Deleted, Revised, and New CPT Codes for 2023

Adjustments to evaluation and management codes will require a period of adaptation.

Within the CPT 2023 update, medical coders will encounter 101 fresh codes interspersed within the existing code set. However, it is the modified and removed codes that demand your utmost scrutiny.

Deleted CPT Codes for 2023

To comprehend the altered evaluation and management (E/M) codes, we must begin by examining the codes that have been omitted from that segment of CPT® 2023. Prepare yourselves!

•  Beneath the Hospital Observation Services section, the codes for observation care discharge services (cpt code 99217), initial observation care (cpt code99218-cpt code 99220), and subsequent observation care (cpt code 99224-cpt code 99226) have been removed.
• Within the Consultations category, the code for office consultation (cpt code 99241) and inpatient consultation (cpt code 99251) are no longer included.
• The code for other nursing facility services (cpt code 99318) has been eliminated. Codes pertaining to domiciliary, rest home, or home care plan oversight (99339 and 99340) have been removed, along with custodial care codes (99334-99337) for established patients and (cpt code 99324-cpt code 99328) for new patients in those settings.
• Under the Home Services heading, the code for home visits involving new patients (cpt code 99343) has been deleted.
• Additional codes that have been removed include the prolonged services add-on codes (cpt code 99354-cpt code 99357).

Moreover, several Category III codes have been expunged for the year 2023.The services represented by these codes may have either transitioned to become Category I codes or were considered outdated. Additionally, laparoscopy codes (cpt code 49652-cpt code 49657) have also been removed.

Revised CPT Codes for 2023

The adjustment of E/M observation codes, among others, prompted the American Medical Association (AMA) to revise the descriptions of numerous codes within the E/M section. As an illustration:

Within the Hospital Inpatient Services category, the codes for initial hospital care (cpt code 99221-cpt code 99223), subsequent hospital care (cpt code 99231-cpt code 99233), observation or inpatient care services (99234-99236), and hospital discharge services (cpt code 99238-cpt code 99239) have been altered to incorporate “inpatient or observation care.”

The office or other outpatient consultation codes (cpt code 99242-cpt code 99245) and inpatient consultation codes (99252-99255) under the Office or Other Outpatient Consultation heading are revised to include “office or other outpatient consultation.”

Revisions to other codes conform to AMA’s guideline modifications for E/M leveling based on time or medical decision making (MDM). For instance, the emergency department codes (cpt code 99281-cpt code 99285), initial and subsequent nursing facility care codes (cpt code 99304-cpt code 99310), and home services codes (cpt code 99341-cpt code 99342, cpt code 99344-cpt code 99350) are modified to necessitate a medically appropriate history “and/or” examination and MDM, rather than all three key components.

The nursing facility discharge codes (cpt code 99315-cpt code 99316) are altered to specify that the time must be “on the date of the encounter.”

The prolonged service code (99417) is revised to clarify that this code is intended for an outpatient E/M service, as opposed to an “office or other outpatient” E/M service. Worth noting is that the phrase “on the date of the primary service” has been removed.

Additionally, in the E/M section, there are slight adjustments to the descriptors of interprofessional telephone/internet/electronic health record consultation codes (cpt code 99446-cpt code 99449, cpt code 99451), cognitive assessment and care plan services code (99483), and transitional care management codes (cpt code 99495-cpt code 99496).

New CPT Codes for 2023

In the E/M section, there is one final alteration: While cpt code 99417 will now apply to prolonged services within the outpatient setting, a novel code, 99418, will encompass prolonged services for inpatient or observation care (instead of cpt code 99356-cpt code 99357).

Within the Surgery segment of CPT® 2023, new codes have emerged across various subsections. For instance:

Within the Integumentary subsection, three fresh codes are designated for absorbable mesh implantation and suture removal.

The Musculoskeletal System subsection introduces just one new code for total disc arthroplasty. In the Cardiovascular subsection, surgeons have five additional codes for reporting percutaneous pulmonary artery revascularization through stent placement (cpt code 33900-cpt code 33904) and two new codes for reporting percutaneous arteriovenous fistula creation in the upper extremity (cpt code 36836- cpt code 36837).

Coders might find themselves grappling with a plethora of 17 new codes in the Digestive subsection. These codes document procedures such as esophagogastroduodenoscopy (43290-43291), repair of anterior abdominal hernias (cpt code 49591-cpt code49618), repair of parastomal hernias (cpt code 49621- cpt code 49622), and removal of total or near total non-infected mesh or other prosthesis (cpt code 49623).

The Female Genital System subsection introduces just a single new code: 55867 for Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), including robotic assistance if performed.

Coders will be surprised to find only three new codes in the Auditory System subsection, namely CPT® codes 69729-69728, which describe procedures for implantation, replacement, or removal of an osseointegrated implant.

The Radiology section brings forth a solitary new code, 76883, which pertains to diagnostic ultrasound encompassing nerves and their accompanying structures along the entire anatomical path within one extremity, including comprehensive real-time cine imaging with image documentation.

The Pathology and Laboratory section showcases a substantial expansion with 11 fresh codes spanning various tests.

The Medicine section has also been enhanced with 10 new codes encompassing vaccines, specialized ophthalmological services, cardiac catheterization, quantitative pupillometry, multi-family group behavior management, and remote therapeutic monitoring.

Lastly, a series of new Category III codes have been introduced to document emerging technology, services, and procedures.

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