CPT Code Changes You Should Know About for 2022

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The 2022 CPT changes are out, and there are over 400 revisions, deletions, and additions for the new year. Below is an overview of the main code changes you should know, compiled by the billing and coding experts at MMG.

One change that impacts many sections is the shift from a semicolon to a comma, which has an impact on the description and the documentation requirements. Be sure to keep an eye on the punctuation!

The 2021 major overhaul on the E/M Codes resulted in very few changes in that section, but the Chronic Care and Principal Care sections had changes in time requirements and new add-on codes for additional time. Luckily, there were no modifier changes.

The Pathology and Laboratory subdivisions saw the most changes with 82 new codes. Only 5 were deleted and 3 were revised. The new code descriptions are very specific to the type of specimen, how the specimen is obtained, and the specific tests that are done.

The Anesthesia section had a few changes in spinal procedures, select new codes that provide more granularity, and a few deletions.

There were only a few additions and deletions in the Radiology Codes, while the Surgery section had a large number of changes, including a revision of the guidelines for simple closure and fracture repair, among others.

The Medicine section contains the changes for COVID and non-COVID vaccines, as well as the administration codes. Many heart catheterization codes have been changed for the new year; again, new codes have more specific descriptions. There were also a few changes on the respiratory therapy and monitoring codes.

There are many pages of Category III Codes, which are temporary codes for new and emerging services and procedures.

The COVID-19 testing codes, immunization codes, and vaccine codes have changed and multiplied several times over the past two years, leading to a great deal of confusion and frustration for providers, but the 2022 CPT code changes are finally complete. The codes are separated below with a short description including the manufacturer on both the vaccine codes and the administration codes. The vaccine codes also list the corresponding administration codes, and the differences between similar codes are underlined for ease of review.

COVID-19 TESTING CODES:

86408 – Neutralizing antibody presence screening; COVID-19

86409 – Neutralizing antibody titer dilution [concentration]; COVID-19

86413 – Immunoassay antibody, quantitative; COVID-19

87426 – Immunoassay technique, qualitative or semiquantitative; COVID-19

87428 – Immunoassay technique, qualitative or semiquantitative; COVID-19 and Flu A & B

87636 – Multiplex amplified probe technique [DNA/RNA], COVID-19 and Flu A & B

87637 – Multiplex amplified probe technique [DNA/RNA], COVID-19, Flu A & B, and respiratory syncytial virus

87811 – Immunoassay with direct optical observation, COVID-19

COVID-19 VACCINE CODES:

91300Pfizer SARS-CoV-2 [COVID-19] vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3 mL dosage, diluent reconstituted, for IM

Used with admin codes 0001A-0004A

91301Moderna SARS-CoV-2 [COVID-19] vaccine, mRNA-LNP, spike protein, preservative free, 100 mcg/0.5 mL dosage, for IM

Used with admin codes 0011A-0013A

91302AstraZeneca SARS-CoV-2 [COVID-19] vaccine, DNA, spike protein, chimpanzee adenovirus Oxford 1 (ChAdOx1) vector, preservative free, 5×1010 viral particles/0.5 mL dosage, for IM

Used with admin codes 0021A-0022A

91303Janssen SARS-CoV-2 [COVID-19] vaccine, DNA, spike protein, adenovirus type 26 (Ad26) vector, preservative free, 5×1010 viral particles/0.5 mL dosage, for IM

Used with admin codes 0031A-0034A

91304Novavax SARS-CoV-2 [COVID-19] vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, preservative free, 5 mcg/0.5 mL dosage, for IM

Used with admin codes 0041A-0042A

91305Pfizer SARS-CoV2 [COVID-19] vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3 mL dosage, tris-sucrose formulation, for IM

Used with admin codes 0051A-0054A

91306Moderna SARS-CoV2 [COVID-19] vaccine, mRNA-LNP, spike protein, preservative free, 50 mcg/0.25 mL dosage, for IM

Used with admin code 0064A

91307Pfizer SARS-CoV-2 [COVID-19] vaccine, mRNA-LNP, spike protein, preservative free, 10 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation, for IM

Used with admin codes 0071A-0072A

COVID-19 ADMINISTRATION CODES:

AstraZeneca vaccine, DNA, spike protein, chimpanzee adenovirus Oxford 1 (ChAdOx1) vector, preservative free, 5×1010 viral particles/0.5 mL dosage:

0021A – first dose

0022A – second dose

Janssen vaccine, DNA, spike protein, adenovirus type 26 (Ad26) vector, preservative free, 5×1010 viral particles/0.5 mL dosage:

0031A – single dose

0034A – booster dose

Moderna vaccine, mRNA-LNP, spike protein, preservative free, 100 mcg/0.5 mL dosage:

0011A –first dose

0012A – second dose

0013A – third dose

Moderna vaccine, mRNA-LNP, spike protein, preservative free, 50 mcg/0.25 m dosage:

0064Abooster dose

Novavax vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, preservative free, 5 mcg/0.5 mL dosage:

0041A – first dose

0042A – second dose

Pfizer vaccine, mRNA-LNP, spike protein, preservative free, 30mcg/0.3mL, diluent reconstituted:

0001A – first dose

0002A – second dose

0003A – third dose

0004A – booster dose

Pfizer vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3 mL dosage, tris-sucrose formulation:

0051A –first dose

0052A – second dose

0053A – third dose

0054A – booster dose

Pfizer vaccine, mRNA-LNP, spike protein, preservative free, 10 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation:

0071Afirst dose

0072A – second dose

If you have questions about the 2022 CPT Code Changes or other billing and coding needs, our team is here to help. Please contact Laura Summy at LSummy@medicmgmt.com to schedule a conversation.

Laura Summy is Manager of Coding and Erin Saunders is a Coder II at MMG Healthcare Solutions / Medic Management Group. MMG is a national provider of consulting services and back office administrative support to independent and system owned physician practice groups.  Additionally, MMG has been formally recognized as a multi-year Northeast Ohio Top Workplaces award winner.

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