Revised CPT book includes new codes for care coordination

The changes are intended to better capture the work physicians and others at medical practices do to manage patients with complex chronic conditions.

By — Posted Aug. 16, 2012

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The American Medical Association added codes to the CPT 2013 Professional Edition for care coordination that patients with complicated, ongoing health issues receive within a patient-centered medical home, accountable care organization or other novel medical service delivery model. The codes should be used for claims filed as of Jan. 1, 2013.

Numerous private and government payers have programs supporting medical practice participation in new delivery models that incorporate care coordination. Codes for some of these services are already available. The codes 99487-99489 were created so that medical practices could bill for time that was not necessarily face-to-face but spent connecting patients to community services, transitioning them from inpatient to other settings and preventing readmissions, according to those involved in the revision.

The volume is updated annually, and other key differences between the 2013 and 2012 editions include significant changes to cardiology, neurologic testing and psychiatry codes. The AMA took the action in response to improvements in technology that mean some services have become much more common while others are no longer performed.

In total, 119 codes were deleted and 186 were added to 2013’s CPT code list. An additional 263 were changed in some way, and 18 CPT modifiers were altered.

The CPT 2013 Professional Edition, which will be published in September, is available to AMA members for $77.95 and nonmembers for $109.95 (link).

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