Medical Coding and Billing Changes for Family Practice in 2015


Medical Coding and Billing Changes for Family Practice in 2015The CPT 2015 will have approximately 550 new, revised or deleted codes. It will also include revised guidelines and terminologies. These changes will affect the family medicine physicians, cardiologists, radiologists and internal medicine practitioners too. Similar to the other medical specialties, the family medicine will too have to gear up for dozens of new and revised vaccine codes in 2015. It will include additions of 90630 and 90654 codes for flu immunizations.

The 2015 coding changes will alter the way family medicine practices report vaccinations, chronic care management services and arthrocentesis (joint aspiration). Some descriptor changes to old codes will also affect this medical specialty.

Coding Changes for Family Medicine Practitioners

Family medicine providers need to take CPT coding changes into serious consideration if they want to make the most of their reimbursement opportunities. Here are some of the CPT 2015 code revisions, deletion and additions that will affect family medicine practitioners in the next year.

Two new vaccine codes will be added in 2015, just like it was done in 2014. These two new codes and descriptor changes for vaccination will include:

  • 90630 – Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, for intradermal use
  • 90651 – Human Papilloma virus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58 nonavalent (HPV), 3 dose schedule, for intramuscular use

The addition of these two codes has been announced by the CMS; however, the FDA is yet to approve them. The codes 90654, 90734, 90721 and 90723 will go through descriptor changes. These codes had been primarily revised for distinguishing the existing codes from new ones that are to appear in 2015.

Apart from these coding changes, new CPT codes will be added for arthrocentesis. The new codes for the joint aspiration are 20604, 20611 and 20606. These codes need to be reported by the family physicians when they perform procedures that involve ultrasound guidance.

For instance, 20600 will have to be used when a procedure is performed without ultrasound guidance and 20604 needs to be used when ultrasound guidance is used with permanent reporting and recording. Some ‘arthrocentesis’ codes will also go through description changes such as 20600, 20610 and 20605.

These are some of the scheduled CPT code changes for 2015. If family medicine physicians fail to update their coding with the above-mentioned requirements, they will have to face claims denials effective from January 01, 2015.

The shortage of family medicine physicians is becoming an increasing concern in the US. The pressure caused by healthcare reforms and the increasing numbers of baby boomers will create trouble for this medical specialty. These challenges will keep family practitioners busier than before, hard pressed for time and suffer from untimely payments.

Many family medicine practitioners across the US have started outsourcing their family practice billing services and coding requirements to a third party. Seeking assistance from a third party billing partner has helped them balance their time and attention to clinical and administrative tasks.

Billing companies like have been helping family physicians overcome their coding and billing changes. With less than two months left for the implementation of CPT 2015, providers can still seek assistance from billing partners like MBC for avoiding delayed collectibles and enhancing their revenue.

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