Category III Codes: What Radiologists Should Know Before July 1, 2024
June 5, 2024
Below are the category III codes that may affect radiology groups effective July 1, 2024.
Category III codes are a set of temporary codes for emerging technology, services, procedures, and service paradigms which allow for data collection.
If a Category III code is available, this code must be reported instead of a Category I unlisted code. This section of codes allows physicians and other qualified health care professionals, insurers, health services researchers, and health policy experts to identify emerging technology, services, procedures, and service paradigms for clinical efficacy, utilization, and outcomes.
Most importantly, a service/procedure assigned a Category III code does not guarantee recognition or reimbursement from third party payers
Code
Description
0714T
Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume less than 50 mL
0867T
… prostate volume greater or equal to 50 mL
Code
Description
0870T
Implantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, including all imaging and initial programming, when performed
0871T
Replacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed
0872T
Replacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when performed
0873T
Revision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, when performed
0874T
Removal of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters
0875T
Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional
Code
Description
0876T
Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)
Code
Description
0877T
Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without concurrent CT examination of any structure contained in previously acquired diagnostic imaging
0878T
… obtained with concurrent CT examination of the same structure
0879T
… radiological data preparation and transmission
0880T
… physician or other qualified health care professional interpretation and report
Code
Description
0888T
Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance
Code
Description
+0899T
Noninvasive determination of absolute quantitation of myocardial blood flow (AQMBF), derived from augmentative algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (CMR), pharmacologic stress, with interpretation and report by a physician or other qualified health care professional (List separately in addition to code for primary procedure)
+0900T
Noninvasive estimate of absolute quantitation of myocardial blood flow (AQMBF), derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (CMR), pharmacologic stress, with interpretation and report by a physician or other qualified health care professional (List separately in addition to code for primary procedure)
By Leslie Shisler, CPC, CIRCC, RCC, RCCIR, Director, Coding Education & IR Services for Zotec Partners
