HAP Radiology Billing and Coding Blog

Coding Changes That Will Impact Radiology Practices In 2022

Posted: By Erin Stephens on January 24, 2022

Coding Changes That Will Impact Radiology Practices In 2022There are 249 new codes in Current Procedural Terminology[i] (CPT)® 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.


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.

View a recording of our webinar 2022 Updates to the MPFS & Radiology  Reimbursement Impact

Trabecular Bone Score (TBS)

Four new codes are available for reporting TBS, which measures the structural condition of the bone micro-architecture 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 (DXA) 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, it and became available for use in 2022. The code description is:

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 non-invasively, 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 vs. 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 (non-elastographic), 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 Mid-Year 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:

  • Quantitative computed tomography (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 magnetic resonance 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)

Contact HAP

Our team is constantly monitoring changes in coding and reimbursement that will affect the success of your practice. Subscribe to this blog to stay in touch with the latest news.

 

[i] Current Procedural Terminology is a copyrighted code set developed and maintained by the American Medical Association, and CPT is a registered trademark.

 

Erin Stephens, CPC, CIRCC  is the Sr. Client Manager, Education at Healthcare Administrative Partners. 

 

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Topics: radiology coding, IR coding, CPT codes, radiology

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