2022 CPT Changes: Interventional Radiology
Endovascular Repair of Aortic Coarctation
Previously, no codes existed to report these endovascular procedures
Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches
Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches
Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta
Destruction of Intraosseous Basiverterbral Nerve Procedures (64628, 64629)
- Codes 64628, 64629 are inclusive of imaging guidance
Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral
Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (List separately in addition to code for primary procedure)
Category III Codes
Used for new and emerging technology
Data collection purposes
Generally, no RVU’s
Transcatherter Tricuspid Valve Implantation (TTVI)/Replacement (0646T)
Transcatheter tricuspid valve implantation (TTVI)/replacement with prosthetic valve, percutaneous approach, including right heart catheterization, temporary pacemaker insertion, and selective right ventricular or right atrial angiography, when performed
Percutaneous US Gastrostomy Tube Placement with Magnetic Gastropexy (0647T)
The provider inserts a gastrostomy tube (feeding tube) through the skin, using magnets to bring the stomach to the abdominal wall under ultrasound guidance
Insertion of gastrostomy tube, percutaneous, with magnetic gastropexy, under ultrasound guidance, image documentation and report
Thyroid Nodule Laser Ablation (0673T)
This is a new minimally invasive outpatient procedure, compared to the traditional open surgical excision of thyroid nodule(s).
It is reported one time per session, no matter how many nodules are ablated.
It includes all types of imaging guidance
Can be used for single or multiple nodules
Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance
A new Category III code (0686T) has been established to report histotripsy of malignant hepatocellular tissue.
This is a new ablative technique.
This code is specific for the treatment of liver lesions.
This new procedure is different from other ablative methods in that it does not use thermal energy (e.g., radio frequency, cryogenic, etc.).
Instead, it destroys tissue non-thermally using focused acoustic energy.
Code 0686T includes all imaging guidance necessary to perform the procedure.
Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance
Documentation should include:
• Malignant hepatocellular tissue or liver lesions
Re-Evaluation of Potentially Misvalued Services
Certified Professional Coder, Director of Physician Education
Kim Snyder is a Certified Professional Coder (CPC) with more than 20 years of experience in healthcare coding and compliance. She joined MSN Healthcare Solutions in 2016 and currently serves as Director of Physician Education, specializing in the development of educational materials and programs designed to improve complete and compliant documentation.
This educational guide was prepared as a tool to provide education for documentation and coding. It is not intended to affect clinical treatment patterns. The material provided is for informational purposes only. Efforts have been made to ensure the information within this document was accurate on the date of distribution. Reimbursement policies vary from insurer to insurer and the policies of the same payer may vary within different U.S. regions. All policies should be verified to ensure compliance. CPT® codes, descriptions and other data are copyright of the American Medical Association (or such other date of publication of CPT®).All Rights Reserved. CPT® is a registered trademark of the American Medical Association. Proprietary and confidential document. All rights reserved. No part of this document may be reproduced or used in any manner without the written permission of MSN Healthcare Solutions, LLC.