2024 Orthopedic Coding Updates
2024 Orthopedic Coding Key Updates
As we step into the year 2024, the field of orthopedic coding sees several important updates to keep abreast of. These changes encompass a range of procedures and guidelines that directly impact the coding and billing processes within orthopedic practices. It is crucial for orthopedic coders and billing professionals to stay informed and adapt to these updates to ensure accurate and compliant reimbursement for the services provided. The 2024 orthopedic coding changes highlights are on vertebral body tethering (VBT) codes, bunion correction clarifications, and several new Category III codes.
CPT 2024 introduces four new codes for vertebral body tethering (VBT), a procedure performed to treat adolescent idiopathic scoliosis. The implants are an alternative to spinal fusion to correct progressive scoliosis while allowing natural growth and mobility of the spine. Anchors and bone screws are placed in the vertebrae above and below the spinal curvature, and a tether cord is secured to the bone screws, to which the surgeon can apply tension to straighten the spine.
The new Category I codes are:
22836- Anterior thoracic vertebral body tethering, including thoracoscopy, when performed, up to 7 vertebral segments
22837- Anterior thoracic vertebral body tethering, including thoracoscopy, when performed, 8 or more vertebral segments
22838- Revision (eg, augmentation, division of tether), replacement, or removal of thoracic vertebral body tethering, including thoracoscopy, when performed
27278- Percutaneous sacroiliac joint fusion (replaces Category III code 0775T)
The new Category III code is:
0790T- Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body tethering, including thoracoscopy, when performed
Revised Category III codes are:
0656T- Anterior lumbar or thoracolumbar vertebral body tethering, up to 7 vertebral segments
0657T- Anterior lumbar or thoracolumbar vertebral body tethering, 8 or more vertebral segments
Coding Clarification: Bunion correction
Changes have been made to CPT codes 28292 and 28295-28299, adding the word “with” to the base code description.
28292- Correction, hallux valgus with (bunionectomy), with sesamoidectomy, when performed
Adding “with” to the code description clarifies that the surgical procedures reported by codes 28292 and 28295-28299 should include the removal of the bunion by excision or resection.
To prevent inappropriate reporting of code 28297, parenthetical notes were added following codes 28297 and 28740 clarifying that code 28740 should be reported if a first tarsometatarsal (metatarsal-cuneiform) joint fusion is performed that does not include an associated removal of the distal medial prominence of the first metatarsal to accomplish the correction of a hallux valgus.
Another New Category III code
0814T- Percutaneous injection of calcium-based biodegradable osteoconductive material, proximal femur, including imaging guidance, unilateral.
This category III code was established to report percutaneous injection of calcium-based biodegradable osteoconductive material. The procedure involves implanting a calcium-based, osteoconductive material into the lateral femoral cortex to form new bone in voids in the proximal femur of patients with disorders such as osteoporosis. The procedure is performed under image guidance.
Evaluate E/M timing changes
The 2024 manual updates the guidelines for time in the introduction to make it clear that the mid-point concept does not apply to E/M services that have a total time threshold.
Specifically, office visit codes 99202-99205 and 99212-99215 have been revised to remove the code range from each code. Instead, clinicians billing based on time will have a single minimum time threshold that must be met or exceeded.
Practices shouldn’t be alarmed by this; the editorial updates simply change the codes’ format to match the rest of the level-based E/M codes. They do not change the threshold time that the treating practitioner must meet to select a code based on time.
11 procedures added to the ASC-payable list
CMS has added 11 additional surgical codes to the ASC payable list for 2024, below is what affects Orthopedics:
CPT Code 23470: Reconstruction of shoulder joint
CPT Code 23472: Reconstruction of shoulder joint
CPT Code 27006: Incision of hip tendons
CPT Code 27702: Reconstruction of ankle joint
CPT Code 29868: Meniscal transplant knee with scope
The 2024 orthopedic coding updates demand a proactive approach from orthopedic practices and coding professionals. Staying informed, embracing education, and meticulously applying these updates to coding and billing processes are critical to the financial health and regulatory adherence of orthopedic practices.
By keeping abreast of these coding changes, orthopedic practices can navigate the evolving healthcare landscape with confidence, ensuring that their services are appropriately reimbursed while upholding compliance with the latest coding and documentation guidelines.