December 1, 2022
New Category I Codes:
Percutaneous Arteriovenous Fistula Creation
Two new codes for percutaneous or endovascular approaches describing reporting less invasive techniques will be available. Present codes describe open surgical arteriovenous anastomosis creation.
These new codes allow reporting less invasive techniques using endovascular methods via magnets or mechanical capture, which approximate the target vein and artery. Alternate endovascular procedures may also use balloons or coils to direct blood flow and different imaging methods to guide the endovascular procedure for creating arteriovenous anastomoses.
Currently, existing codes only describe open surgical arteriovenous anastomosis creation.
A new code was created for reporting comprehensive ultrasound of nerves and accompanying structures.
New Category III Codes:
Four new Category III codes were released early to the AMA’s (American Medical Association’s) website this year with an effective date of July 1, 2022.
CT Tissue Characterization
Two codes were created to describe quantitative CT tissue characterization. These brand-new codes were designed similarly to active quantitative ultrasound tissue characterization codes 0689T and 0690T.
Quantitative CT tissue characterization is a new technology that can improve population health strategies and patient outcomes by using computer algorithms to characterize tissues quantitatively on CT images that could only be subjectively evaluated in the past.
Two codes are available to describe quantitative MRCP, which will allow the reporting of quantitative evaluation of pancreato-biliary structure anatomy from MR images that produce quantitative data of the biliary tree and pancreatic ducts. The data can inform radiologist evaluation and interpretation, aid physician decision-making, and possibly reduce the time for initiation of targeted treatments and interventions in diseases such as cholestatic liver disease, chronic pancreatitis, or gallstones.
NEW ARTIFICIAL INTELLIGENCE (AI) TAXONOMY APPENDIX
A new appendix will be included in the CPT 2023 code book that defines various applications of AI, such as expert systems, machine learning, and algorithm-based medical services and procedures.
The new taxonomy will help to increase understanding of AI and clarify how these services are used by physicians or other qualified health professionals (QHPs). The classification of AI services will be grouped into one of three categories:
Radiology Code Description Revisions:
76882: Ultrasound, limited, joint or other nonvascular extremity structure(s) (e.g., joint space, peri-articular tendon[s], muscle[s], nerve[s], other soft tissue structure[s], or soft tissue mass[es]), real-time with image documentation will be revised to include the phrase “focal evaluation of”.
The code descriptions for Somatic Nerve Injection 64415-64417 and 64445-64448 will now be revised to include e “imaging guidance, when performed”.
A new table will be added with editorial instructions for the appropriate coding for unilateral and bilateral of paravertebral facet injection of the T12-L1 and L1-L2 levels or nerves innervating those joints. Paravertebral Spinal Nerves and Branches codes 64490-64495.
Source: 2023 CPT Anticipated Changes | American College of Radiology (acr.org)