November 1, 2023
Source: 2024 CPT Anticipated Changes | American College of Radiology (acr.org)
New Category I Codes:
New Category I codes will be available January 1, 2024, and are summarized below.
Transcervical RFA of Uterine Fibroids
Transcervical RFA of uterine fibroids includes intraoperative ultrasound guidance and monitoring, a minimally invasive procedure that includes real-time intrauterine ultrasound guidance for the treatment of symptomatic uterine fibroids (ie, leiomyomas) will be converted from Category III code 0404T to a new Category I code.
Dorsal SI Joint Arthrodesis
Category III code 0775T will be converted to a Category I code to report percutaneous arthrodesis of the SI joint using an intra-articular implant(s) without the placement of a transfixation device across the joint. The new Category I code will enable the reporting of percutaneous intra-articular placement of one or more fusion implants directly into the SI joint under imaging guidance. This is usually performed from a posterior approach.
In contrast, existing code 27279 is used to report percutaneous placement of a transfixation device, such as a screw, across the SI joint to perform fusion. This is usually performed from a lateral approach.
Coronary FFR with CT
Coronary FFR with CT Codes 0501T-0504T will be converted to a single, new Category I code to report noninvasive estimated coronary FFR derived from augmentative artificial intelligence (AI) software analysis of coronary CT angiography (CCTA) data.
Revisions to E/M Codes:
Additional revisions will be made to the E/M codes in 2024 as part of the work of the AMA/Specialty Society Relative Value Scale (RVS) Update Committee (RUC) to decrease the administrative burden of documentation outlined in Medicare’s 2023 Final Rule.
The following updates will include:
• Time ranges will be removed from the office or other outpatient visit codes for codes 99202- 99205 and 99212-99215 to align with the format of other E/M codes.
• The portion of physician’s services that may be reported for split (or shared) visits will be defined.
• Reporting instructions will be added for codes 99234-99236 [(hospital inpatient or observation care services) (including admission and discharge services)] when the duration of the visit crosses over two calendar dates.
Telemedicine Office Visits
A CPT/RUC Telemedicine Office Workgroup was created to assess and develop appropriate coding guidance for E/M telemedicine office visits performed via audio-visual and audio-only mechanisms. The workgroup determined that a new E/M subsection with new guidelines for telemedicine services will be established in the CPT 2024 code set. The new codes will align with the current E/M office or other outpatient services code structure (ie, using time or medical decision making [MDM]) with separate codes for new and established patient encounters and the addition of a virtual check-in code that could be used to determine whether a patient needs a face-to-face visit. Codes 99441, 99442, and 99443 will be deleted.
Reporting Guidelines for Unlisted Codes
In 2024, revisions will be made to various sections of the CPT code set that contain unlisted service codes to reflect their appropriate use when reporting with other services. An unlisted code workgroup was established by the CPT Editorial Panel to evaluate the use of unlisted service codes. The workgroup addressed how unlisted codes are used in conjunction with existing Category I and III codes during the same intervention and whether there is a need for guidance on their appropriate use.
Deleted Codes:
The codes below will be deleted from the CPT 2024 code set:
99441 Telephone evaluation and management service by a physician or other qualified health care professional who may report evaluation and management services provided to an established patient, parent, or guardian not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion
99442 Telephone evaluation and management service by a physician or other qualified health care professional who may report evaluation and management services provided to an established patient, parent, or guardian not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 11-20 minutes of medical discussion
99443 Telephone evaluation and management service by a physician or other qualified health care professional who may report evaluation and management services provided to an established patient, parent, or guardian not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 21-30 minutes of medical discussion
0404T Transcervical uterine fibroid(s) ablation with ultrasound guidance, radiofrequency
0501T 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; data preparation and transmission, analysis of fluid dynamics and simulated maximal coronary hyperemia, generation of estimated FFR model, with anatomical data review in comparison with estimated FFR model to reconcile discordant data, interpretation and report
0502T 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; data preparation and transmission
0503T 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; analysis of fluid dynamics and simulated maximal coronary hyperemia, and generation of estimated FFR model
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; anatomical data review in comparison with estimated FFR model to reconcile discordant data, interpretation and report
0715T Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure)
0775T Arthrodesis, sacroiliac joint, percutaneous, with image guidance, includes placement of intra-articular implant(s) (eg, bone allograft[s], synthetic device[s])