Coding Changes for 2020: Don't Miss Out

Betsy Nicoletti, MS

Disclosures

December 11, 2019

The change here is the same as for the prior code: changing "20 minutes of time" to "the first 20 minutes." This covers clinical staff, physicians, or other qualified healthcare professional time in a calendar month, requiring interactive communication with the patient or caregiver during that month.

These professionals can also use 99458 for each additional 20 minutes.

New Codes for Vaccines

Two new vaccine codes have been added in 2020:

Code 90694: Influenza virus vaccine, quadrivalent (allV4), inactivated, adjuvanted, preservative free, 0.5 mL dosage, for intramuscular use

Code 90619: Meningococcal conjugate vaccine, serogroups A, C, W, Y; quadrivalent, tetanus toxoid carrier (MenACWY-TT), for intramuscular use

Health Behavior Assessment and Intervention

In 2019, testing codes in this section were significantly revised. In 2020, the intervention codes are revised once again.

Codes 96150–96155 were deleted and replaced with codes in the series 96156–96171. These codes describe assessments and individual, group, and family interventions related to health behaviors based on time.

New Online Services Codes 

CPT developed these services for use by professionals who do not have E/M services within their scope of practice, such as registered dietitians.

The Centers for Medicare & Medicaid Services (CMS) is not recognizing these codes because they use the words "evaluation and management" in their description, but CMS did develop Healthcare Common Procedure Coding System (HCPCS) codes for use by clinicians other than physicians, NPs, and PAs. These codes have a status indicator of invalid in the Medicare Fee Schedule.

There are three clinical examples in CPT Changes 2020: An Insider's View to describe these codes, and all three show the clinician providing the service as a registered dietitian nutritionist.

Code 98970 is defined as: Qualified nonphysician healthcare professional online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 5-10 minutes. Code 98971 would be used for services 11-20 minutes and 98972 for those 21 or more minutes.

CMS has developed the following HCPCS codes that do not use the words "evaluation and management" for use by other professionals who do not have E/M in their scope of practice.

Code G2061 is defined as: Qualified nonphysician healthcare professional online assessment service, for an established patient for up to 7 days, cumulative time during the 7 days; 5-10 minutes. Code G2062 would be used for services 11-20 minutes and G2063 for those 21 or more minutes.

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