A Look at the Changes in 2023 to Radiology and IR CPT Codes

StreamlineMD has provided updates for 2023 Radiology and IR CPT coding, which may impact your practice’s coding, billing, and reimbursement operations.

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January 5, 2023 — StreamlineMD has provided updates for 2023 Radiology and IR CPT coding, which may impact your practice’s coding, billing, and reimbursement operations. To avoid unnecessary denials, which can delay reimbursement, review the coding changes below to ensure your radiology practice is ready to go for patients treated beginning January 1, 2023.

New Category 1 Codes

Interventional Radiology

Pulmonary Artery Revascularization

33900 - Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral
33901 - Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral
33902 - Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral
33903 - Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral
+33904 (add-on code) - Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (List separately in addition to code for primary procedure)

Fistula Creation

36836 - Percutaneous arteriovenous fistula creation, upper extremity, single access of both the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radiologic supervision and interpretation.
36837 - Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radiologic supervision and interpretation.

Diagnostic Radiology

Ultrasound

76883 - Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity.

New Category 3 Codes

0691T - Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report.
0721T - Quantitative computed tomography (CT) tissue characterization, including interpretation and report, obtained without concurrent CT examination of any structure contained in previously acquired diagnostic imaging.
+0722T (add-on code) - Quantitative computed tomography (CT) tissue characterization, including interpretation and report, obtained with concurrent CT examination of any structure contained in the concurrently acquired diagnostic imaging dataset (List separately in addition to code for primary procedure).
0723T - Quantitative magnetic resonance cholangiopancreatography (QMRCP) including data preparation and transmission, interpretation, and report, obtained without diagnostic magnetic resonance imaging (MRI) examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session.
+0724T (add-on code) - Quantitative magnetic resonance cholangiopancreatography (QMRCP) including data preparation and transmission, interpretation, and report, obtained with diagnostic magnetic resonance imaging (MRI) examination of the same anatomy (eg, organ, gland, tissue, target structure) (List separately in addition to code for primary procedure).
- (Use 0724T in conjunction with 74181, 74182, 74183, when also evaluating same organ, gland, tissue, or target structure).
+0742T (add-on code) - Absolute quantitation of myocardial blood flow (AQMBF), single-photon emission computed tomography (SPECT), with exercise or pharmacologic stress, and at rest, when performed (List separately in addition to code for primary procedure).
0743T - Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (BMD), with concurrent vertebral fracture assessment, utilizing data from a computed tomography scan, retrieval and transmission of the scan data, measurement of bone strength and BMD and classification of any vertebral fractures, with overall fracture-risk assessment, interpretation, and report.
0749T - Bone strength and fracture-risk assessment using digital X-ray radiogrammetry-bone mineral density (DXR-BMD) analysis of bone mineral density (BMD) utilizing data from a digital X ray, retrieval and transmission of digital X-ray data, assessment of bone strength and fracture risk and BMD, interpretation, and report.
0750T - Bone strength and fracture-risk assessment using digital X-ray radiogrammetry-bone mineral density (DXR-BMD) analysis of bone mineral density (BMD) utilizing data from a digital X ray, retrieval and transmission of digital X-ray data, assessment of bone strength and fracture risk and BMD, interpretation, and report; with single-view digital X-ray examination of the hand taken for the purpose of DXR-BMD.
+0777T (add-on code) - Real-time pressure-sensing epidural guidance system (List separately in addition to code for primary procedure).

Revisions Affecting Billing

Somatic Nerve Injections, CPTs 64415-64417 and 64445-64448 will all be inclusive of imaging guidance.

Revisions Not Affecting Billing

Nuclear Medicine

78803 - Radiopharmaceutical localization of tumor, inflammatory process, or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), single area (eg, head, neck, chest, pelvis), or acquisition, single day imaging.
78830 - Radiopharmaceutical localization of tumor, inflammatory process, or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) with concurrently acquired computed tomography (CT) transmission scan for anatomical review, localization and determination/detection of pathology, single area (eg, head, neck, chest, pelvis), or acquisition, single day imaging.
78831 - Radiopharmaceutical localization of tumor, inflammatory process, or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), minimum 2 areas (eg, pelvis and knees, chest, and abdomen) or separate acquisitions (eg, lung ventilation and perfusion), single day imaging, or single area or acquisition over 2 or more days.
78832 - Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) with concurrently acquired computed tomography (CT) transmission scan for anatomical review, localization and determination/detection of pathology, minimum 2 areas (eg, pelvis and knees, chest and abdomen) or separate acquisitions (eg, lung ventilation and perfusion), single day imaging, or single area or acquisition over 2 or more days.

In Conclusion

Make sure your teams are ready for these changes and that they understand the subtle nuances that may affect your practice.
Update or create new report templates to support the documentation for medical necessity for new/revised procedures, as appropriate.
Review CPT changes and latest information each year because it can have a major impact on your bottom line.
StreamlineMD is your resource for Radiology/IR coding and billing, and we have the answers to your questions.

For more information: www.streamlinemd.com