Medical Coding, Medical Billing

# Navigating The New Medical Billing Codes: 2025 Edition

- January 13, 2025
- Posted by Kristen Edwards

30 May

The medical billing and coding system is very dynamic. Every year, we see a lot of changes being made to the codes, modifiers, and the overall billing system in general. The American Medical Association publishes a new list of these codes and modifiers and the guidelines to use these codes effectively.

These guidelines show us the codes to keep and the ones to delete and modify. Staying up to date with the new system each year is essential as it allows us to properly file medical billings, comply with insurance guidelines, and get timely reimbursements.

Today, we are going to take a look at some of these medical coding updates. We will dive deep into some of the most important additions and removals and discuss some of the revisions made in the previous codes.

## Medical Coding Updates – 2024 CPT Code Changes

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The total number of codes and modifiers the American Medical Association appropriates is about 11,163. However, in 2024, some important changes to these codes were made by the association. The AMA press release explaining the guidelines for 2024 has been released, according to which the 2024 CPT coding changes had 349 editorial changes, 230 additions, 70 revisions, and 49 removals. We will take a look at some of these changes one by one.

## Updated Covid-19 Codes

To identify the modern monovalent vaccines for COVID-19, the CPT Editorial Board approved the provisional code (91318-91322). This code identifies vaccines against the Covid-19 vaccine by the companies Moderna and Pfizer. The following codes have been added:

- 91318 – Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, tris-sucrose formulation, 3 mcg/0.3 mL dosage, for IM use
- 91319 – Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, tris-sucrose formulation, 10 mcg/0.3 mL dosage, for intramuscular use
- 91320 – Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, tris-sucrose formulation, 30 mcg/0.3 mL dosage, for intramuscular use.

## Code Changes To Identify Moderna Products

- 91321 – Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, 25 mcg/0.25 mL dosage, for intramuscular use
- 91322 – Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, 50 mcg/0.5 mL dosage, for intramuscular use

In addition, to report the administration of vaccines for any case of COVID-19, a new code (90480) is also added which also replaces any previous codes used for the same purpose.

## Codes For Respiratory Syncytial Virus (RSV) Immunizations

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The Respiratory Syncytial Virus (RSV) causes respiratory infections in individuals of all age groups. To identify the immunizations against the strains of this virus, five new codes have been added (90380, 90381, 90683, 90679, and 90678). These codes not only allow medical billing and insurance claims but also help us keep track of ongoing infections and their treatment strategies.

## Surgery: Musculoskeletal System Code Changes

The 2024 CPT code changes and guidelines provide new codes to identify the replacement of spinal fusion therapy. This replacement is anterior thoracic vertebral body tethering, is particularly beneficial for scoliosis patients and is being identified by the following codes:

– 22836: Anterior thoracic vertebral body tethering limited to seven vertebral segments.

– 22837: Anterior thoracic vertebral body tethering limited to eight or more vertebral segments.

– 22838: Revision, replacement, or removal of thoracic vertebral body tethering.

## Surgery: Respiratory System Code Changes

Two codes have been added to the nasal or sinus endoscopy procedure to destroy the posterior nasal nerve: 31242 and 31243. Two additional codes have also been added to identify ablation techniques. The code 31242 recognizes ablation performed using radiofrequency, while 31243 covers cryoablation methods.

## Surgery: Cardiovascular System

The new 2024 CPT code changes and guidelines include eight new codes to recognize the surgical procedures done on the cardiovascular system. Some of the most important additions include:

– 33276: initial analysis and Insertion of the pulse generator and its leads.

– +33277: Add-on code for transvenous sensing lead insertion.

– 33287: Removal/replacement of pulse generator.

## Surgery: Urinary System Code Changes

A new code, 52284, recognizes the use of a drug-coated balloon-type catheter to perform cystourethroscopy with mechanical urethral dilation and delivery of drugs to the urethra using this catheter. This procedure is done under the guidance of fluoroscopy measures to relieve male patients from stricture and stenosis issues in the urethra.

## Surgery: Female Genital System Code Changes

CPT 2024 guidelines introduce a new code (58580) to treat uterine fibroids using ablation techniques through a transcervical approach. Using intraoperative ultrasound for proper guidance, this code covers the whole procedure and helps us effectively treat uterine fibroids.

## Surgery: Eye and Adnexa Code Changes

A new code (67516), recognizes the introduction of drugs into the suprachoroidal space using an injection. The administered medication, however, is not counted under this code and requires a separate code for its identification.

## Radiology

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CPT 2024 has also made a lot of changes in the radiology department. Some codes have been removed, while many others have been added. The code 74710 used for pelvimetry has been removed. A new code (75580) is used to estimate the coronary fractional flow reserve (FFR) originating through a non-invasive method using the data from computed tomography angiography data analysis already done on the patient.

Another new addition to this area is code 76984, which is used for intraoperative thoracic aorta ultrasounds that are done for diagnostic purposes. In echocardiography, three new codes (76987, 76988, and 76989) have also been added.

## Medicine

CPT 2024 guidelines also contain four updated codes for identifying phrenic nerve stimulation. Code 93150 is used for therapy activation, while 93151 is used for nerve interrogation and programming. During polysomnography used to diagnose sleep disorders, the code 93152 is used for interrogation and programming of the disorder, and 93153 is used when interrogation is done without programming.

For the diagnosis of congenital heart defects through venography, five new additions in the coding guidelines allow adequate coverage of the issue, with each code specifying catheter placement under imaging supervision and interpretation of the results. Examples of these additions to the codes include:

– +93584 for the strange or persistent superior vena cava

– +93585 for the azygos/hemiazygos venous system

In addition to these codes, three updated codes (97550-97552) also allow proper caregiver training and treatment of the underlying disorder to facilitate the patient.

## FAQs

### What are CPT Codes?

CPT codes are the medical codes used to identify and recognize medical, surgical, and diagnostic processes. These codes allow hospitals to contact insurance companies to get reimbursements for the procedures and services provided to patients.

### Why are CPT Codes 2024 changes important?

CPT code changes are important as they allow hospitals to comply with insurance guidelines properly. These codes also signify the updated and proper treatment options provided to the patient to get the latest services and modern innovative care.

### What are some notable changes in the CPT code guidelines for 2024?

Some notable changes in the new 2024 guidelines include 98232, 98234, 98235, and 98233, which identify several important surgical procedures done on various body parts.

## Conclusion

New medical billing codes are added each year to the coding systems being operated by the American Medical Association. The AMA itself devises and adds these codes to the system and is also responsible for any removals or updates in the already present coding system. Keeping up with these coding changes is essential as it allows the hospitals to properly provide treatment services to patients, and get adequate reimbursements from the insurance companies.

We discussed some of the major medical coding updates introduced in the CPT 2024 guidelines. Significant changes have been made in the surgery departments, and new codes have been added in the respiratory, urinary, musculoskeletal, and cardiovascular systems. New codes have been added for respiratory infections like Covid-19 and RSV infections.

Hospitals, physicians, and surgeons alike should have a clear understanding of these codes to be aware of the services they provide to the patient. This not only keeps the hospitals and the insurance companies in the loop but also allows the patients to know what services they are getting from the hospital.

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