By: Stacey Hall, RHIT, CPC, CCS-P, RCC, Senior Director, Corporate Coding
If you’re anticipating the code changes for 2023, the ACR published a list of the changes, as well as early release Category III codes in the March/April 2022 ACR Radiology Coding Source™.
Here, we’ve summarized four new Category III codes that have been released early and will go into effect on July 1, 2022, for CT Tissue Characterization and Quantitative MRCP. See below, four codes and guideline revisions radiologists can expect 2023:
The anticipated code changes are outlined below:
Category III
These are a set of temporary codes for emerging technology, services, procedures, and service paradigms. Category III codes allow data collection for these services/procedures. If a Category III code is available, this code must be reported instead of a Category I unlisted code. The use of the codes in this section 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. A service/procedure assigned a Category III code does not guarantee recognition or reimbursement from third party payers.
The following codes relevant to radiology will be made available July 1, 2022. (See the AMA website for a full list of Cat III codes effective in July)
CT Tissue Characterization
Quantitative CT tissue characterization is a new technology that can improve population health strategies and lead to better patient outcomes by using computer algorithms to quantitatively characterize tissues on CT images that could only be subjectively evaluated in the past.
Two new codes were created to describe this service.
Quantitative MRCP
Quantitative MRCP (QMRCP) is the quantitative evaluation of pancreato-biliary structure anatomy from MR images that produces quantitative data of the biliary tree and pancreatic ducts. The data can inform radiologist evaluation and interpretation, aid physician decision making, and potentially reduce the time for initiation of targeted treatments and interventions in diseases, such as cholestatic liver disease, chronic pancreatitis, or gallstones.
Two new codes were created to describe this service.
Parenthetical notes state that QMRCP cannot be reported in conjunction with 3D post-processing (76376 or 76377).
2023 CPT Code Changes
Please note, while this summary lists the code changes that are proposed, codes are not assigned, nor exact wording finalized until just prior to final CPT publication in the fall.
New codes will be created effective January 1, 2023, for the following:
Percutaneous Arteriovenous Fistula Creation
Two new codes will be available for percutaneous or endovascular approaches for creating arteriovenous anastomoses.
The new codes will allow the reporting of less invasive approaches utilizing endovascular methods, such as magnets or mechanical capture, to approximate the target vein and artery. The different endovascular procedures may also use balloons or coils to direct blood flow, as well as different imaging methods to guide the endovascular procedure.
Neuromuscular Ultrasound
A new code will be available to report comprehensive ultrasound of nerves and accompanying structures.
The descriptor for existing code 76882 (US joint or other nonvascular extremity structures) will be revised to include the phrase “focal evaluation of,” and the guidelines will be revised to clarify the reporting of these two codes.
Revisions will also be made to existing codes and will also be effective January 1, 2023, for the following:
Somatic Nerve Injection
The somatic nerve injection codes (64415-64417 and 64445-64448) will be revised to include imaging guidance when performed.
Pulmonary Angiography
The pulmonary angiography code (93568) will be revised to specifically state it is for nonselective angiography performed on the pulmonary artery.
Paravertebral Spinal Nerve
Several changes will be made to this subsection in CPT. Changes include:
New Artificial Intelligence (AI) Taxonomy Appendix
According to the ACR, a new appendix will be added to the CPT 2023 code book that describes various applications of AI, such as expert systems, machine learning, and algorithm-based medical services and procedures which will be classified into one of three categories:
The new taxonomy will help to improve understanding of AI and clarify how these services are used by physicians or other qualified health professionals.
Evaluation and Management
The most highly anticipated changes are in relation to E/M for non-office/outpatient services (office/outpatient services were revised in 2021). Below are some of the most pertinent changes. Zotec will provide detailed education material regarding these updates as 2023 approaches.
Inpatient and Observation Care Services
Consultations
Emergency Department Services
Nursing Facility Services
Home and Residence Services
Prolonged Services
Stay tuned for more radiology coding updates from Zotec Partners, especially as we continue to track and research upcoming E/M code changes to the specialty in 2023.
