Coding changes that will impact radiology practices in 2022

By Erin Stephens, AuntMinnie.com contributing writer

January 27, 2022 -- There are 249 new codes in the Current Procedural Terminology (CPT) system that are now in effect for 2022, plus 93 revised codes and 63 deleted codes. However, of all those changes, relatively few will impact radiology practices.

Erin Stephens
Erin Stephens.

Diagnostic radiology

Although the following codes that were deleted from use were rarely used, practices should review their systems to be sure they are not used in the future, which would result in payment denial and delay:

  • Radiologic examination, complex motion body section, other than urography; unilateral (76101) and bilateral (76102)
  • Epidurography, radiological supervision and interpretation (72275); the injection codes related to this code include imaging guidance.

Trabecular bone score (TBS)

Four new codes are available for reporting TBS, which measures the structural condition of the bone microarchitecture and predicts the risk of major osteoporotic fracture independent of bone mineral density and clinical risk factors. The new codes are as follows:

CPT Code Description
Trabecular bone score (TBS), structural condition of the bone microarchitecture; using dual x-ray absorptiometry (DEXA) or other imaging data on grayscale variogram,
77089 Includes calculation, with interpretation and report on fracture risk
77090 Technical preparation and transmission of data for analysis to be performed elsewhere
77091 Technical calculation only
77092 Interpretation and report on fracture-risk only by other qualified healthcare professional

GI tract

New code 91113 was created to replace category III code 0355T, described as follows:

Gastrointestinal tract imaging, intraluminal (e.g., capsule endoscopy), colon, with interpretation and report.

As a category I code, this procedure now carries reimbursement on the 2022 national Medicare fee schedule of $122.85 for the professional component and $971.74 global (although payment is limited to $933.33 due to the OPPS cap).

Interventional Radiology

Thermal nerve destruction

Two new codes are available for reporting thermal destruction of the intraosseous basivertebral nerve. This procedure provides effective relief for patients suffering from certain types of chronic low-back pain. The new codes are as follows:

CPT Code Description
Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance;
64628 First 2 vertebral bodies, lumbar or sacral
64629 Add-on Each additional vertebral body, lumbar or sacral

Category III codes

Category III codes are temporary codes that allow for data collection for emerging technologies, services, procedures, and service paradigms. When initially issued they are not routinely covered by most payers, including Medicare; however, that situation can change as they become accepted. Use of Category III codes is important because it can lead to eventual Category I classification with regular reimbursement.

CT for vertebral fracture analysis

An artificial intelligence (AI) code 0691T was created during 2021, as we reported, and it became available for use in 2022. The code description is as follows:

Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, and report.

Quantitative multiparametric MRI (mp-MRI)

According to the American College of Radiology, "Quantitative mp-MRI uses software to analyze tissue physiology of visceral organs and other anatomic structures noninvasively, and is a tool to assist in physician decision-making." Codes were issued for use beginning July 1, 2021, and the series has been updated for 2022 to specify single versus multiple organs, as follows:

 
CPT Code Description
Quantitative magnetic resonance for analysis of tissue composition (e.g., fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation, and report,
obtained without diagnostic MRI of the same anatomy (e.g., organ, gland, tissue, target structure) during the same session;
0648T single organ
0697T multiple organs
obtained with diagnostic MRI of the same anatomy (e.g., organ, gland, tissue, target structure) during the same session;
0649T single organ
0698T multiple organs

Quantitative ultrasound tissue characterization

Two new codes are available as follows:

CPT Code Description
Quantitative ultrasound tissue characterization (nonelastographic), including interpretation and report
0689T Obtained without diagnostic ultrasound examination of the same anatomy
0690T Obtained with diagnostic ultrasound examination of the same anatomy

Codes effective midyear 2022

The CPT update for December 30, 2021, contained several category III codes of interest to radiology that will become effective on July 1, 2022. They include the following:

  • Quantitative CT tissue characterization, including interpretation and report,
    • Obtained without concurrent CT examination of any structure contained in previously acquired diagnostic imaging (0721T)
    • Obtained with concurrent CT examination of any structure contained in the concurrently acquired diagnostic imaging dataset (0722T)
  • Quantitative MR cholangiopancreatography (QMRCP) including data preparation and transmission, interpretation, and report,
    • Obtained without diagnostic magnetic resonance imaging (MRI) examination of the same anatomy (e.g., organ, gland, tissue, target structure) during the same session (0723T)
    • Obtained with diagnostic magnetic resonance imaging (MRI) examination of the same anatomy (e.g., organ, gland, tissue, target structure) during the same session (0724T)

Erin Stephens is senior client manager, education at Healthcare Administrative Partners.

The comments and observations expressed are those of the author and do not necessarily reflect the opinions of AuntMinnie.com.


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