By: Jennifer Studdard, MLS, RCC, RCC-IR, CCS-P, CPC, CPCO, MSN-ARC
MSN Client Services, Senior Director of Coding Compliance
The American College of Radiology (ACR) has announced anticipated Current Procedural Terminology (CPT®) code changes for 2026 in an article providing an overview. We have highlighted changes impacting a wide range of radiology practices.
The article states, “Several new and revised radiology Category I codes will be available, including computed tomography angiography (CTA) of the head and neck, computed tomography cerebral perfusion (CTP), irreversible electroporation (IRE), thoracic branch endograft services, prostate biopsy, lower extremity (LE) vascular procedures, radiation oncology treatment delivery, endovascular therapy, and sacroiliac (SI) arthrodesis.”
CTA Head and Neck Coding Update
While a new code for CTA head and neck is being created, it appears that the stand-alone codes will be treated like the CTA abdomen/pelvis, where both are still available but only used in the rare circumstances that the single anatomic region is studied. MSN feels this change will most likely result in an RVU loss but until the RVUs are published, we are unable to measure the impact.
The ACR article noted, “Codes 70496 and 70498 were identified by the Relativity Assessment Workgroup (RAW) of the AMA/Specialty Society Relative Value Scale (RVS) Update Committee (RUC) as being reported together 75% of the time or more. Therefore, these codes were referred to the CPT Editorial Panel (the Panel) for bundling.”
CTP Coding Revisions
Another change deletes 0042T for Computed Tomography Cerebral Perfusion (CTP) and will establish two new Category I codes to report CTP. Based on available information, we believe one code will represent CTP performed with concurrent CTA and the other code will represent CTP performed without a concurrent CTA. Related commentary in the ACR article states, “Recent published literature has demonstrated the utility of CTP in clinical decision-making related to neuroendovascular intervention in patients who are in the acute stroke phase.”
Thoracic Branch Endograft Services
The article reported “Two new codes will be available to report thoracic branch endograft services. Additionally, the Endovascular Repair of Descending Thoracic Aorta guidelines and codes 33880, 33881, 33883, and 33886 will be revised. Codes 33884, 33889, 33891, and 75956-75959 will be deleted.” There was no discussion regarding the specific revisions.
Overhaul of Lower Extremity Revascularization Codes
The Lower Extremity Revascularization section is being completely overhauled. Current codes will be deleted and there will be 46 new codes. Proposed coding changes include expanding the regions to include the inframalleolar region in addition to the iliac, femoral-popliteal, and tibial-peroneal regions. Codes will also differentiate between treatment of straightforward and complex lesions.
Revisions in Radiation Therapy Delivery
Codes for radiation therapy delivery will also be revised. Once announced, MSN will review them to identify potential impact on Y-90 cases, although preliminary information does not indicate changes will occur.
Updates to Endovascular Therapy Coding
Revisions to codes for Endovascular Therapy are being revised to include RS&I so imaging guidance (75894) will no longer be separately billable and it is doubtful that follow-up angiography remain separately billable (75898). ACR article stated, “Code pairs 61624/75894 and 61624/75898 were identified on a RAW screen for services performed together 75% of the time or more, and therefore both code pairs were referred to the Panel for bundling. Codes 61624 and 61626 will be revised to include all RS&I guidance necessary to complete the intervention. In addition, the Vascular Embolization and Occlusion guidelines will be revised, and new guidelines will be added to the Endovascular Therapy subsection.” This will have an RVU impact for interventionalists but exactly how much is unknown at this time.
Anticipated Impacts and Next Steps
These are significant changes for radiology that will impact not only the documentation practices of the physicians but will also most certainly have an impact on revenue and productivity measurements. Once the final code changes are published and reviewed at AMA CPT Symposium, MSN will provide documentation tips, practice education and other guidelines to assist our clients as they prepare to implement these changes.
Jennifer Studdard
MLS, RCC, RCC-IR, CCS-P, CPC, CPCO, MSN-ARC
MSN Client Services, Senior Director of Coding Compliance
Jenny Studdard has more than twenty-five years of healthcare compliance, coding and billing experience. As the MSN Director of Coding Compliance, Jenny provides the coding department education and support to ensure accurate, consistent, and compliant coding practices. Prior joining MSN, Jenny was a Director of Compliance and Client Services responsible for supporting clients with due diligence reviews, audits, operational assessments, onsite training, and other consulting support services.
