With October just around the corner, we’re approaching the finish line for ICD-10. But another important date is on the horizon: you must update your CPT® Codes by January 1, 2016. The AMA creates and distributes new CPT code sets every calendar year. The 2016 CPT codes will be available in late November/early December 2015. The updates typically include new CPT codes, de-activated codes, and other revisions where the CPT descriptions may have changed. Even if you purchased the 2015 codes and only want to manually add new 2016 codes or change some descriptions, the AMA expects clients to pay the annual fees on a per user basis to be able to use their intellectual property.
Avoid risks – fines, claim rejections, overcharging, and more
As healthcare rapidly advances, you may struggle to receive appropriate reimbursement for the care you provide. As a result, it’s imperative to update your systems with the most recent CPT and HCPCS codes. You must use the updated CPT codes by 1/1/16or you put your organization at risk for:
- Overpayment/overcharging
- Underpayment/undercharging
- Claims rejections
- Fines and penalties levied by the AMA for non-compliance
By understanding the AMA’s licensing terms and conditions, you also will be compliant with their definition of a “user,” which can greatly decrease your chances of being audited.
We’ve got the CPT solutions required
NextGen Healthcare will continue to offer CPT, HCPCS, and RVU codes as part of the NextGen Healthcare Coding Update File as soon as they become available for purchase. This NextGen Healthcare value-add service is less costly than if you purchased the CPT and HCPCS codes from the AMA directly. Plus, you are assured that the codes will be imported seamlessly into your EHR/PM system. Enjoy the benefits of pre-formatted codes that you can effortlessly import into your system.
For clients who are already subscribed to the annual renewal based on your purchase of the 2015 codes directly from NextGen Healthcare, you will receive the 2016 codes for $25 per user. You’ll need to verify that your user counts have not increased, in which case you may need to purchase additional licenses in addition to your renewal. Any price increase will reflect additional fees that the AMA is charging and they will be reflected in the annual renewal for those who have previously purchased the 2015 CPT codes, as well as any new purchases of the 2016 codes.
For those clients who have not purchased CPT codes in 2015, the AMA’s expectation is that you be current and claiming the correct number of users to ensure you are not at risk of an audit by the AMA.
Convenient automatic annual updates
As an added convenience, any NextGen Healthcare clients who have purchased the Annual CPT Code Subscription will automatically receive the annual update. This ensures you receive subsequent year codes and updates by January 1 of each year, giving you peace of mind that your codes are in compliance.
CPT codes are available for purchase directly through your NextGen Healthcare sales rep or by going to insidesales@nextgen.com.