Transcranial magnetic stimulation (TMS) is a non-invasive brain stimulation technique that has been used to treat various neuropsychiatric disorders, including major depressive disorder, obsessive-compulsive disorder, and post-traumatic stress disorder. TMS treatment is typically delivered in an outpatient setting, and healthcare providers who offer this service must use the appropriate billing codes when submitting claims for reimbursement. One of the most commonly used billing codes for TMS is the Current Procedural Terminology (CPT) code 90834, which is used to report individual psychotherapy services.
Over the years, there have been updates and changes to the TMS CPT code that providers should be aware of. In this article, we will review some of the recent changes to the TMS CPT code and what they mean for providers who offer TMS services.
In 2021, the American Medical Association (AMA) made some changes to the TMS CPT code to reflect new clinical scenarios and advances in technology. One of the most significant changes was the creation of a new TMS code: 97129. This code is used to report cognitive function intervention, which includes the use of TMS to improve cognitive function in patients with neurological conditions. Providers who offer TMS for cognitive function intervention must use this new code to submit claims for reimbursement.
Another change to the TMS CPT code in 2021 was the deletion of code 90867. This code was previously used to report TMS-related services, such as the development of treatment plans and documentation of treatment progress. Providers who previously used this code must now use other appropriate codes, such as 96130 or 96131, to report these services.
In addition to these changes, there were also revisions to the descriptors of existing TMS codes. For example, the descriptor for code 90834 was revised to include the phrase “with or without evaluation and management services.” This change reflects the fact that TMS services may be delivered in conjunction with other evaluation and management services.
It is important for providers who offer TMS services to stay up-to-date with these changes to the TMS CPT code to ensure that their billing practices are compliant and accurate. Failure to use the appropriate codes could result in denied claims, delayed reimbursements, or even legal consequences.
Importance Of Staying Updated On CPT Code Changes For Providers
Staying updated on CPT code changes is essential for healthcare providers for several reasons:
- Accurate billing: CPT codes are used to describe and bill for medical procedures and services. Using the correct code ensures that providers are reimbursed appropriately for their work and helps to prevent billing errors and denials.
- Compliance: Providers must comply with regulations related to billing and coding, and staying up-to-date on CPT code changes helps to ensure compliance with these regulations.
- Patient care: Accurate billing and compliance with regulations can have a direct impact on patient care. Providers who are not paid correctly or who run afoul of regulations may have difficulty providing the best care to their patients.
- Financial health: Staying up-to-date on CPT code changes can also have a positive impact on a provider’s financial health. Accurate billing and compliance can help to ensure timely payment and can help to prevent financial losses due to denied claims or other billing errors.
In short, staying up-to-date on CPT code changes is critical for providers to ensure accurate billing, compliance with regulations, high-quality patient care, and financial stability.
Conclusion:
There have been recent updates and changes to the TMS CPT code that providers should be aware of. These changes reflect new clinical scenarios, advances in technology, and revisions to code descriptors. Providers who offer TMS services must use the appropriate codes when submitting claims for reimbursement to ensure that their billing practices are compliant and accurate. By staying informed about these changes, providers can continue to offer high-quality TMS services to their patients while minimizing the risk of billing errors and other compliance issues.
