2024 Dermatology CPT Updates

The ever-evolving landscape of medical coding sees 349 changes in the 2024 Current Procedural Terminology (CPT) updates, encompassing 225 additions, 75 deletions, and 93 revisions. While Dermatology experiences minimal alterations, practitioners should stay vigilant to ensure accurate billing. While you have the option to search the internet independently, we recognize the value of a trustworthy source that offers a concise overview of significant changes impacting dermatological services.

Direct Supervision Extension

CMS extends the Direct Supervision waiver to December 31, 2024, enabling audio-visual means for incident-to services to Medicare patients. Dermatologists are urged to verify policies with commercial carriers to align with the latest updates.

Conversion Factor and Billing Changes

With a 2024 conversion factor of $32.74, Dermatology witnesses a subtle shift in billing dynamics. Notably, a change in billing for prolonged services codes (99417/99418) now requires a full 15 minutes beyond the base time.

Pathology Update

Within the realm of Dermatology, significant changes emerge in the Pathology domain. New CPT codes address the digitization of glass slides, serving as add-ons to surgical path codes. Dermatologists should reference the CPT manual for precise billing details, especially when dealing with less common path codes.

88342 is billed with 0760T
88341 is billed with 0761T
88344 is billed with 0762T
88331 is billed with 0841T
88332 is billed with 0842T
88302 is billed with 0751T
88304 is billed with 0752T
88305 is billed with 0753T
88307 is billed with 0754T
88309 is billed with 0755T
88312 is billed with 0756T

Time-Based Billing Alignment

In a notable alignment, both the American Medical Association (AMA) and CMS converge on time-based billing. Dermatologists must adapt to the new standard, embracing the requirement for a full 15 minutes over the base time to bill prolonged services codes.

E/M Coding Guidance on Time

Introduction of G2211

CMS introduces G2211, an add-on code for office and other outpatient services (99202-99215), effective January 1, 2024. Aimed at primary care and select specialties managing long-term, complex conditions, Dermatology specialists should exercise caution when considering its application.

Restrictions on G2211 Usage

CMS stipulates that G2211 will not be reimbursed when used with modifier 25 on the evaluation and management (E/M) code during a minor procedure. Furthermore, not all E/M visits are eligible for G2211, with specific examples of non-qualifying conditions provided in the Final Rule (p. 432).

“…E/M visit complexity add-on code would not be appropriately reported, such as when the care furnished during the O/O E/M visit is provided by a professional whose relationship with the patient is of a discrete, routine or time-limited nature…”. They provide specific examples of conditions that would not require the add on complexity code: mole removal, treatment of a simple virus, seasonal allergies, new onset GERD, treatment for a fracture, and/or “when the billing practitioner has not taken responsibility for ongoing medical care for that particular patient with consistency and continuity over time, or does not plan to take responsibility for subsequent, ongoing medical care for that particular patient with consistency and continuity over time.”

Practitioner-Patient Relationship Criteria

CMS emphasizes the importance of the practitioner-patient relationship in determining G2211 eligibility. The code is intended for practitioners serving as the “continuing focal point for all needed health care services” over an extended period. Dermatologists should exercise discretion, as the inherent complexity captured by G2211 lies in the cognitive load associated with maintaining longitudinal relationships.

CMS stated:  “We clarify that it is the relationship between the patient and the practitioner that is the determining factor of when the add-on code should be billed. First, the “continuing focal point for all needed health care services” describes a relationship between the patient and the practitioner, when the practitioner is the continuing focal point for all health care services that the patient needs. For example, a patient has a primary care practitioner that is the continuing focal point for all health care services, and the patient sees this practitioner to be evaluated for sinus congestion. The inherent complexity that this code (G2211) captures is not in the clinical condition itself— sinus congestion —but rather the cognitive load of the continued responsibility of being the focal point for all needed services for this patient.”

In 2024, Dermatology finds itself within a relatively stable coding environment amid the broader CPT updates. While the field experiences minimal changes, staying attuned to nuances, particularly with the introduction of G2211, is crucial for practitioners. Navigating through 349 alterations and a total code count of 11,163 requires careful consideration. Dermatologists, facing this intricate landscape, can alleviate the burden and worry of keeping pace with these changes by partnering with a specialized dermatology billing company like ours. We take pride in our ability to not only provide accurate information but also to excel in navigating the advancing coding landscape, ensuring optimal reimbursement and compliance for all our clients.

External Links:

CMS FACT SHEET 2024
CMS G2211 OFFICE/OUTPATIENT E/M
CMS FEE SCHEDULE FINAL RULE SUMMARY
CODING INTEL – HCPCS ADD ON CODES

Read more from our published resources:

MAXIMIZING PROFIT FOR MOHS SURGEONS
CODING AND DOCUMENTATION GUIDANCE FOR MOHS SURGERY REIMBURSEMENT
UNDERSTANDING THE ROLE OF MODIFIERS IN MEDICAL BILLING