Preparing for 2025: Key CPT Code Changes for Medical Billers October 30, 2024
It’s that time of year again when the American Medical Association (AMA) rolls out its new CPT code changes, setting the stage for the future of medical billing. Whether you’re a coder, physician, or practice manager, these updates are more than just routine adjustments—they’re valuable opportunities to refine practices and ensure accurate representation of healthcare services.
As we prepare for these new AMA CPT codes, it’s crucial to understand their impact on our daily operations. In this blog, we’ll explore the significant 2025 releases and discuss how they will influence AMA CPT coding practices moving forward.
Keep Track of the Latest CPT Code Changes
What are AMA CPT Codes?
Current Procedural Terminology (CPT) codes are a standardized system created by the AMA to represent medical procedures and services. Both in-house and outsourced medical billers use this coding system to ensure accurate reimbursement and streamline communication with payers.
Overview of 2025 CPT Code Changes
The new CPT code set brings 420 updates, consisting of 270 new codes, 38 revisions, and 112 deletions. Keeping track of these changes can be overwhelming, which is why many healthcare providers choose to outsource their medical billing. This approach not only alleviates their administrative burden but also offers a variety of benefits.
To help prepare you for what’s ahead, here’s a quick overview of the notable 2025 CPT code changes:
New Codes
The 2025 release introduces several significant enhancements, including the rollout of new codes across these healthcare areas:
- Telemedicine
Telehealth has transformed care delivery, making the introduction of 17 new telemedicine codes (98000-98016) essential. These AMA CPT codes enhance the Evaluation and Management (E/M) section, ensuring quality care is accessible from anywhere.
- Genetic Testing
Approximately 37% of the new codes are dedicated to proprietary lab analyses, with a strong emphasis on genetic testing. This highlights its importance in developing tailored treatment plans.
- AI Medical Services
There’s an exciting shift in healthcare with the launch of seven new Category III codes for artificial intelligence (AI) medical services. These codes cover advancements like electrocardiogram measurements and image-guided procedures, showing how AI is transforming diagnostics and improving treatment outcomes.
- Surgical Procedures
The latest updates also introduce 33 new surgical codes reflecting advancements in surgical techniques, especially for autografts and innovative tumor removal in the abdomen. These codes represent a commitment to improving surgical outcomes and patient care.
Revised Codes
In addition to new codes, the 2025 CPT updates introduce revisions to existing codes, ensuring the coding system remains relevant and practical.
- Remote Therapeutic Monitoring (RTM)
With the growing emphasis on remote care, critical code revisions include updates to 98975 to incorporate digital therapeutic interventions and modifications to codes 98976-98978. These codes now cover device supplies for data access related to RTM. These changes highlight a robust effort to support healthcare providers in delivering effective remote care.
- Surgical Procedures
If you work in surgery, you’ll notice updates in the general surgery section. New codes for skin grafts in wound care (codes 15011-15018) and advanced tumor removal techniques in the abdomen (codes 49186-49190) reflect the ongoing evolution of surgical methods that enhance patient care and safety.
- Diagnostic Imaging
The world of diagnostic imaging is also experiencing transformative changes. Expect updates in codes that capture the latest technologies and practices, empowering healthcare providers to report the comprehensive care they deliver accurately.
Deleted Codes
As we embrace progress in healthcare, specific codes will be retired, signaling a shift in focus for specific specialties.
- Evaluation and Management
The deletion of E/M Codes 99441-99443 signifies a transition from telephone evaluation services, emphasizing the importance of more comprehensive telehealth interactions utilizing audio-video capabilities.
- Diagnostic Imaging
Other deleted codes relate to older diagnostic imaging procedures that have become outdated due to technological advancements.
Why These Changes Matter
The new AMA CPT codes are more than just technical changes; they have real implications for medical billers and healthcare providers like you. Here’s why staying informed is essential:
- Coding Accuracy
Integrating new and revised codes into your billing practices is crucial for maintaining accuracy. Mistakes in coding can lead to claim denials and payment delays, impacting your revenue cycle and cash flow.
- Reimbursement Impact
Your coding accuracy can directly affect reimbursements. With new codes and revisions rolling out, it is essential to use the correct codes to ensure your practice thrives.
- Compliance Risks
Adapting to the new codes is not just a good practice; it’s necessary for compliance. Sticking to outdated codes could result in audits, fines, or other regulatory headaches no one wants to deal with.
- Improving Patient Care
These updates focus on diagnostics and treatment procedures, ultimately aiming to enhance the quality of patient care. Better documentation and billing practices mean better outcomes for your patients.
- Facilitating Research and Analysis
The revised coding structure allows for improved data collection, which will drive better healthcare policies and practices, benefiting everyone in the long run.
How to Stay Informed
Staying updated on CPT code changes is crucial for effective revenue cycle management and streamlined operations. A proactive approach to monitoring these updates not only keeps your practice compliant but also strengthens your financial health.
At 5 Star Billing, we recognize the importance of being informed, so we’ve compiled valuable resources to help you remain current:
- Webinars and Workshops
Engaging in webinars and workshops hosted by the AMA and other organizations offers in-depth insights into the 2025 CPT code updates and their impact on billing practices. These interactive sessions allow you to ask questions and gain clarity on complex topics.
- Coding Books and Products
The AMA Storefront is an excellent resource for essential coding books, including the CPT 2025 Professional Edition codebook. Data products like the CPT 2025 Standard Data File are also available through the AMA Intelligent Platform, providing comprehensive coding information at your fingertips.
- Medical Coding Blogs
Leverage online AMA CPT coding resources from trusted organizations like 5 Star Billing to stay updated on the latest changes and insights. Our blogs offer valuable best practices to enhance your billing expertise and improve your operations.
Tap Into the Expertise of 5 Star Billing to Stay Current on CPT Code Changes
Staying proactive about CPT coding updates ensures accurate coding and maximizes reimbursements. With the support of 5 Star Billing’s revenue cycle management experts, you can alleviate the stress of keeping up with these changes and ensure compliance.
The future of medical billing depends on our ability to adapt to evolving industry standards, and staying on top of AMA CPT coding updates is a critical milestone in that journey. Trust 5 Star Billing to help you navigate these changes with confidence!
Overwhelmed by the 2025 CPT Code Changes?