You would almost think that after all these years there really couldn’t be many additional CPT procedure code set updates. The 2012 codes, however, have been released and we do find another year with new codes, definition changes and deleted codes. Some changes are of course more dramatic than others. For example, there are a lot of new laboratory codes for genetic testing, which is not surprising given that this an emerging area in medicine. Next to lab I think the areas with the greatest number of changes for 2012 are cardiology and pain management.

The vaccine administration codes are changing in CPT 2011 and the new series of codes is no longer assigned based on the number of “sticks” the patient receives.

Effective January 1, 2010, the Centers for Medicare & Medicaid Services (CMS) began no longer paying for CPT consultation codes (inpatient and office/outpatient codes) except for telehealth consultation HCPCS G-codes. Providers should now report visits that would have been billed under CPT consultation codes, with an E/M code based on where the visit occurs and the complexity of the visit performed. This change in policy applies only to providers billing Medicare under the fee-for-service program.

The new CPT codes for 2011 have been released and include new subsequent observation codes for physicians who perform hospital services. Three new codes are being introduced for subsequent observation care per day. While observation codes have previously had a code that captured admission and discharge services, coders were often instructed to use office visit codes or an unlisted code to capture other observation care services for subsequent day care.

Per CPT guidelines, you may only report one “initial” vaccine administration code per day, regardless of the route of administration. Simple, straightforward, and easy to understand…right?