I See New Codes
Melody W. Mulaik, MSHS, CPC, CPC-H, RCC, PCS, FCS
A new year is upon us, so that means it is
time to get ready for coding changes. It
never fails, just when we think we have it
all under control, we turn around and
there are new challenges to address in radiology. When it comes to coding challenges,
2011 will be no different. I was tempted to
classify the coding changes into the “good,”
the “bad,” and the “ugly.” However, the
classifications are yet unknown because as
of the submission date of this article so we
do not know the reimbursement of the
codes and thus their impact.
As of the writing of this article, only the
2011 CPT procedure codes are available
for review and comment.* The HCPCS
codes are typically released in November,
so the January/February 2011 issue of
Radiology Management will provide commentary and discussion on any relevant
HCPCS issues for radiology.
The biggest coding changes for radiology are in the interventional area; however,
there are some critical changes for diagnostic services as well. This article will
focus on the biggest procedure coding
changes that are anticipated to impact
radiology. There are additional coding
changes not covered in this article.
*CPT® is a registered trademark of the American
Medical Association. CPT® five digit codes, nomenclature, and other data are copyright 2010 American
Medical Association. All Rights Reserved. No fee
schedules, basic units, relative values, or related listings are included in the CPT® book. AMA does not
directly or indirectly practice medicine or dispense
medical services. AMA assumes no liability for the
data contained herein or not contained herein.
CT Abdomen + Pelvis
There are finally combination codes for
CT of the abdomen and pelvis performed
during the same encounter. The format of
these new codes is consistent with existing
CT codes (Table 1).
The existing procedure code for extremity
ultrasound, 76800, has been deleted for
2011 and replaced with two new codes
that differentiate whether the study is
complete or limited (Table 2). More information will be forthcoming that provides
guidance as to the specific definition of
complete versus limited studies.
In the vascular ultrasound section, the
definitions of the three physiologic study
codes (93922-93924) have been revised to
provide clearer information as to what is
contained in each code. Specifically, the
code definitions have been revised per
The outdated codes for xeroradiology
(76150) and subtraction in conjunction
with contrast studies (76350) have been
deleted for 2011.
Lower Extremity Revascularization
The biggest changes for 2011 occur in the
codes for lower extremity revasculariza-
tion interventional procedures. Specifi-
cally, the codes for angioplasty, stent place-
ment, and atherectomy have either been
deleted or revised to exclude lower extrem-
ity vessels from their definitions. New
codes have been created to cover the per-
formance of multiple transcatheter thera-
pies during the same patient encounter.
Revised code definitions include those in
Sixteen new codes were added for 2011 for
angioplasty, stent placement, and atherectomy procedures in the lower extremities
(Table 5). We are still awaiting guidance as
to whether or not these codes will stand
alone or if an additional code will be
added for the imaging component. Diagnostic studies will still be coded in accordance with CPT guidelines.
In addition to these regular CPT codes,
five Category III codes were created for
atherectomy procedures performed in locations not addressed in the new codes listed.
Specifically, new codes were created for the
renal artery (0234T), visceral artery(ies)
(0235T), abdominal aorta (0236T), brachiocephalic trunk and branches (0237T),
and iliac artery (0238T).
The chemotherapy administration code
96445 (Chemotherapy administration
into peritoneal cavity, requiring and