CPT® 2021 CODE CHANGES - WRS Health

1 CPT 2021 code CHANGESCATEGORYNEWREVISEDDELETEDEVALUATI ON & MANAGEMENTC lick for More Details 99417, 9943999202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99354, 99355, 99356, 99415, 99416, 99487, 99489, 9949099201 INTEGUMENTARY 80189, 80204, 815290400T, 0401 TMUSCULOSKELETAL 0627T, 0628T, 0629T, 0630T, 8019329822, 298230396T, 63180, 63182, 69605 RESPIRATORY 0632T, 32408, 71271, 80189, 81554, 94 61971250, 71260, 71270, 94617, 9507032405, 94250, 94400, 94750, 94770, 95071 CARDIOVASCULAR 0623T, 0624T, 0625 T, 0626T, 06 32 T, 33741, 33745, 33746, 33995, 33997, 80151, 80181, 93241, 93242, 93243, 93244, 93245, 93246, 93247, 932480577T, 33990, 33991, 33992, 339930126T, 0295 T, 0296T, 0297 T, 0298 T, 0381T, 0382T, 0383T, 0384T, 0385T, 0386T, 92992, 92993 GENITOURINARY 0016M, 55880, 57465, 81513, 81514, 8268174 425, 826700058T, 57112, 58293 MATERNITY CARE & DELIVERY 0633T, 0634T, 0635T, 0636T, 0637T, 0638T80415 NERVOUS 0632T, 0639T, 80161, 80167, 80210, 81419, 9 26 5364455, 64479, 64480, 64483, 644840228 T, 0229 T, 022OT, 023 0T, 0231T, 61870, 62163, 92585, 92586 EYE & OCULAR ADNEXA 0621T, 0622 T, 92229, 92518 , 9251976513, 92227, 92228 AUDITORY 69705, 69706, 92650, 92651, 92652, 9265392585, 92586 DISCLAIMER.

2 This information is not intended to provide legal advice to physicians and their staffs. If you have specific questions regarding the permissibility of your billing or other practices, we recommend that you consult legal counsel directly for assistance in evaluating any legal, regulatory or compliance issues regarding these matters. CPT five digit codes, nomenclature and other data are copyright American Medical Association. All Rights Reserved. No fee schedules, basic units, relative values or related listings are included in CPT. HealthWRSA bout WRS BILLING SERVICESCONTAC T HealthWRSCPT 2021 code CHANGESCATEGORYNEWREVISEDDELETEDRADIOLOG Y 0620T, 0631T, 0632T, 0639T, 32408, 33741, 33745, 33746, 33995, 55880, 57465, 71271, 7614533990, 33991, 33993, 64479, 64480, 64483, 64484, 71250, 71260, 71270, 74425, 76513, 92227, 922280228T, 0229T, 0230T, 0231T, 76970, 78135 PATHOLOGY AND LAB 80143, 80151, 80161, 80167, 80179, 80181, 80189, 80193, 80204, 80210, 8116 8 , 8119 1, 8119 2 , 8119 3 , 81194 , 81278, 81279, 81338, 81339, 81347, 8134 8, 81351, 81352, 81353, 81357, 81360, 81419, 81513, 81514, 81529, 81546, 81554, 82077, 8268180415.

3 81401, 81402, 81403, 81404, 81405, 82075, 8267081545 MEDICINE 90377, 92229, 92517, 92518, 92519, 92650, 92651, 92652, 92653, 93241, 93242, 93243, 93244, 93245, 93246, 93247, 93248, 9461994617, 95070 CATEGORY III 0620T, 0621T, 0622 T, 0623T, 0624T, 0625T, 0626T, 0627T, 0628T, 0629T, 0630T, 0631T, 0632T, 0633T, 0634T, 0635T, 0636T, 0637T, 0638T, 0639T0577T0 0 58 T, 0 0 85 T, 0111T, 0126T, 0228 T, 0229 T, 023 0T, 0231T, 0295 T, 0296T, 0297 T, 0298 T, 03 01T, 03 02 T, 03 03T, 03 8 4T, 03 85 T, 03 8 6T, 0396T, 0 4 0 0T, 0401T, 0405 TOTOLARYNGOLOGY 30468, 69705, 69706, 8154681545 ONCOLOGY 0015M, 0016M, 0633T, 0634T, 0635T, 0636T, 0637T, 0638T, 71271, 76145, 80204, 81168, 81191, 81192, 81193, 81194, 81278, 81279, 81338, 81339, 81347, 8134 8, 81351, 81352, 81353, 81357, 81360, 81529, 8154611970, 11971, 19318, 19325, 19328, 19330, 1934 0, 19342, 19357, 19361, 1936 4, 19367, 19368, 19369, 19370, 19371, 1938 00400T, 0401T, 19324, 19366, 49220, 81545 VASCUL AR 0620T, 0631T HealthWRSE valuation & ManagementNEW CODESDESCRIPTIONADVICE9 9417 Prolonged office or other outpatient evaluation and management service(s)

4 Beyond the minimum required time of the primary procedure which has been selected using total time, requiring total time with or without direct patient contact beyond the usual service, on the date of the primary service, each 15 minutes of total time (List separately in addition to codes 99205, 99215 for office or other outpatient Evaluation and Management services)CPT 2021 adds +99417 as part of its overhaul of the office and other outpatient E/M codes, which emphasizes reporting based on either total time or medical decision making. Use +99417 only when coding is based on time. Report +99417 with 99205 for services 75 minutes or longer and with 99215 for services 55 minutes or longer.

5 One unit of +99417 represents 15 minutes of additional date of this code : January 1, care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, comprehensive care plan established, implemented, revised, or monitored; each additional 20 minutes of clinical staff time directed by a physician or other qualified Health care professional, per calendar month (List separately in addition to code for primary procedure)CPT 2021 revises chronic care management code 99490 to be specific to the first 20 minutes of directed clinical staff time in a calendar month and adds +99439 for each additional 20 minutes in that month.

6 New guidelines state you may report +99439 only twice per calendar month. So, for 20-39 minutes, report 99490; for 40-59 minutes, report 99490, 99439; and for 60 minutes or more, report 99490, 99439 date of this code : January 1, 2021. HealthWRSE valuation & ManagementREVISED CODESDESCRIPTIONADVICE99202 Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using time for code selection, 15-29 minutes of total time is spent on the date of the 2021 revises new-patient office and other outpatient evaluation and management (E/M) code 99202 so that it applies when an encounter requires straightforward medical decision making (MDM) or 15-29 minutes of total 2021 significantly alters office and other outpatient E/M coding by deleting low-level code 99201, revising the descriptors of 99202-99215, and providing extensive new guidelines.

7 In 2020, the three key components of history, examination, and MDM typically drove code choice for 99201-99205 and 99212-99215. If counseling and/or coordination of care dominated the visit, you could code based on intraservice time. In 2021, 99202-99205 and 99212-99215 code choice is based on either MDM level or the amount of total time (both face-to-face and non-face-to-face time). There is also a new code , +99417, for prolonged services. code 99211 does not have a time component in 2021 and is appropriate for visits that may not require a physician or other qualified healthcare professional to be date of this revision: January 1, or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making.

8 When using time for code selection, 30-44 minutes of total time is spent on the date of the 2021 revises new-patient office and other outpatient evaluation and management (E/M) code 99203 so that it applies when an encounter requires a low level of medical decision making (MDM) or 30-44 minutes of total 2021 significantly alters office and other outpatient E/M coding by deleting low-level code 99201, revising the descriptors of 99202-99215, and providing extensive new guidelines. In 2020, the three key components of history, examination, and MDM typically drove code choice for 99201-99205 and 99212-99215. If counseling and/or coordination of care dominated the visit, you could code based on intraservice time.

9 In 2021, 99202-99205 and 99212-99215 code choice is based on either MDM level or the amount of total time (both face-to-face and non-face-to-face time). There is also a new code , +99417, for prolonged services. code 99211 does not have a time component in 2021 and is appropriate for visits that may not require a physician or other qualified healthcare professional to be date of this revision: January 1, 2021. HealthWRSE valuation & ManagementREVISED CODESDESCRIPTIONADVICE99204 Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making.

10 When using time for code selection, 45-59 minutes of total time is spent on the date of the 2021 revises new-patient office and other outpatient evaluation and management (E/M) code 99204 so that it applies when an encounter requires moderate medical decision making (MDM) or 45-59 minutes of total 2021 significantly alters office and other outpatient E/M coding by deleting low-level code 99201, revising the descriptors of 99202-99215, and providing extensive new guidelines. In 2020, the three key components of history, examination, and MDM typically drove code choice for 99201-99205 and 99212-99215. If counseling and/or coordination of care dominated the visit, you could code based on intraservice time.