The American Medical Association (AMA) has officially released the Calendar Year (CY) 2023 Current Procedural Terminology (CPT®) code set. The AMA will publish the new codes in the 2023 CPT codebook, but healthcare leaders can access them now within Vitalware® by Health Catalyst products.
The CY 2023 updates include 102 new codes, 68 deleted codes, and 87 codes with revised long descriptions. The updates are effective beginning January 1, 2023.
Evaluation and Management
The Evaluation and Management (E/M) section has one addition, 26 deletions, and 50 revisions for 2023. A new add-on code (99418) describes prolonged inpatient or observation E/M services. Many observation codes are deleted due to the consolidation of inpatient and observation E/M codes in CY 2023. The other deleted codes include domiciliary or rest home and prolonged service codes.
The revisions include the following:
- Clarifying hospital E/M codes to include “inpatient or observation” care due to the consolidation of inpatient and observation codes in 2023.
- Replacing the wording describing a detailed or comprehensive history and examination with a “medically appropriate history and/or examination.”
- Changes to the total time to meet when using time for code selection.
- On hospital discharge day management codes, the words “on the date of the encounter” have been added for clarification.
- Office consultation codes have been revised to include “other outpatient” consultation services.
- An emergency department E/M code has been revised to include services that may not require the presence of a physician or other qualified healthcare professional.
- Home visit codes have been revised to include “residence” as a place of service.
- Minor clarifying word changes have been made to the prolonged outpatient E/M service add-on code.
- Interprofessional telephone/internet/EHR assessment and management consult service codes have been revised to include “other qualified health care professional” when referring to the consultant.
- Minor clarifying word changes have been made to the transitional care management service codes.
Surgery
Coding updates in the surgery section include the following systems: integumentary, musculoskeletal, respiratory, cardiovascular, digestive, urinary, male genital, and nervous.
Integumentary System
There are three new codes in the integumentary system section, plus one deletion and one revision:
- Code 15778 describes the implantation of absorbable mesh or another prosthesis for delayed closure defects.
- Codes 15853 and 15854 describe the removal of sutures or staples not requiring anesthesia.
- Code 15850, describing the removal of sutures under anesthesia, has been deleted.
- Code 15851 has been revised to include the removal of staples.
Musculoskeletal System
One new add-on code (22860) in the musculoskeletal system section describes a total disc arthroplasty and discectomy to prepare an interspace. Codes 22857 and 27280 have minor revisions to their long descriptors.
Respiratory System
One new respiratory system code (30469) describes repairing a nasal valve collapse using temperature-controlled remodeling.
Cardiovascular System
There are seven new codes in the cardiovascular section and one revision:
- Codes 33900–33904 describe percutaneous pulmonary artery revascularization by stent replacement.
- Codes 36836 and 36837 describe a percutaneous arteriovenous fistula creation of an upper extremity.
- Code 35883 has a revision to the example listed within the long descriptor.
Digestive System
The digestive system section includes 17 new codes and 18 deletions:
- Codes 43290 and 43291 describe an esophagogastroduodenoscopy with the deployment or removal of an intragastric bariatric balloon.
- Codes 49591-49596 and 49613-49618 describe the repair of an anterior abdominal hernia, including the implantation of mesh or another prosthesis.
- Codes 49621-49623 describe the repair of a parastomal hernia, including the implantation of mesh or other prosthesis or the removal of a non-infected mesh or prosthesis (49623).
- All 18 deleted codes in this section describe the repair of various types of hernias.
Urinary System
Urinary system codes 50080 and 50081 have been revised in this section to include more detail to clarify a percutaneous nephrolithotomy or pyelolithotomy lithotripsy procedure.
Male Genital System
One new code (55867) has been added to the male genital system section to describe a laparoscopic simple subtotal prostatectomy, including robotic assistance when used.
Nervous System
Three new codes (69728–69730) describing the removal, implantation, and replacement of an osseointegrated skull implant were added to the nervous system section, plus several revisions:
- Codes 64415–64417 and 64445–64448 were revised to include imaging guidance.
- Codes 66174 and 66175 were revised to include an example procedure.
- Codes 69716–69717, 69719, and 69726–69727 were revised to clarify the description of an osseointegrated skull implant replacement or removal.
Radiology
The radiology section gained one code (76883), which describes an ultrasound of the nerves and accompanying structures in one extremity. Five codes (76882,78803, and 78830–78832) have been revised in this section to include clarifying words to the long descriptors.
Pathology and Laboratory
There are 11 new codes and three revisions in the pathology and laboratory section:
- Three new codes (81449, 81451, and 81456) describe targeted genomic sequence analyses.
- Four new codes (87468, 87469, 87478, 87484) describe various infectious agent detections using DNA or RNA.
- One new code (81418) has been added for drug metabolism analysis using a genomic sequence.
- Another new code (81441) describes the detection of inherited bone marrow failure syndromes (IBMFS).
- Code 84433 describes the detection of an enzyme called thiopurine S-methyltransferase (TPMT).
- Code 87467 describes the detection of the hepatitis B surface antigen.
- Three codes were revised in this section (81445, 81450, and 81455) to move the placement of some of the examples and descriptive wording within the descriptors, but the overall meaning of the descriptor did not change.
Medicine
Ten new codes have been added to the medicine section:
- Three new codes (93569 and 93573–93575) are add-on codes describing injection procedures for angiographies during cardiac catheterizations.
- New codes 96202 and 96203 are for multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis.
- Additional new codes describe the respiratory syncytial vaccine (90678), orthoptic training (92066), quantitative pupillometry (95919), and remote therapeutic monitoring for cognitive behavioral therapy (98978).
The medicine section also includes seven revisions:
- Code 92065 now includes wording stating that a physician or other qualified healthcare professional should perform the orthoptic training.
- Code 92229 replaces “automated analysis” with “autonomous analysis” when referring to a retina imaging report.
- Code 92284 has been revised to clarify that it’s a diagnostic examination.
- Clarifying words have been added to add-on code 93568 to describe an injection procedure during cardiac catheterization.
- Finally, codes 98975–98977 have been revised to remove some previously listed examples.
Category III
There are 46 new Category III codes representing a wide variety of new and emerging services, including the following:
- Treatment planning and ablation of malignant prostate tissue by magnetic field induction.
- Remote autonomous algorithm-based recommendation system for insulin dosages.
- Absolute quantitation of myocardial blood flow (AQMBF) using computed tomography.
- Bone strength/fracture risk analysis and assessment using digital X-ray radiogrammetry.
- Insertion of a bioprosthetic valve into the femoral vein.
- Cardiac focal ablation utilizing radiation therapy for arrhythmia.
- Injections of stem cell product into perianal perifistular soft tissue.
- Digitization of glass microscope slides.
- Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction.
- Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse of the peripheral nerve.
- Virtual reality technology to assist therapy.
- Arthrodesis of the sacroiliac joint, including the placement of an intra-articular implant.
- Therapeutic induction of intra-brain hypothermia.
- Real-time pressure-sensing epidural guidance system.
- Surface mechanomyography (sMMG) with concurrent application of inertial measurement unit (IMU) sensors to measure multi-joint range of motion, posture, gait, and muscle function.
- Gastrointestinal myoelectrical activity study.
- Installation of fecal microbiota suspension via rectal enema into the lower gastrointestinal tract.
- Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves.
- Transcutaneous auricular neurostimulation.
This update also includes 23 code deletions in Category III, including the following:
- Total disc arthroplasty (artificial disc), anterior approach.
- Vagus nerve-blocking therapy for morbid obesity.
- Optical coherence tomography (OCT) for imaging of the skin.
- Recording of fetal magnetic cardiac signal.
- Biomechanical mapping, transvaginal.
- Ablative laser treatment, non-contact, for an open wound.
- Contact near-infrared spectroscopy studies of lower extremity wounds.
- Electrocardiographic rhythm-derived event recorder without 24-hour attended monitoring.
- Cystourethroscopy with mechanical dilation and urethral therapeutic drug delivery.
- Intraoperative visual axis identification using patient fixation.
- Remote therapeutic monitoring of a standardized online digital cognitive behavioral therapy program.
The Category III section has revisions to two remote therapy codes (0733T and 0734T), changing the description of the remote therapy from “body and limb kinematic measurement based” to “real-time, motion capture-based neurorehabilitative.”
Ensuring Integrity and Accuracy
Healthcare organizations should remember that the creation of new CPT coding does not guarantee coverage for the service. However, choosing the appropriate code allows for the integrity of the medical record and accurate data collection.
Additional Reading
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