Date Posted: Thursday, March 28, 2024

 

The annual update to the Current Procedural Terminology (CPT)® for 2024 has 230 new codes, 70 revised codes, and 49 deleted codes. In addition, there are 395 new diagnosis codes contained in the ICD-10-CM update, about one-third of them describing new ways to capture accidents and injuries. Although relatively few of these changes will impact radiology practices, it's essential to know what they are and adjust your practice systems accordingly.

 

Diagnostic Radiology

 

Coronary Fractional Flow Reserve (FFR) with CT

 

New Category I code 75580 will replace Category III codes 0501T, 0502T, 0503T, and 0504T to describe noninvasive estimated coronary FFR derived from augmentative artificial intelligence (AI) software analysis of coronary CT angiography (CCTA) data. "Augmentative" means that a physician or other qualified healthcare professional is required to interpret and report on the analysis. When the interpretation occurs on the same day as the CCTA, then 75580 is used in conjunction with coding for the CCTA (75574).

 

Cardiac Intraoperative Ultrasound (IOUS) Services

New codes are available to report cardiac IOUS, as follows:

 

 

Cardiac IOUS is used primarily during cardiothoracic surgery procedures to evaluate structures, provide intraoperative guidance, and real-time perioperative surgical decision-making information that may affect the operative strategy.

 

Vascular Ultrasound Guidance

 

Beginning January 1, 2024, Medicare will no longer pay separately for CPT code 76937, defined as "ultrasound guidance for vascular access requiring ultrasound evaluation of potential access sites ..." and associated with any procedure that "includes radiological supervision and interpretation." Ultrasound guidance is now bundled with the primary procedure. The removal of separate billing for the ultrasound guidance code means a loss of $37.66 per procedure when billing globally, or $13.43 for the professional component, using the national Medicare reimbursement rates.

 

Several specialty societies have filed their objection to this rule change with CMS, and there is hope that it could possibly be reversed.

 

Interventional Radiology

 

Dorsal Sacroiliac Joint Arthrodesis

 

New Category I code 27278 will replace Category III code 0775T, and existing code 27279 has been modified. According to the American College of Radiology (ACR)'s description of the new code changes, the new code 27278 "will allow the reporting of percutaneous intra-articular placement of one or more fusion implant(s) directly into the SI joint under imaging guidance. This is typically performed from a posterior/dorsal approach." Regarding code 27279, ACR says that it is "used to report percutaneous placement of a transfixation device, such as a screw, across the SI joint to perform fusion. This is typically performed from a lateral approach."

 

 

Transcervical Radiofrequency Ablation (RFA) of Uterine Fibroids

 

New Category I code 58580 will replace Category III code 0404T.

 

 

Coronary Intravascular Lithotripsy (IVL) Interventions

 

New Category I code 92972 will replace Category III code 0715T to describe coronary IVL, a revascularization technique used to treat heavily calcified coronary arteries. This is an add-on code, to be used in conjunction with the primary procedure codes such as those describing coronary transluminal angioplasty, atherectomy, or stent placement.

 

 

Cystourethroscopy

 

A new code has been added, as follows:

 

 

Category III Codes

 

Category III codes are temporary codes that allow for data collection for emerging technologies, services, procedures, and service paradigms. They are not routinely reimbursed by most payors, including Medicare, when they are initially issued, but that can change as they become more accepted and eventually transitioned into a Category I classification with regular reimbursement.

 

For 2024, several new Category III codes will be available, as follows:

 

 

Diagnosis Coding

 

The most relevant ICD-10-CM code changes for radiology involve the expansion of coding for breast density, including laterality. Breast density is categorized by the breast imaging-reporting and data system (BI-RADS). Here are the codes to be used for 2024:

 

Recommendation

 

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Erin Stephens, Sr. Client Manager, Education for Healthcare Administrative Partners

www.hapusa.com