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CY2022 CPT codes released: Hundreds of code changes cover E/M, surgical services

Take a first glimpse of the 2022 CPT code set. The annual update, released by the AMA, reveals hundreds of code changes, including more than 240 new codes that usher in a batch of care management services, surgical procedures and pathology and laboratory testing.
You’ll find code and guideline changes great and small throughout the 2022 CPT manual and they start with a revision to code 99211. The new descriptor will read:
“Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician or other qualified health care professional.”
In the final sentence, the phrase, “Usually, the presenting problem(s) are minimal,” has been deleted.
The new principal care management codes (99424-99427) – the care management service that covers cases of a single chronic condition – expand on the performance, reporting and reimbursement opportunities offered by codes G2064 (30 minutes of physician or qualified health care professional [QHP] time per month) and G2065 (30 minutes of supervised clinical staff time per month), which they’re replacing.
First, the new codes apply to more patients. The descriptors state that the patient must have a “complex chronic condition that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or death.”
The G codes require that the patient have a condition that is “of sufficient severity to place patient at risk of hospitalization or have been the cause of a recent hospitalization.”
In addition, the new code group consists of a 30-minute primary and 30-minute add-on code pair, which will allow for reimbursement that is more in line with effort.
Practices will report codes 99424-99425 when a physician or QHP personally performs the work and 99426-99427) for supervised clinical staff.
The new codes are featured in revised guidelines throughout the E/M chapter of the manual. For example, they were added to the list of codes that can’t be reported during the same month as self-measured blood pressure monitoring codes 99473-99474.
Don’t overlook the invisible E/M update
The updates that the AMA issued March 9 were retroactive to Jan. 1 and are not flagged in next year’s manual. But note that the changes are highlighted in the online version of the guidelines.
More revisions, additions
Code 11981 is revised to now include “bioresorbable, biodegradable” drug delivery implants, as well as non-biodegradable ones, as the 2021 version of the code describes. A new parenthetical guideline directs you to unlisted code 17999 for removal of a biodegradable or bioresorbable implant.
Spinal fusion codes 22600-22634, which describe use of a posterior, posterolateral or combined posterolateral with posterior interbody technique, have been revised to specify that each code describes fusion of an “interspace,” not a “vertebral segment.”
In tandem with that revision, the AMA added two new laminectomy add-on codes in the nervous system section, 63052 and 63053, which are to be used with posterior interbody codes 22630-22634 when the procedure is done at the same interspace level to decompress nerves or spinal components such as the spinal cord.
Extensive new illustrations and definitions were added to clarify facetectomy, foraminotomy, hemilaminectomy laminectomy and laminotomy procedures.
Changes for cardiothoracic surgery include eight new codes, two revised codes and two deletions. The new procedure codes include open and thorascopic exclusion of the left atrial appendage, a procedure that may help prevent blood clots and strokes among atrial fibrillation patients.
Also added: endoscopic harvest of an upper extremity artery for coronary artery bypass procedures and codes for repair of aortic coarctation (narrowing) using endovascular stents and angioplasty.
Heart catheterization codes that address congenital defects were overhauled, with deletion of six cardiovascular medicine codes (93530-93533 and 93561-93562) and the addition of seven replacements. Changes also include revisions to three comprehensive electrophysiology evaluation codes (33653-93656).
The tables below show the total number of new, revised and deleted codes per code family.
2022 CPT codes: New, revised, deleted
Code series Section New Revised Deleted
00100 - 01999 Anesthesia 6 - 2
10004 - 69990 Surgery 30 25 12
70010 - 79999 Radiology procedures 4 1 3
80047 - 89398, 0001U - 0222U Pathology and laboratory procedures 96 46 8
90281 - 99607 Medicine services and procedures 36 4 11
99202 - 99499 E/M services 5 10 -
0001F - 9007F Category II codes - - -
0042T - 0639T Category III codes 72 7 26
  Total 249 93 62
2022 surgical CPT codes (10004-69990): New, revised, deleted
Code series Section New Revised Deleted
10004 - 10021  General surgical procedures - - -
10030 - 19499 Integumentary system - 1 -
20100 - 29999 Musculoskeletal system - 8 1
30000 - 32999 Respiratory system - - -
33016 - 37799 Cardiovascular system 8 2 2
38100 - 38999 Hemic and lymphatic systems - - -
39000 - 39599 Mediastinum and diaphragm - - -
40490 - 49999 Digestive system 2 - 2
50010 - 53899 Urinary system 4 - -
54000 - 55899 Male genital system - 4 -
55920 - 55920 Reproductive system procedures - - -
55970 - 55980 Intersex surgery - - -
56405 - 58999 Female genital system - - -
59000 - 59899 Maternity care and delivery - - 1
60000 - 60699 Endocrine system - - -
61000 - 64999 Nervous system 9 6 5
65091 - 68899 Eye and ocular adnexa 3 2 -
69000 - 69979 Auditory system 4 2 2
69990 - 69990 Operating microscope procedures - - -
  Total 30 25 13
Source: Part B News analysis of the CPT 2022 code set
Clarification: When first published, the story listed 125 new CPT code additions for CY2022. That number represents the new CPT codes that had not been released prior to the publication of the 2022 CPT Manual. However, dozens of codes have been released and activated throughout CY2021. All told, the number of new CPT codes that are first appearing in the CPT Manual is 249, including codes that have been added throughout the year. The final count is now reflected above.
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