How to Keep Up With CPT/HCPCS Updates Without Slowing Down Claims

Healthcare billing relies on up-to-date CPT and HCPCS codes. These code sets are constantly revised to reflect new medical procedures, devices, and technologies. As the AMA notes, the CPT code set is the “foundation for the efficient and effective exchange of standardized information” in medicine. For example, the AMA’s 2025 CPT update included 270 new codes (with 112 deletions and dozens of revisions). 

At the same time, CMS issues quarterly HCPCS Level II files. Using outdated codes can have immediate consequences: “Submitting outdated codes on a claim will result in claim rejections”. Staying current is vital to avoid denials and keep revenue flowing. Fortunately, there are systematic ways to integrate these updates seamlessly, so your claims cycle doesn’t slow down.

Code Update Schedules

CPT and HCPCS follow a defined update cycle. 

• CPT (AMA) codes are updated annually (effective Jan. 1), while HCPCS Level II (CMS) codes are refreshed quarterly (with new code files issued in January, April, July, and October). 
• (ICD‑10 diagnosis codes also change each Oct. 1, but that’s managed separately.)

In practice, this means your billing team must handle multiple update deadlines each year. 

Knowing the schedule is the first step, for example, ensure your practice plans a codebook or EHR update in late December so January claims use the new CPT set.

Subscribe to Official Updates

The easiest way to stay informed is to hear about code changes from the source. For CPT, the AMA offers a free monthly “CPT News” email alert, which delivers summaries of code changes and guidance directly to subscribers. For HCPCS Level II, CMS provides email listservs (such as the HCPCS Updates Listserv) to notify providers of the latest code additions and deletions. 

Beyond official channels, professional organizations and forums also help: for instance, associations like AAPC or AHIMA publish newsletters and host webinars on coding changes. 

Sign up for these newsletters and listservs well in advance of update dates. That way, you’ll receive announcements (and often detailed tables) of new, revised, or deleted CPT/HCPCS codes. Regularly checking AMA and CMS coding websites, or trusted coding news sources, ensures you never miss a bulletin.

• Example: AMA’s CPT resources page offers a sign-up for CPT News, while CMS’s HCPCS page links to an “HCPCS Level II Updates” email sign-up. Professional coding groups likewise send updates on changes.

Integrating Updates Seamlessly

Getting new code lists is one thing; smoothly incorporating them into your billing system is another. Best practice is to update your EHR or billing software code libraries before each effective date. Coordinate with your IT or software vendor to load the new code files into your system. 

For example, update your EMR’s CPT/HCPCS tables in late December and schedule any needed system freezes so that January 1 claims will use the current codes. Similarly, apply each quarterly HCPCS file promptly. It’s important to communicate these dates to your team in advance.

To streamline this, consider using structured data feeds or automated update tools. Many modern coding software solutions ingest official code updates via APIs or data files. 

• AMA’s “CPT Refresh” data products provide code changes and deletions in a format that can be directly imported by software. 
• By contrast, manual data entry of new codes is error-prone and slow. 
• With automatic feeds, your system can flag deleted codes and highlight new ones. 
• After loading updates, run a test batch of claims or reports to verify that the new codes are accepted and no legacy codes remain. 
• This proactive testing catches problems before they hit actual claim submissions.

Related: 5 Ways a $200K Audit Strategy Can Recover 10X in Lost Claims

Best Practices for Your Team

Technology and schedules aside, human processes are equally important. Here are some key strategies:

1. Regular Coding Audits

Periodically review a sample of coded claims or medical records. Audits help catch lingering use of outdated codes or common mistakes. As one coding guide notes, audits not only ensure accuracy and compliance but also help staff “keep up with the latest coding updates”. For example, after a major update, an audit might reveal if any team members forgot about a deleted CPT code.

2. Continuous Education

Invest in training for coders and billers. Host quick review sessions whenever new codes arrive (for example, go over any significant additions or deletions). 

Ongoing education keeps the team sharp: coders who understand why code changes are more likely to apply them correctly. The same source emphasizes that ongoing training “ensures implementation of the latest coding practices”. Even short lunch-and-learn meetings can be valuable around update time.

3. Team Communication

Encourage coders, billers, and clinicians to share information. Often, a clinician might mention a new procedure, that is a cue for coders to check for a corresponding new code. 

Hold brief meetings after each update cycle to discuss any coding issues encountered. Peer feedback is also helpful: discussing a puzzling claim can surface missed updates. As one expert blog notes, “feedback and discussions with colleagues will help you be on track with medical coding updates”.

4. Documentation Tools

Keep up-to-date code references handy. Ensure all staff have access to the latest CPT codebooks (print or online) and HCPCS files. Many organizations use digital coding tools or smartphone apps for quick lookup. The more accessible the new information is, the less likely someone will revert to an old code by mistake.

By building these practices into your workflow, your team becomes proactive. Instead of scrambling after denials, staff work from current data and catch errors before submission.

Related: 10 Medical Billing Denial Codes That Affect Your Revenue

Leveraging Technology and Automation

Modern digital health tools can greatly reduce the manual burden of tracking code changes. The key is to use billing and EHR systems that automatically sync with code updates. Many software platforms now include functionality to import new CPT/HCPCS code sets without manual effort. 

For example, integrated coding engines or APIs can push updates into your system so coding tables are always current. This means coders and billers can search for and select codes as usual, confident they’re choosing valid entries.

Beyond automatic updates, advanced analytics and AI can further catch issues. Some solutions use AI and rules-based checks to flag potentially outdated or mismatched codes before claims go out. For instance, an AI-based system might scan a claim and alert the coder if it detects a deleted CPT code or a combination of codes that violates new coding rules. 

• According to experts, AI “can help medical practices automate routine tasks like data entry and processing claims,” reducing errors and ensuring “correct application of current codes”. 
• AI can also be set up to remind teams of upcoming update deadlines (e.g., sending an alert that new codes are effective Jan. 1), which builds a fail-safe into the process.

Other technical best practices include:

• Denial analytics: Use your practice management system’s reporting tools to monitor denial reasons. A spike in “invalid CPT code” rejections, for example, can immediately signal an update issue.
• Interoperability with payers: Some organizations integrate directly with payer systems or clearinghouses. If a payer updates its system to the new codes, any claim sent with an old code will bounce. Having real-time awareness of payer accepted code sets (via clearinghouse updates) ensures claims are only submitted with valid codes.
• Data-driven reminders: Track which codes have been removed or revised in a centralized system. Then use your workflow tool (or even simple calendar reminders) to alert staff on key dates (e.g., when a commonly used code will be deleted).
  

By leveraging these digital capabilities, you make code updating a background process rather than a bottleneck. In effect, technology shields your billing staff from the worst of the administrative load.

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