It's déjà vu all over again. As December comes to an end, it's time once more to review the CPT codes that will take effect Jan. 1 to see which ones have a bearing on your practice. To avoid having claims denied or payments delayed, update your billing forms and systems now to reflect the new codes. And if you haven't already incorporated the ICD-9-CM code changes that went into effect in October, now's the perfect time to take care of both in one fell swoop.(See, "ICD-9-CM codes: The latest changes," Sept.7, 2007).

There are 242 new CPT codes and 54 deleted codes. But what's noteworthy for the coming year is that there are 305 revised codes—about four times as many as in 2007. Many of the revisions stem from changes in the list of codes that are exempt from modifier –51, which indicates that you did more than one non-E&M procedure during a single session. It's attached to the secondary, or lesser valued procedure, for which insurers typically reduce the fee.

Procedures that are exempt from modifier –51 have a symbol—a circle with a slash through it—next to their code number in the CPT book. The AMA CPT Editorial Panel reviewed these exemptions, using new criteria, and deleted 152 of them from the 2008 list.

The actual codes for the previously exempt procedures haven't changed, but because they appear in the 2008 CPT book without the exemption symbol, they're counted as revisions. Additionally, many of the no-longer exempt codes are now add-on codes—which always appear with a "+" in front of the code to indicate that they can't be reported as stand-alones.

CPT 2008 is available in hard copy, on CD-ROM, or via downloadable files, from the AMA at http://www.amabookstore.com|~|~.

Here are important changes to be aware of.

E&M codes

There are 12 new, five deleted, and nine revised E&M codes. A new subsection, Non-Face-to-Face Physician Services, has been added that includes new codes for telephone services and online medical evaluations.

Three new telephone codes (99441-99443) are for physicians to use to report E&M services provided by phone at the request of established patients. But they can't be used if the doctor sees the patient within 24 hours or the call refers to an E&M visit within the previous seven days. The new online E&M code (99444) is intended to report a physician's Internet response to an established patient's online inquiry. These services should be documented in the medical record.

The AMA created these codes in response to changes in patient expectations and advancements in technology. But Medicare won't be reimbursing these new codes, and neither will most private payers. "It's important to recognize the difference between code establishment and coverage decisions," Thorwarth points out.

Another new subheading, Counseling Risk Factor Reduction and Behavior Change Intervention, features four new codes. Two of them report smoking cessation counseling (99406, 99407) and replace the G codes (G0375, G0376) that Medicare used to report this service. The other two (99408, 99409) apply to alcohol and/or drug abuse screening and brief intervention services. But you'll have to use new G codes (G0396 and G0397) when you submit this service to Medicare.

Three new codes (99366-99368) cover interdisciplinary team conferences for patients or families by physicians and allied health professionals, such as audiologists, physical therapists, and psychologists. The specific conference code depends on time, whether the patient is present, and whether physicians or nonphysicians attend.