas that may need to be adjusted to the 2024 updates. This will help you address any potential issues before they impact your revenue cycle.
- Communicate with Payers: Communicate closely with your payers and Medicare/Medicaid representatives to make sure you are aware of any specific requirements or changes related to the 2024 coding updates. These actions can help you avoid denials and ensure timely payments.
- Leverage Outsourcing and Expert Support: To ensure accuracy and compliance while minimizing the burden on your in-house staff, consider outsourcing coding services to professionals who specialize in ICD-10, CPT, and HCPCS codes.
Medical documentation and billing will undergo an important evolution in 2024 with the updates to ICD-10, CPT, and HCPCS coding systems. Healthcare organizations can maximize reimbursement, reduce claim denials, and ensure compliance by staying informed about these changes and taking proactive steps to prepare. It’s time to review these updates and make the necessary changes for the coming year, whether you’re a small practice or a large health system.