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While the 2025 CPT^® code set won’t see many code changes, it will have several guideline revisions or additions taking effect on January 1. As a radiology coder, it’s essential that you review these adjustments to ensure your coding knowledge is up to date.

Check out the upcoming code year’s guideline revisions as they relate to radiology coding.

Familiarize Yourself With fMRI Guideline Changes

Functional magnetic resonance imaging (fMRI) is an imaging scan that displays the most active areas of the patient’s brain. Healthcare providers use fMRI exams to plan a surgery or other brain-related procedures. You report fMRI procedures with 70554-70555 (Magnetic resonance imaging, brain, functional MRI …) depending on who administers the test.

Starting Jan. 1, 2025, the guidelines preceding 70554-70555 will be revised to change the language regarding which providers may administer the fMRI test according to 70555’s requirements:

“Functional MRI involves identification and mapping of stimulation of brain function. When neurofunctional tests are administered by a technologist or other nonphysician or non-psychologist, use 70554. When neurofunctional tests are entirely administered by a physician or other qualified health care professional or psychologist, use 70555.”

Check Out Cardiac Examination Guidelines

The Heart section of the Radiology CPT^® codes also sees guideline updates in 2025. The first change removes limitations on how many flow velocity add-on codes may be reported during an encounter (deleted information is crossed out):

“Listed procedures may be performed independently or in the course of overall medical care. If the individual providing these services is also responsible for diagnostic workup and/or follow-up care of the patient, also see appropriate sections. Only one procedure in the series 75557-75563 is appropriately reported per session. Only one add-on code for flow velocity can be reported per session.”

Following the above passage, you’ll find a new addition to the code set guidelines:

“To report absolute quantitation of myocardial blood flow (AQMBF), cardiac magnetic resonance (CMR), see 0899T, 0900T. Report 0899T, 0900T in conjunction with code for primary procedure.”

This information is repeated in a parenthetical note listed under 75563 (Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging).

Verify New Vascular Procedure Coding Guidelines

The Vascular Procedures section of CPT^® 2025 sees the addition of a single word in one section and instructions for proper assignment of +75774 (Angiography, selective, each additional vessel studied after basic examination, radiological supervision and interpretation (List separately in addition to code for primary procedure)).

Regarding diagnostic angiography coding instructions, the code set sees the following change starting January 1 (emphasis added): “Diagnostic angiography performed at a separate session from an interventional procedure is separately reported.”

Next, prior to the start of the codes, you’ll find the following note added in the new year: “Add-on code 75774 may be used with both arteries and veins for each additional vessel.”

Understand Revised Ultrasound Guidelines

In the Diagnostic Ultrasound section of the 2025 CPT^® code set, the note under 76513 (Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, unilateral or bilateral) is revised to delete one word and add a code.

“For scanning computerized ophthalmic diagnostic imaging of the anterior and posterior segments using technology other than ultrasound, see 92132, 92133, 92134, 92137.”

In the note listed above, scanning will be removed from the note and 92137 (Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [OCT]), posterior segment, with interpretation and report, unilateral or bilateral; retina, including OCT angiography) will be added. Code 92137 is a new code starting January 1.

In addition to these guideline changes, new codes and guidelines related to magnetic resonance (MR) procedure coding will take effect in the new year. Check out Radiology Coding Alert, volume 26, number 10, for more information on the MR guideline and coding changes.

Mike Shaughnessy, BA, CPC, Development Editor, AAPC