Radiology Coding Alert

Temporary codes can help promote better patient outcomes.

Four new Category III CPT^® codes that apply to radiology practices will take effect July 1, 2022. Here’s what you need to know about these new quantitative computed tomography (CT) tissue characterization and magnetic resonance cholangiopancreatography (MRCP) category III CPT^® codes.

Select 0721T or +0722T Based on Concurrent CT

Two of the new codes describe quantitative CT tissue characterization:

• 0721T (Quantitative computed tomography (CT) tissue characterization, including interpretation and report, obtained without concurrent CT examination of any structure contained in previously acquired diagnostic imaging)
• +0722T (… obtained with concurrent CT examination of any structure contained in the concurrently acquired diagnostic imaging dataset (List separately in addition to code for primary procedure))

Through computer algorithms, quantitative CT tissue characterization technology analyzes body tissue quantitatively, which was only evaluated subjectively in the past. According to the American College of Radiology, the technology “can improve population health strategies and lead to better patient outcomes” (www.acr.org/Advocacy-and-Economics/Coding-Source/March-April-2022/2023-CPT-Anticipated-Changes).

A parenthetical note for 0721T instructs you to not report the code in conjunction with several CT procedure codes, when the procedure is performed on the same anatomy. This makes sense because the 0721T descriptor states “obtained without concurrent CT.” These code ranges include, but are not limited to:

• 70450-70470 (Computed tomography, head or brain …)
• 71250-71270 (Computed tomography, thorax, diagnostic …)
• 73200-73202 (Computed tomography, upper extremity …)
• 74150-74170 (Computed tomography, abdomen …)

On the other hand, +0722T applies when the quantitative tissue characterization is “obtained with concurrent CT,” so +0722T features a parenthetical note that allows you to use the add-on code in conjunction with the same CT codes listed in 0721T’s note.

Use QMRCP Codes for Pancreato-Biliary Structure Evaluations

MRCP is a noninvasive magnetic resonance imaging (MRI) exam that visualizes the biliary and pancreatic ducts, so providers can evaluate if gallstones are stuck in the ducts surrounding the gallbladder. Quantitative MRCP procedures measure the actual duct diameter to provide precise measurements with minimal error, which allows providers to view and assess changes in cholangiopathy (bile duct disease).

The following new Category III CPT^® codes were created for quantitative MRCP procedures:

• 0723T (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 (eg, organ, gland, tissue, target structure) during the same session)
• +0724T (… obtained with diagnostic magnetic resonance imaging (MRI) examination of the same anatomy (eg, organ, gland, tissue, target structure) (List separately in addition to code for primary procedure))

A parenthetical note under 0723T instructs to not report the code in conjunction with the following codes when also evaluating the same organ, tissue, gland, or target structure:

• 74181-74183 (Magnetic resonance (eg, proton) imaging, abdomen …)
• 76376-76377 (3D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision …)
• +0724T

At the same time, a parenthetical note for +0724T states you may use the code in conjunction with 74181-74183 when the provider also evaluated the “same organ, gland, tissue, or target structure.” A second parenthetical note instructs you to not report this MRCP add-on code with 76376-76377 or 0723T.

Understand the Significance of Category III CPT^® Codes

Category III CPT^® codes are temporary codes the AMA has assigned to represent emerging technologies, services, procedures, and services. According to the AMA, the codes are “intended to be used for data collection to substantiate widespread usage or to provide documentation for the Food and Drug Administration (FDA) approval process” (www.ama-assn.org/practice-management/cpt/category-iii-codes). These codes are published on the AMA website every six months following approval by the CPT® Editorial Panel. For instance, AMA posted the four new radiology codes on their website in January with an effective date of July 1, 2022.

Category III CPT^® codes may not adhere to one or more of the following Category I code requirements:

• Drugs and devices necessary to perform the service or procedure have received FDA approval or clearance when required
• Service or procedure is performed by many physicians or qualified healthcare professionals across the United States
• Procedure or service is performed consistently
• Procedure or service is consistent with current medical practice
• Documentation of the procedure or service clinical efficacy meets the CPT^® code change application requirements

“Data collected from Category III codes is crucial to establishing Category I codes,” says Kristen R. Taylor, CPC, CHC, CHIAP, associate partner of Pinnacle Enterprise Risk Consulting Services.