AMA 2024 CPT Code Set: Addressing Language Barriers and Immunization Codes

The American Medical Association (AMA) has made significant updates to the 2024 Current Procedural Terminology (CPT) code set. These changes aim to address language barriers and streamline coding for COVID-19 immunizations.

One notable update is the addition of Spanish descriptors to the CPT code set, allowing for better communication and understanding of medical services. This inclusion aims to improve healthcare access for Spanish-speaking patients.

The AMA follows an annual release schedule, with the new edition of the CPT code set being released four months before the operational date of January 1. To ensure accuracy and relevance, the CPT Editorial Panel gathers feedback from various healthcare stakeholders.

In total, the CPT code set updates for 2024 consist of 230 additions, 49 deletions, and 70 revisions. These editorial changes amount to a total of 349 updates, reflecting the evolving coding demands in the healthcare industry.

The 2024 version of the CPT code set aims to enhance transparency for Spanish-speaking patients by incorporating consumer-friendly, Spanish-language descriptors for over 11,000 medical procedures and services. Many healthcare facilities and providers, along with health plans, already employ consumer-friendly descriptors in English for various medical documents, insurance forms, price listings, and patient portals. The inclusion of these descriptors in Spanish will enable CPT users to better assist patients within the community, as stated by the American Medical Association (AMA).

The senior vice president of health solutions at AMA emphasized the unique challenges faced by community patients who are not proficient in English or use it as a second language when navigating medical care and paperwork. Offering clear and accessible descriptions of medical procedures and services for approximately 41 million Spanish-speaking individuals in the United States can foster a more inclusive healthcare environment. In such an environment, language will no longer be a barrier, allowing patients to actively participate in their own care.

In addition to the language enhancements, the 2024 CPT code set has streamlined the coding and reporting procedures for vaccinations and immunizations. This update consolidates more than 50 codes related to reporting COVID-19 immunizations. The editorial panel has also endorsed provisional codes to identify monovalent vaccine products from leading biotechnology companies for COVID-19 immunizations, all of which have received recent approval from the US Food and Drug Administration (FDA).

A new vaccine administration code has been introduced in the CPT code set to report the administration of any COVID-19 vaccine for any patient. This code replaces all previously approved product-specific administration codes. Furthermore, the editorial panel has introduced five new CPT codes to facilitate the reporting of product-specific Respiratory Syncytial Virus (RSV) immunizations, thereby enhancing tracking, reporting, and analysis.

In response to CMS (Centers for Medicare & Medicaid Services), the editorial panel has made revisions to the code set to provide clarity in reporting evaluation and management (E/M) services. For example, time ranges have been removed from office or other outpatient visit codes, aligning the format with other E/M codes. The panel has also added a definition to specify the substantive portion of a split/shared E/M visit, where both a physician and a non-physician practitioner collaborate in providing services related to the visit. Additionally, the code set now includes instructions for reporting hospital inpatient or observation care services, as well as admission and discharge services, in cases where a patient’s stay spans over two calendar dates.