October 2024 Newsletter Highlights
A Note From Natalie
October is upon us, and with it comes the Columbus Day holiday as well as several other important dates to note.
October 10 is World Mental Health Day, a time to raise awareness of mental health issues around the world. What can you do to improve mental health at work? October 10 is also World Homeless Day, a time to acknowledge the needs of people who currently experience homelessness, a social determinant that can negatively affect health outcomes. Finally, October 16 is World Hunger Day, a time to unite and celebrate solutions that end hunger. Recognize these important dates as you continue to promote revenue integrity within your organization. And always remember: QualCode can help.
Natalie Williams ~ President & CEO
AMA releases 2025 CPT codes
The specifics: The American Medical Association recently released its 2025 CPT code update that includes 270 new codes, 112 deletions, and 38 revisions. The changes take effect January 1, 2025.
What’s next: Be sure to review key updates relevant to your specialty. In particular, there are editorial revisions for codes for remote therapy monitoring services, new codes for certain types of artificial intelligence augmentative data analysis, and updates to CPT’s general surgery section to reflect novel surgical approaches.
OPPS updates took effect October 1
The specifics: In the October 2024 OPPS update, you’ll find various changes to proprietary lab analyses codes; device pass through categories; drugs, biologicals, and radiopharmaceuticals; skin substitutes; blood products; and more.
What’s next: Review the changes and monitor claims to ensure your Medicare Administrative Contractor processes and pays them correctly.
Medicare Advantage plans receive at least $11.8 billion in bonus payments
The specifics: After years of steady increases, total spending on Medicare Advantage plan bonuses will decline to $11.8 billion in 2024. Twenty-four million people, or 72% of Medicare Advantage enrollees, are in plans that receive bonuses.
What’s next: Be cognizant of these bonuses when thinking about contracting with specific Medicare Advantage plans. Why? The bonuses are based on a five-star rating system and could provide insight into enrollment, quality ratings, and more.