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CPT Changes and What This Could Mean for Your Revenue Cycle Management

Posted By Giovanna Stahl

With this new year comes new and improved changes to the Current Procedural Terminology (CPT) code set, which is utilized by physicians and health insurance companies to report medical, surgical, and diagnostic procedures that require payment. After numerous revisions to these codes, your administrative staff will have to navigate how they fit within the previous billable codes. As the new codes are more specific to your patient’s health, it may cause fiscal issues when it comes to charging them for said procedures.

 

Working together with an experienced team of professional revenue cycle management advisors will bring favorable results when done right. At ECLAT Health Solutions, we understand how difficult it is to make sure your team incorporates updates and changes to previously-existing technological systems. Having a dedicated partner that is readily equipped to facilitate with the expected change resistance or adjustment from all aspects of the revenue cycle, will become invaluable down the road. Furthermore, utilizing the combination of our up-to-date services such as, medical billing, and ICD-10 auditing services will help relieve the gaps that this change may cause. 

 

Below, we explain how the new CPT code set may change your facility’s system and how we can assist you in effectively incorporating it:

What Are The CPT 2020 Changes?

Since the previous code set hindered some patients from receiving proper medical services and devices because the revenue cycle was not properly categorized, the 248 new codes, 71 deletions, and 75 revisions clarify this problem so that patients in need of additional resources and medical devices receive proper treatment. The new codes also have expanded the use of secure patient portals in order to increase focus on the role played by non-visual patient-physician communication. Furthermore, the SMBP codes allows a diversity of patients to receive reliable readings while also expanding access to the vulnerable populations who live in rural areas. Here are just a few of those CPT code updates: 

Evaluation and Management (E/M)

Online Digital E/M Services

The online E/M service has been around for a long time, but with the new updates, it is more defined to help streamline telephone care services codes. Here are the new time-based codes that were generated: 

  • Code #99421 For an established patients, online digital evaluation and management service, for up to 7 days, cumulative time during the 7 days; 5-10 minutes.
  • Code #99422 11-20 minutes.
  • Code #99423 21 or more minutes.
  • Code 99444 (online E/M service) will be deleted.

 

Remote Physiologic Monitoring

Code #99457 was updated to designate it only as the first 20 minutes of remote physiologic monitoring, including treatment management services, clinical staff/physician/other qualified health care professional time requiring consistent communication with the patient/caregiver throughout each calendar month. 

Surgical

Cardiovascular

Codes #33017, 33018, and 33019 were created in 2020 and are related to pericardium services, which means that in order to report on the pericardial drainage, including the insertion of an indwelling catheter, the catheter needs to remain in place once the procedure is completed.

 

Male Genital System

Code #54640 is for Orchiopexy inguinal or scrotal approach “with or without hernia”. It was revised and updated to specifically omit “with or without hernia”.

 

Nervous System

Code #62270 was recently updated to include “with flouroscopic or CT guidance” to make sure that a single code is reported specifically when there is flouroscopic or CT guidance. However, the MRI or ultrasound imaging is not included alongside this detail and may be reported separately, and parenthetical notes that specify imaging services are also not to be reported separately.

 

How the CPT changes May Affect Your Revenue Cycle Management

It’s been almost one month since the 2020 CPT changes came into effect and here is what we know so far. 

 

ECLAT expert, Marie Thomas states that, “during this time of change, monitor your CMI carefully.”

 

With these codes being subjected to rigorous processes, this proves that the codes meet the highest standards of category 1 codes. Due to these new codes, your hospital’s staff will have to comply with new standards along with the former codes that were kept, which can be troublesome if improperly implemented. However, these revisions may help Medicare, Medicaid, and commercial payers clearly define the reason for a visit and the comensarated fees that are attached. This means that the hospital revenue staff will have to determine how the new codes will exist within what they already have in existence, but will have a much easier time performing proper documentation, billing, and communication with patients over their financial responsibilities. 

How Can ECLAT Help?

As medical billing experts, we assist your practice by mitigating errors in your coding and billing systems, faster and more consistent reimbursement and billing collections, thus achieving a more efficient revenue cycle system. Though this year’s new CPT code changes may be difficult to incorporate, we will keep all important records while assisting you with the implementation of the new codes to maintain accuracy and security. Coupled with our ICD-10 auditing services, which helps to maintain an accurate code assignment that optimizes reimbursements, we will also assist in helping your staff understand how the new codes affect your billing, as well as making sure physicians are providing accurate documentation to the parties who need it. 

Reliable Offshore Revenue Cycle Management Partner

With a new coding set in place, having a trustworthy offshore revenue cycle management system is highly advised to allow your staff to settle into these new protocols. Having decades worth of experience, our ECLAT experts will give you the freedom to focus on your facility as we maintain the organization of your records. 

 

Fill out our contact form today to expand your healthcare facility’s knowledge and regulation in accordance with the new codes, as well as get a free custom consultation on our numerous medical support services. 

 

Resources:

  1. https://www.ama-assn.org/press-center/press-releases/ama-releases-2020-cpt-code-set 
  2. https://www.beckershospitalreview.com/finance/5-changes-to-cpt-codes-in-2020.html
  3. https://www.beckershospitalreview.com/finance/cpt-code-changes-in-2020-what-hospital-revenue-cycle-staff-should-know-before-jan-1.html

Tags: Medical Coding, RCM, Revenue Cycle Management, CPT Codes