2020 has been a challenging year for the Global healthcare sector, which resulted in sweeping changes affecting healthcare and Medical billing outright. With these challenges and changes anticipated to carry over, Medical Billing in 2024 as predicted will see a lot of updates, advancements, revised medical billing and coding guidelines, compliances, and regulations. Read further to educate yourself with the latest changes in Medical billing.
Updates in Medical Coding for 2024 – Major overhaul of CPT codes in last 25 years.
American Medical Associates (AMA) announced major updates in medical billing codes and guidelines for 2024. Release of an updated version of CPT (Current Procedural Terminology) codes includes modification of codes for outpatient evaluation and management (E/M) services as listed below:
- Eliminating history and physical exam as elements for code selection.[1]
- Allowing physicians to choose the best patient care by permitting code-level selection based on medical decision-making (MDM) or total time.[1]
- Promoting payer consistency with more detail added to CPT code descriptors and guidelines.[1]
Further to the above E/M coding changes; around 329 CPT codes have been edited for 2024 code set inclusive of
- 206 new codes – Important additions are in response to COVID-19
- 54 deletions – CPT code sets are continuously modified to keep up with the fast-paced innovation in digital medicines
- 69 revision of existing codes – to meet the current requirement
- Updated CPT codes for technological advances in Cardiac monitoring and detection
- Revision and addition of codes set for Retinal Imaging and screening diabetic retinopathy and increase early detection
- Descriptive codes for Artificial Intelligence (AI) and technology-augmented solutions
Of the new codes introduced, the majority of codes are updated to cover the novel areas of medicine and almost 63% are involved in new technological services in healthcare.
Unchanged Guidelines
While the revision of CPT codes is closely monitored for better reimbursement, it is of prime importance to know what remains the same.
- Guidelines for new and established patients remain intact
- The use of CPT code 99211 still remains unchanged.
- Requirement of clinical documentation by physicians
- The CPT manual for shared/split services is similar to previous versions
Telehealth and Telemedicine
Tele-health and Telemedicine emerged as the best solution during the Novel COVID-19 Pandemic. It ultimately served as an alternative option for patient care by helping to maintain social distancing. Owing to growth in Telehealth and Telemedicine, related industry-based digital tools and information technology are trending. Recent research concludes that the majority of patients embrace Telehealth and digital interactions compared to regular medical services. As a result of the ongoing crisis and surge in the current requirement, Telehealth is expected to see about 80% growth.
Medical Billing Outsourcing
The Medical Billing Outsourcing market is witnessing increased growth due to the changes and twists involved due to the COVID-19 pandemic and majorly because of the complexity in keeping abreast of the recent CPT and ICD-10 coding guidelines, changes in medical billing rules and regulations, etc. Physicians and medical groups are considering Medical billing outsourcing to cope with the industrial changes.
About MGSI
MGSI is a 29-year-old national Medical Billing Company serving more than 600 physicians across the US. MGSI has trained and experienced medical billing and coding team handling complete revenue cycle management services to our clients. We also have the prerequisite to facilitate your medical billing and educate your providers and team with all compliant and regulatory policies. To know more about the recent changes in Medical Billing and to outsource your RCM process contact MGSI today or visit our website: Revenue Cycle Management: Healthcare Services for Physicians (mgsionline.com)
Reference
[1]2021 CPT code set reflects tech innovation, COVID-19 response | American Medical Association (amassn.org)