Radiology Coding Alert

Plus: Find out if AI has a role in the new radiology codes.

On Sept. 8, 2023, the AMA released the 2024 CPT^® code set. Among the 230 new codes, 70 revisions, and 49 deletions, are nine significant changes that radiology coders like yourself will want to take note of.

Get to know the radiology code changes that take effect on Jan. 1, 2024.

Examine AI’s Assistance in FFR Analysis

New to the CPT^® code set in 2024 is a method of appraising a patient’s coronary fractional flow reserve (FFR) with the help of artificial intelligence (AI):

• 75580 (Noninvasive estimate of coronary fractional flow reserve (FFR) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified health care professional)

This code is designated for procedures where the provider estimates the blood flow in the patient’s heart arteries derived from augmentative software analysis of coronary computed tomography angiography (CCTA) data. The software uses AI to analyze the CCTA data and produce data, which the physician or qualified healthcare professional (QHP) interprets to write their report.

Code 75580 is a new Category I code for 2024, which replaces the Category III codes 0501T-0504T (Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation software analysis of functional data to assess the severity of coronary artery disease …).

Augmentative AI: According to the CPT^® Appendix S, services that fall under the augmentative classification cover “[the] work performed by the machine for the physician or other QHP is augmentative when the machine analyzes and/or quantifies data in a clinically meaningful way.” A physician or other QHP is still required to interpret the results and write the report.

Code US Use During Surgeries

In 2024, you’ll have several new codes to report a physician’s ultrasound use during surgery. Code 76984 (Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic) is designated for reporting the provider’s use of ultrasound imaging of the thoracic aorta to diagnose a condition during a surgical operation or to guide the operation.

The 2024 CPT^® code set also includes three new cardiac intraoperative ultrasound (IOUS) codes:

• 76987 (Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report)
• 76988 (… placement, manipulation of transducer, and image acquisition only)
• 76989 (… interpretation and report only)

According to the American College of Radiology (ACR), these services are “are used to evaluate cardiovascular structures, provide intraoperative guidance, and provide real-time perioperative surgical decision-making information that may affect the intraoperative strategy (e.g., changing cannulation strategies, altering bypass targets, and identifying additional defects)” (www.acr.org/-/media/ACR/Files/Advocacy/CPT-2024-Anticipated-Code-Changes.pdf).

Identify Procedure Codes With Image Guidance

As a radiology coder, having a strong knowledge of the radiology code section is important, but knowing other procedure codes that apply to the specialty is a huge benefit. These additional codes include several services that radiologists provide, such as image guidance, and the 2024 CPT^® code set includes several new codes that you’ll want to review.

One new code for 2024 is 58580 (Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency), which is reserved for the transcervical radiofrequency ablation (RFA) of uterine fibroids. This procedure may require the use of real-time IOUS guidance and monitoring.

In the 2024 code set, the AMA is converting Category III code 0404T (Transcervical uterine fibroid(s) ablation with ultrasound guidance, radiofrequency) to the 58580 Category I code.

Code 27278 (Arthrodesis, sacroiliac joint, percutaneous, with image guidance, including placement of intra-articular implant(s) (eg, bone allograft[s], synthetic device[s]), without placement of transfixation device) is another 2024 addition that uses image guidance during the procedure. This code “will enable the reporting of percutaneous intra-articular placement of one or more fusion implants directly into the [sacroiliac] joint under imaging guidance. This is usually performed from a posterior approach,” the ACR wrote.

In a similar manner, 27278 is being converted to a Category I code from Category III code 0775T (Arthrodesis, sacroiliac joint, percutaneous, with image guidance, includes placement of intra-articular implant(s) (eg, bone allograft[s], synthetic device[s])).

Crack Down on Coronary Calcium Deposits

Effective January 1, you’ll assign 92972 (Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure)) for percutaneous transluminal coronary lithotripsy procedures. The code replaces Category III code 0715T (Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure)).

In the procedure, a physician uses sound waves to break up calcifications in the heart vessels. A balloon-based catheter is introduced to the vascular system through a small opening in the skin. By breaking down the calcium deposits in the coronary vessel, the blood vessel’s hollow space (lumen) diameter increases to help improve blood flow.

Find out Which Radiology Code Gets the Axe in 2024

The CPT^® code set’s radiology section doesn’t just feature new codes for the new year. The AMA has decided to delete 74710 (Pelvimetry, with or without placental localization) from the code set when the calendar flips to 2024.

CPT^® code 74710 is a female-only code used for maternity exams. Pelvimetry is an X-ray examination where the provider can measure the patient’s bony pelvic dimensions while the patient is in labor to assess if the baby’s head will have sufficient space to pass through. The provider also may or may not localize the placenta. This procedure is an accurate measure of the mother’s pelvic bony structures to determine if the structures are adequate for a normal vaginal delivery.

According to the AMA’s CPT^® Editorial Summary of Panel Actions from May 2023, 74710 will be deleted from the code set Jan. 1, 2024, “due to low utilization” (www.ama-assn.org/system/files/cpt-summary-panel-actions-may-2023.pdf).