AMA’s CPT 2022 Updates

The American Medical Association (AMA) has released the 2022 Current Procedural Terminology (CPT®) code set, which incorporates a series of 24 vaccine-specific codes that are the model for efficiently reporting and tracking immunizations and administrative services against the coronavirus (SARS-CoV-2).

The COVID-19 vaccine and administration codes are among 405 editorial changes in the 2022 CPT code set, including 249 new codes, 63 deletions and 93 revisions. More than 40% of the editorial changes are tied to new technology services described in Category III CPT codes and the continued expansion of the proprietary laboratory analyses section of the CPT code set.

Other important additions to the 2022 CPT code set include the creation of five new CPT codes to report therapeutic remote monitoring, expanding on the remote physiologic monitoring codes that were created in 2020. The CPT Editorial Panel also created new codes for principal care management, which allow physicians and qualified health care professionals to report care management services for patients with one complex chronic condition.

The following information contains details about the 2022 CPT Professional updates and is listed in sequential order. This is NOT an all-inclusive list. Page numbers referenced are in relationship to the AMA’s CPT® 2022 Professional Edition textbook. Updates are noted in green throughout the text. For additional information see the AMA CPT 2022 text in its entirety or visit ama-assn.org.

Page xiii: Introduction contains revised language for Category I section clarification

Evaluation and Management / Care Management Services

Page 20: 99211 has been revised to no longer include any MDM language.

Page 32: Critical Care Services: Guidelines identify clarification on included services.

Page 54: Remote Physiological Monitoring Treatment Management Services includes updated guidelines.

Page 62: Care Management & Care Planning have revised definitions and guidelines.

Page 64: Chronic Care Management: update includes clarification on how to report these unique services and an updated table for reference.

Page 66: Complex Chronic Care Management: revision includes clarification of requirements for reporting these codes.

Page 67: Principal Care Management: Includes revision of guidelines & new codes 99424 & 99425 & new reference chart on pg. 68

Surgery Section

Page 90: The surgery section includes a revised definition of foreign body/implants.

Page 106: Repairs have guideline updates with revision to the definition of a simple repair.

  • The musculoskeletal, cardiovascular, nervous, auditory, radiology sections include several updates to definition of terms, new codes and additional coding considerations.
  • The urinary system offers 4 new codes to identify specificity for periurethral transperineal adjustable balloon continence device.
  • Pathology updates include additional definitions and an updated MDM/time table for certain laboratory codes: 80503-80505
  • ENT Updates: 21310 (Closed treatment of nasal bone fracture without manipulation) has been deleted and replace with 21315 & 21320 that both include manipulation.

Page 613: Pathology Clinical Consultations and new path MDM table have been revised.

Medicine Section

Page 718: Foreign body/implants defined again.

Page 720: Immunization updates including many new codes & COVID reporting guidance.

Page 727: Interactive complexity guideline update includes clarification for appropriate reporting of 90785.

Page 745: Audio Function Test requirements clarified.

Page 775: Cardiac Catheterization includes significant revisions to guidelines and reporting requirement and an updated Cardiac ablation table.

Page 842: Remote Services – Updated guidelines and 3 New Codes have been added to this section 98975-98977.

Category III Section

Many updates and New Codes are added to this section including cardiac pacing, device evaluations, uterus transplantations, diaphragmatic stimulation system, and new valve replacement codes.

Appendices

Still no E/M Vignettes under 2022 GL

Page 919: Appendix A: Revised Modifier 63: Procedure Performed on Infants less than 4kg.

Page 1021: New Appendix Q: Severe Acute Respiratory Syndrome Coronavirus 2 Vaccines includes updated language and new vaccine code decision table.

Page 1022: New Appendix R: Digital Medicine – Services Taxonomy

Updates relevant to the FQHC:

Updates to Medicare Benefit Policy Manual, Chapter 13, RHC & FQHC Services include:

  • Updates to requirements for Principal Care Management section 230.2 (see pg. 57)

Updates to Medicare Claims Processing Manual, Chapter 9, RHC & FQHCs include:

  • Updates to definitions and requirements for billing Hospice Attending Physician Services section 60.6 (see pg. 30)

The HRSA Uniform Data System (UDS) website includes updated 2022 resources to assist health centers in collecting and submitting their data include UDS manuals, webinars, trainings, validations, crosswalks, and other technical assistance resources. https://bphc.hrsa.gov/datareporting/reporting/index.html

If you would like additional information on these updates or on the current ICD10CM updates, please visit our website BCAREV.com or contact us at 208-736-3755. https://www.ama-assn.org/about/cpt-editorial-panel/nearly-250-new-cpt-codes-store-2022

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