The AMA released a list of CPT code updates and changes, notably for patient encounters, ordering tests, and discussions, among others. They reported 329 code changes in the most current CPT code edition, some of which impact dermatologists, pathologists, and dermatopathologists.

Although few dermatologists would take pride in their CPT coding skills, being proficient in billing practices can ensure the business side of your practice runs smoothly and gets reimbursed quickly. But as AMA announces major updates to their CPT coding sets, now is the time to check your CPT codes for accuracy and compliance.

There are a few factors that have impacted the need for changes: First, the shift toward value-based care; second, the Patients over Paperwork initiative launched by the US Department of Health and Human Services in 2017; and third, the onset of COVID-19, which required additional codes.

As healthcare systems transition to a VBC model, here’s why it’s important for your CPT codes to be current.  

Why Update CPT Codes?

In response to the growing concern among healthcare providers that the documentation requirements for billing weren’t benefiting patient care, the AMA set out to streamline the CPT coding process. 

According to the AMA, “The CPT code set continues to be modified to respond to the fast pace innovation among digital medicine services that can improve access to health care and improved health outcomes for patients across the country.”

By streamlining the standard for communicating healthcare procedures and services across healthcare teams and health systems, better CPT coding and billing procedures will reduce the cost of care while increasing the quality of care and expand access to it. In addition to preventing fraudulent claims and reducing the risk of monetary or legal penalties, other results may include more accurate billing and a reduction in claim denials, which can frustrate patients and impact a provider’s reputation.

“The AMA is attacking dysfunction in health care by removing obstacles and burdens that interfere with patient care,” the AMA says. “Our focus is on making technology an asset in the delivery of health care, not a burden.”

What CPT Code Changes Can We Expect for Pathology and Dermatopathology?

To focus on codes that impact the pathology, dermatology, and dermatopathology fields, APS Medical Billing released a CPT code change summary highlighting the most common CPT codes. You can access it here

For instance, although coding for inpatient encounters and consultations are not affected by these changes, doctors should note changes in codes 99201 through 99215 that pertain to outpatient office visits. “With these landmark changes, as approved by the CPT Editorial Panel, documentation for E/M office visits will now be centered around how physician think and take care of patients and not on mandatory standards that encouraged copy/paste and checking boxes,” says the AMA, adding that the goal of these coding changes is to decrease the overload of documentation and coding, cut down on unnecessary documentation, reduce audits, and make sure reimbursement for E/M is resource-based.

How Does EMR Technology Make It Easy to Update CPT Codes?

Fortunately, using EMR for your patients’ information makes it easy to update CPT code changes. EMR technology houses patient data in a secure location that is easy to organize and share with other healthcare providers, insurance companies, pharmacies, labs, other clinics, billing services, and more. Compared to traditional handwriting, an EMR facilitates the code assignment for billing, increases legibility to reduce errors, curtails paperwork, and eliminates duplicate tests.  

According to the Centers for Medicare and Medicaid Services, “Documenting a patient’s record with all relevant and important facts, and having that information readily available, allows providers to furnish correct and appropriate services that can improve quality, safety, and efficiency.” 

If your clinic is considering updating to digital patient records, we’ve weighed some pros and cons of using an EMR system. Check it out!