2019 CPT codes offer new paths to payment for digital medicine

Tanya Albert Henry , Contributing News Writer

Reflecting the reality that physicians and their staff spend an increasing amount of time engaging with technology to enhance and improve patient care, the 2019 Current Procedural Terminology (CPT®) code set that takes effect Jan. 1 provides health professionals the codes they need to get paid for emerging services.

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Among the changes in the 2019 CPT code set are three new remote patient monitoring codes that reflect how health professionals can more effectively and efficiently use technology to connect with their patients at home to gather data for care management and coordination. Specifically:

  • 99453 Remote monitoring of physiologic parameter(s), (for example, weight, blood pressure, pulse oximetry, respiratory flow rate) initial; setup and patient education on equipment use.
  • 99454 Device(s) supply with daily recording(s) or programmed alert(s) transmission, each 30 days.
  • 99457 Remote physiologic monitoring treatment management services, 20 minutes or more of clinical staff/physician/other qualified health care professional time in a calendar month requiring interactive communication with the patient/caregiver during the month.

There also are two new interprofessional internet consultation codes to reflect the increasing importance of using non-verbal communication technology to coordinate patient care between a consulting physician and treating physician. Specifically:

  • 99451 Interprofessional telephone/internet/electronic health record assessment and management service provided by a consultative physician, including a written report to the patient’s treating/requesting physician or other qualified health care professional, 5 minutes or more of medical consultative time.
  • 99452 Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting physician or other qualified health care professional, 30 minutes.

Broad input from practicing physicians, medical specialty societies and the greater health care community was considered by the CPT Editorial Panel to produce the latest practical enhancements to CPT that reflect the coding demands of the modern health care system.

“The AMA has urged the Centers for Medicare & Medicaid Services to adopt the new codes for remote patient monitoring and internet consulting and designate the related services for payment under federal health programs in 2019,” said AMA President Barbara L. McAneny, MD.

“Medicare’s acceptance of the new codes would signal a landmark shift to better support physicians participating in patient population health and care coordination services that can be a significant part of a digital solution for improving the overall quality of medical care,” she said.

In all, there will be 335 CPT code changes in the CPT next year: 212 codes are being added; 73 are being deleted and 50 are being revised. The AMA evaluates and changes the code annually to reflect scientific and technological advances in medical, surgical and diagnostic services.

In addition to the changes that help physicians get paid for the new ways they use technology to advance patient care, other revised codes include:

  • Skin biopsy.
  • Fine needle aspiration biopsy.
  • Adaptive behavior analysis.
  • Central nervous system assessments, including psychological and neuropsychology testing.

The 2019 CPT codes and descriptors can be imported into existing claims and billing software using the downloadable CPT 2019 Data File. The file contains the updated code set’s complete descriptor package, including official descriptors for consumers and physicians, and the complete official CPT coding guidelines, according to the AMA.

To help physicians and their staff better understand revisions to the CPT code set, the AMA offers an insider’s view with detailed information on the new code changes in its book CPT® Changes 2019: An Insider's View.

The health care community also can attend the CPT and RBRVS 2019 Annual Symposium in Chicago Nov. 13–16 to learn more about significant revisions to the CPT code and descriptors. In addition, the three-day conference will include, among other things, discussions and payment policy and relative value unit (RVU) changes to the Medicare physician payment schedule. For more information and to register, visit the AMA website.