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Medical Coding Changes in 2021 Explained

December 10, 2020

Medical Coding 2021For 2021, we’re seeing one of the biggest major overhauls to guidelines and codes for office E/M services, with significant changes to the Current Procedural Terminology code set coming. The goal of all the modifications for the coming year is to making E/M office visit documentation and coding more flexible and simpler, reducing the administrative burden on physicians and patient care teams.

According to the AMA President, it’s important for health care offices to begin getting ready to use the new guidelines and revised CPT codes by Jan 1, 2021, to reap the full benefits of administrative relief.

The new E/M modifications involve:

  • Allowing doctors to determine the best type of patient care by letting them select code levels based upon total time or medical decision making.
  • Eliminating physical exam and history as elements for selecting a code.
  • More detail has been added to the CPT code guidelines and descriptors in order to promote consistency among payers.

A total of 329 editorial changes, including the revised E/M codes, have been included in the 2021 CPT code set. This includes 206 new CPT codes, 69 revisions, and 54 deletions. Most of these new codes are a result of growth in novel and new areas of medicine. Here’s a closer look at some of the additions, deletions, and revisions to be aware of as your practice moves into 2021.

New CPT Codes for Covid-19 Testing and Immunizations

As we dealt with the Covid-19 pandemic in 2020, several new codes have been added throughout the year, some being approved to be used immediately earlier in the year. These new SARS-CoV-2 related codes are being published in the 2021 CPT code set. Along with codes for testing for the coronavirus, new codes are available for immunizations as well.

CPT Codes for New Digital Medicine Innovations

Throughout 2020, particularly as we’ve dealt with a pandemic that pushed the need for more telehealth and digital forms of care, there’s been fast-pasted innovation in digital medicine services. These services not only improve patients’ access to care but also improve overall health outcomes for patients. New codes for some of the available cutting-edge innovations have been added to the 2021 CPT code list.

The code 92229 has been added for retinal imaging done with automated point-of-care, and codes 92228 and 92227 have been revised in order to support diabetic retinopathy screening in patients with diabetes to improve early detection and the incorporation of these findings into their care. The augmented intelligence tech that is described by the new 92229 code improves access for patients who are at risk, bringing these capabilities into primary care settings.

There’ve been significant technological developments in the continuous cardiac monitoring and detection field as well. This has resulted in adding on multiple new codes for external extended electrocardiogram monitoring, including:

  • 93248
  • 93247
  • 93246
  • 93245
  • 93244
  • 93243
  • 93242
  • 93241

These new codes are replacing the Category III deleted codes 0298T, 0297T, 0296T, and 0295T. The new codes make use of innovative algorithmic tech working together with a patch that makes it far easier for patients to wear these devices while providing more complete and accurate data for physicians to interpret.

Implementation of these new codes is coming soon, so it’s essential to make sure your practice is ready to handle the new E/M coding changes as well as all the new, revised, and deleted CPT codes. While it will take some adaptation in the coming months, the goal is to ensure that the changes provide physicians with a very needed break in their administrative burden, improving patient care.

At, we offer quality billing and coding services to help practices across the country as they navigate CPT code changes and work towards boosting their bottom line. Our professionals stay current on the latest changes, so we’re able to ease your organization through the coming transitions. Find out more about how we can help you as we move into 2021 by contacting us at today.


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