Comprehensive Guide to Medical Billing for 2024

Successful medical billing hinges on adherence to the latest 2024 CPT guidelines. Under the American Medical Association (AMA) and its CPT Editorial Panel, these guidelines undergo annual revisions to align with current healthcare practices. 

However, clinics that haven’t prepared yet for these coding updates often encounter operational inefficiencies. Staff members grapple with deciphering new coding guidelines, resulting in workflow disruptions, decreased productivity, and potential errors in medical documentation and billing processes. 

Our comprehensive guide aims to mitigate these challenges by providing insights and strategies to navigate the intricacies of the latest coding modifications.

CPT Code Changes for 2024

Explore the evolving coding landscape with 349 editorial changes, including additions, deletions, and revisions. Dive into the latest list of CPT codes below:

• Specification of the “substantive portion” of shared evaluation and management (E/M) visits involving a physician and a non-physician practitioner

• Provision of instructions for same-day discharge codes 99234-99236

• Removal of time ranges from outpatient visit codes (99202-99205, 99212-99215)

• Merger of over 50 previous codes for reporting immunizations for COVID-19

• Introduction of provisional codes (91318-91322) to distinguish monovalent COVID-19 vaccines Moderna and Pfizer

• Addition of the 90480 CPT code for reporting the administration of the COVID-19 vaccine in the home setting

• Inclusion of product-specific immunization codes 90380, 90381, 90683, 90679, and 90678 for respiratory syncytial virus (RSV) 

• Deletion of telemedicine visit codes: 99441 (5–10 minutes of medical discussion), 99442 (11–20 minutes), and 99443 (21–30 minutes)

• Deletion of codes:

1. Noninvasive estimated coronary fractional flow reserve (FFR) codes 0501T, 0502T, 0503T, and 0504T
2. 0404T for transcervical uterine fibroid(s) ablation with ultrasound guidance, radiofrequency
3. 0715T for percutaneous transluminal coronary lithotripsy
4. 0775T for arthrodesis, sacroiliac joint, percutaneous, with image guidance, including placement of the intra-articular implant(s)

In addition, the AMA introduced Spanish language descriptors for over 11,000 medical procedures and services, ensuring that healthcare is accessible to the Latinx community.   

ICD-10-CM 2024 Updates 

Discover the latest insights into the ICD-10-CM 2024 updates, featuring 395 new billable codes, 25 deletions, and 13 revisions.

• 123 code updates for external causes of morbidity (V00-Y99) to further define accident and injury details

• 30 new social determinants of health (SdoH) codes (Z00-Z99)

• 42 new codes to help specify osteoporosis with pathological fracture (M00-M99)

• 45 codes for eye diseases (H00-H59), including 29 codes that break down orbital muscle entrapment to identify affected muscle parts

• Significant code changes (Q00-Q99) to add granularity for conditions like craniosynostosis, Parkinson’s, and epilepsy

• Addition of two codes for chronic obstructive pulmonary disease (J44.81 and J44.89)

• Addition of a fifth digit to supraventricular tachycardia (I47.10, I47.11, and I47.19)

• Addition of a fifth digit to specify other Gram-negative bacteria for pneumonia (J15.61 and J15.61) and acute appendicitis (K35.200, K35.201, K35.209, K35.210, K35.211, and K35.219)

Top Strategies for Medical Billing in 2024

From leveraging advanced technologies to navigating 2024 coding guidelines, discover the top tactics driving efficiency and revenue in successful healthcare practices.

1. Stay Compliant with Updated Regulations

CPT codes are updated annually, but the CPT editorial panel can also make changes to accommodate unforeseen events such as the COVID-19 pandemic. To comply with updates, subscribe to AMA and CMS, attend training, and do internal audits to improve coding and billing practices.

2. Utilize Advanced Software Solutions

Besides CPT changes in 2024, incorporating cutting-edge technology and software solutions designed specifically for medical billing benefits your clinic significantly. Such solutions help optimize billing procedures, minimize errors, and maximize efficiency. 

With automation features, you can replace time-consuming and error-prone manual processes with an accelerated claims processing flow that fulfills patients’ and providers’ objectives.

3. Consider Outsourcing

Outsourcing medical billing offers healthcare providers a cost-effective solution to streamline revenue cycle management while ensuring accuracy, compliance, and enhanced financial performance. To ensure accurate claims processing and regulatory compliance, the ideal medical billing service provider must have a comprehensive knowledge of current and future coding standards, such as CPT 2024.

4. Conduct Regular Training and Education

Providing training and learning opportunities to staff members involved in the medical billing process is critical to any healthcare practice. Ensuring they are well-informed about coding updates, regulatory changes, and best practices boosts your clinic’s billing performance.

5. Streamline Patient Payment Methods

Prioritizing patient payment methods enhances revenue collection, reduces administrative workload, and improves the overall patient experience. Implementing digital payment solutions such as online portals, mobile apps, and secure payment gateways simplifies the billing process for patients, allowing them to pay bills from anywhere at any time.

6. Maximize Revenue through Pain Procedure

When it comes to pain procedures, it’s crucial to have precise documentation that justifies the procedure’s necessity. Using appropriate 2024 CPT codes for pain procedures is one way to ensure accurate documentation. This practice guarantees that the services are represented accurately, leading to optimal reimbursement.

7. Reduce Claim Denials

To manage claim denials effectively, expert billers recommend verifying patient information and insurance coverage before providing services. For claim denials, clinics must determine the cause, whether it is due to coding errors, lack of authorization, or billing discrepancies. 

Taking prompt action—such as correcting errors, resubmitting claims with supporting documentation, and filing timely appeals—ensures a swift resolution. Regularly monitoring denial trends and root cause analysis also helps prevent future occurrences. Complement these with gaining in-depth knowledge of the CPT 2024 updates to enhance your claims processing.

8. Get Claims Approved and Paid on the First Submission

Accurate documentation and verifying insurance coverage increase the likelihood of getting claims approved and paid on the first submission. Your billing staff must obtain any necessary pre-authorizations or referrals to avoid denied claims due to lack of authorization.

Another good billing practice is electronic claim submission, which reduces errors and accelerates processing times compared to manual submission methods.

Takeaway

Understanding the dynamic landscape of CPT code changes for 2024 and billing strategies is paramount for healthcare practitioners. By staying informed about the latest CPT code and ICD-10-CM updates and implementing strategies for medical billing, your clinic can enhance accuracy, compliance, and operational efficiency.

Tap Into Our Expertise

Maximize revenue and streamline operations with our expert medical billing services. Stay proactive in overcoming billing challenges and optimizing revenue with our tailored services. Contact our billing specialists at 480-999-0180 today or complete the form for customized CPT coding and billing solutions.

Sources:

1. American College of Radiology (ACR). “CPT 2024 Anticipated Code Changes.” ACR, 1 Jan. 2024, www.acr.org/-/media/ACR/Files/Advocacy/CPT-2024-Anticipated-Code-Changes.pdf.
2. American Medical Association (AMA). “AMA Releases the CPT 2024 Code Set.” AMA, 8 Sept. 2023, www.ama-assn.org/press-center/press-releases/ama-releases-cpt-2024-code-set.
3. Centers for Medicare & Medicaid Services (CMS). “2024 ICD-10-CM.” CMS, 1 Feb. 2024, www.cms.gov/medicare/coding-billing/icd-10-codes/2024-icd-10-cm.