CPT® coding support with CPT Assistant

CPT® Assistant is the official source for CPT coding guidance. This digital monthly newsletter is an essential resource for medical coding and billing professionals, which offers expert guidance and clarification on the complex and ever-evolving landscape of CPT coding. It is designed to enhance understanding, ensure accuracy and streamline the coding process by providing detailed explanations, coding tips and clinical examples for the proper application of CPT codes.

CPT Assistant serves as a companion to the CPT codebook, offering in-depth articles on coding for new procedures and technologies, answers to frequently asked questions, and updates on regulatory changes and their impact on coding. CPT Assistant has been instrumental in:

• Appealing insurance denials
• Validating coding to auditors
• Training staff
• Answering day-to-day questions that arise with applying the CPT code set correctly

In addition to the monthly updates on the latest coding guidance, CPT Assistant Online is also a fully searchable archive of all previously published CPT Assistant articles. Access articles that educate the industry on proper CPT coding for past, present and future code set releases. The online archive features examples, descriptions and illustrations that help explain the practical application of each new code. Other benefits include:

• Unlimited access to every article published in CPT Assistant since 1990
• Simple search capabilities by keyword, phrase, code number, issue or article index
• Homepage alerts when the latest issue is available
• Official interpretations of guideline changes from the CPT Editorial Panel
• Anatomical illustrations, charts and graphs
• Answers to frequently asked questions

Prior authorization is an administrative process that requires physicians or other qualified health care professionals (QHPs) to obtain approval from a health insurance carrier before a service, supply or medication will be authorized if provided to a patient. This article provides guidance on the appropriate reporting of time and effort of prior authorization related activities performed by clinical staff.

To provide uniform guidance in this area, comprehensive CPT coding guidance on prior authorization activities will be published in the October 2024 issue of CPT Assistant. Download and read the prior authorization issue of CPT Assistant (PDF).

Procedures on the musculoskeletal system represent some of the most commonly performed procedures reported in the CPT code set. The introductory guidelines in this section were revised and reorganized in the 2022 code set to clarify fracture and dislocation treatment services.

To provide additional clarity in use of this section of CPT codes, an article was published in CPT Assistant on the topic. Download and read the article pertaining to musculoskeletal system guidelines. (PDF)

Changes for the CPT 2024 code set included significant changes in coding for neurostimulator services, involving extensive review and revision/establishment of both Category I and Category III codes. These codes are:

• 61889
• 61891
• 61892
• 63685
• 63688
• 64590
• 64595
• 64596
• 64597
• 64598
• 0784T
• 0785T
• 0786T
• 0787T
• 0788T
• 0789T

To provide uniform guidance in this area, comprehensive CPT coding guidance on neurostimulator services was published in the December 2023 issue of CPT Assistant, as well as revised guidelines in CPT 2024 Professional. Download and read the neurostimulator issue of CPT Assistant (PDF).

For additional guidance and clarification regarding proper CPT code usage, sign up for the yearly subscription. AMA members receive a 25% discount!

Do you have a CPT coding topic that you’d like to see addressed in a future issue of CPT Assistant? Submit the form with your suggestion. All requests will be reviewed by the CPT Assistant Editorial Board.

If you have a specific CPT coding question, please sign up for a CPT Network subscription.