2024 CPT changes for Ophthalmology and Ophthalmologic Surgery 

In 2024, there are some important updates in how medical procedures and visits are coded for Ophthalmology Practices. These changes affect various aspects of healthcare, from office visits to surgical procedures and vaccinations. Let’s take a closer look at what’s new and how it might impact medical practices.

2024 CPT Changes Overview for Ophthalmology

The 2024 CPT changes bring significant updates across various medical specialties:

Additions:

• Most additions are focused on laboratory medicine.
• Ten codes are added or relisted for vaccines pending FDA approval.
• New code G2211 is introduced for primary care complexity of visits, integrated into the base E&M code.

Revisions:

• Office visit E&M descriptions now include minimum time requirements.
• “Incident to” services are now permissible if the physician is present by audio/visual during the encounter.

Deletions:

• Temporary codes are replaced with permanent CPT codes, mainly in laboratory medicine, particularly for drug assays.

Revised E&M CPT Updates:

Office or Outpatient Visits:

• 99202: New patient – straightforward medical decision making, minimum 15 minutes required.
• 99203: New patient – low level medical decision making, minimum 30 minutes required.
• 99204: New patient – moderate level medical decision making, minimum 45 minutes required.
• 99205: New patient – high level medical decision making, minimum 60 minutes required.
• 99212: Established patient – straightforward medical decision making, minimum 10 minutes required.
• 99213: Established patient – low level medical decision making, minimum 20 minutes required.
• 99214: Established patient – moderate level medical decision making, minimum 30 minutes required.
• 99215: Established patient – high level medical decision making, minimum 40 minutes required.

Nursing Facility:

• 99306: Initial nursing facility care, per day, high level medical decision making, minimum 50 minutes required.
• 99308: Subsequent nursing facility care, per day, low level medical decision making, minimum 20 minutes required.

New or Pending FDA Approval: Several new vaccines are added or pending FDA approval, including for Dengue, Chikungunya virus, Meningococcal, Influenza, Pneumococcal, RSV mRNA, and SARS-CoV2.

Revised/Clarification on “Incident To” Highlights:

• “Incident to” services apply to non-institutional settings and mid-level providers.
• They require direct supervision of the physician, who can now also be present via audio/visual means.

Revised Surgical CPT:

• 67516: Suprachoroidal space injection of pharmacological agent (separate procedure).

Other CPT Updates: Updates include new codes in various medical fields like gastroenterology, audiology, percutaneous lithotripsy, interventional cardiology, chemotherapy, physical therapy, caregiver training, and more.

Impact and Benefits:

• Practices may need to adjust workflows based on the changes.
• Financial projections can be made based on these adjustments.

SVAST Revenue Cycle Management Service: SVAST offers Ophthalmology Medical Billing and Coding Services which helps in navigating these changes and optimizing practice revenue cycles.