The 2024 updates to the CPT codes in the Evaluation and Management (E&M) section introduce a new code for pelvic examinations and significant revisions based on the time spent on patient care. These changes, outlined in detail at Learn.TheCodingDoctors.com, are designed to reflect the evolving nature of patient encounters and the need for flexibility in coding based on the complexity and time requirements of services provided.

New CPT Code for E&M

• CPT Code 99459: This new code pertains to the pelvic examination and is intended to be reported in addition to the code for the primary procedure.

The revisions primarily update the descriptors related to the total time spent on the date of the encounter:

• CPT Code 99202: For new patients requiring straightforward medical decision making, the total time must be 15 minutes or more.
• CPT Code 99203: For new patients with a low level of medical decision making, a minimum of 30 minutes is required.
• CPT Code 99204: New patient visits with moderate medical decision making must involve at least 45 minutes.
• CPT Code 99205: High-level medical decision making for new patients must equal or exceed 60 minutes of total time.
• CPT Code 99212: For established patients with straightforward medical decision making, at least 10 minutes must be spent.
• CPT Code 99213: Established patient visits involving a low level of medical decision making require a 20-minute minimum.
• CPT Code 99214: If moderate medical decision making is required for an established patient, the encounter must last at least 30 minutes.
• CPT Code 99215: For established patients with high-level medical decision making, 40 minutes or more must be documented.
• CPT Code 99306: Initial nursing facility care for high medical decision making now requires at least 50 minutes.
• CPT Code 99308: Subsequent nursing facility care with a low level of medical decision making requires a 20-minute minimum.