Improve your medical practice’s financial sustainability: Leverage the 2024 ICD-10-CM, ICD-10-PCS, CPT, and HCPCS coding updates

Every year, hundreds of new medical codes enable healthcare providers to capture the totality of each patient’s unique story. These medical codes along with other important details on the medical claim unlock the ‘who,’ ‘what,’ ‘where,’ ‘when,’ and ‘why’ of each healthcare encounter. 

It’s important to understand the changes and report accurate codes to promote clean claims, enhance data analytics and population health management, and improve revenue integrity.

The good news? 

In fiscal year (FY) 2024, the details of that story will be richer and more specific than ever. Every year, medical codes become more specific as we learn new information about health outcomes and patterns and develop new healthcare technologies and procedures. The pace of change will likely continue to increase over time, making comprehensive revenue cycle management a necessary business strategy. 

There are three types of medical codes to put on your radar—CPT, ICD-10 (CM and PCS), and HCPCS Level II codes. But, what is the relationship between CPT, ICD-10, and HCPCS Level II codes? 

Each type conveys different information to payers, providers, regulators, researchers, and others. However, they’re all equally important in the big picture, and they’re all necessary to tell a complete and accurate story. Consider the following:

Following are some common questions about medical coding updates for 2024. As you review these questions, be sure to also take a look at the list of telehealth services for calendar year (CY) 2024. These are services payable under the Medicare Physician Fee Schedule when furnished via telehealth through December 31, 2024. 

Now is a great time to re-evaluate your telehealth strategy and give it a boost, if needed.

There are 395 new ICD-10-CM diagnosis codes that took effect October 1, 2023. For example, there are more specific medical codes for pneumonia, Parkinson’s disease, chronic migraines, metabolic disorders and insulin resistance, and more. 

There are also new medical codes to help providers capture information that would have previously been unreported, such as resistant hypertension, dense breasts, certain child custody arrangements, familial conflict, and caregiver non-compliance. Again, it’s about telling the patient’s entire story as accurately as possible.

Here's how the new ICD-10-CM codes are broken down by chapter in the FY 2024 ICD-10-CM coding manual:

If you want to know how to apply these codes, be sure to check out the FY 2024 ICD-10-CM official coding guidelines — particularly the text in bold font that indicates new information.

To learn more about all of the ICD-10-CM code changes for 2024, including the 25 code deletions and 13 code revisions, visit  https://www.cms.gov/medicare/coding-billing/icd-10-codes/2024-icd-10-cm. 

There are 78 new ICD-10-PCS procedure codes that took effect October 1, 2023. The ICD-10 MS-DRG Grouper software package that accommodates the new codes (Version 41.1) takes effect for discharges on or after April 1, 2024.

More than 40 of the new ICD-10-PCS codes for 2024 denote new technologies (i.e., new procedures, substances, and devices) assigned to one of the following ICD-10-PCS tables:

For example, 

There are many new technologies to review and put on your radar for 2024. Also, be sure to review the 2024 ICD-10-PCS official guidelines for coding and reporting. To learn more about the changes, visit https://www.cms.gov/medicare/coding-billing/icd-10-codes/2024-icd-10-pcs. 

There are 230 new CPT codes that take effect January 1, 2024, including five new CPT codes for product-specific RSV immunizations (i.e., 90380, 90381, 90683, 90679, and 90678), notable changes to office visit evaluation and management (E/M) codes, and new codes for caregiver training services (96202, 96203, 97550, 97551, and 97552).

In addition, effective November 1, 2023, a new vaccine-administration code (90480) for the administration of any COVID-19 vaccine for any patient, replaced all previously approved specific vaccine administration codes. 

To learn more about all of the CPT changes for 2024, visit https://www.ama-assn.org/press-center/press-releases/ama-releases-cpt-2024-code-set. 

There are 345 HCPCS Level II codes that took effect January 1, 2024. These include:

Be sure to review these new HCPCS codes to determine whether you may be able to generate additional revenue:

Here’s a good summary of the CY 2024 Medicare Physician Fee Schedule Final Rule that explains how to bill these and many other new codes. Be sure to review this concise document with your medical coding and billing teams as well as physicians and other providers in the medical practice.

To learn more about HCPCS Level II coding updates, visit HCPCS Quarterly Update | CMS. 

The bottom-line answer to that question is education, education, education. 

Educate yourself on what’s new and how it might impact clinical documentation and other workflows. With the 2024 medical coding update, there are countless opportunities to capture greater specificity, address healthcare disparities, improve outcomes, and boost medical practice revenue. Understanding the changes is paramount. 

Work together with your staff to identify changes that impact your medical practice and strive for data and revenue integrity in 2024 and beyond.