For the upcoming year, there are some changes to the code set that affects interventional radiology: two new procedural codes, revisions to the evaluation and management (E/M) code set, and two deleted codes.
Dorsal sacroiliac arthrodesis
A new code (27278) has been created to describe percutaneous placement of an intra-articular stabilization device into the sacroiliac joint using a minimally invasive technique that does not transfix the sacroiliac joint. This code is inclusive of all image guidance. For arthrodesis of the sacroiliac joint that does include placement of a percutaneous transfixation device, code 27279 should still be used. If a bilateral procedure is done, 27278 should be reported with modifier -50.
Proximal femur osteo-enhancement procedure
A Category III code (0814T) has been created for the percutaneous injection of calcium-based biodegradable osteoconductive material into the proximal femur. This is a unilateral code and is inclusive of all image guidance.
E/M coding
Guidelines have been revised in various E/M codes for clarification purposes. Below are the coding changes pertinent to clinical IR.
Office outpatient services
Office or other outpatient codes 99202–99205 (new patient) and 99212–99215 (established patient) have been revised to replace total time ranges with a minimum of total time that must be met or exceeded.
Hospital inpatient or observation care services (including admission and discharge services)
The guidelines have been revised to be consistent with CMS policy. They now clarify that codes 99234–99236 are only reported when the length of stay is more than 8 hours and when the same physician, or other quality health policy team, performs both the initial hospital inpatient or observation care and discharge services. The revised guidelines also clarify how to report lengths of stay that are fewer than 8 hours. Guidelines were also revised by replacing the term “encounter” with “visits.”
Split or shared visits
Split or shared E/M visits are defined as E/M services provided jointly between a physician and a non-physician provider, who both work in the same group and same specialty. These visits can be for new or established patients in the facility setting. In 2024, clarification has been provided whether you are reporting using time or medical decision-making (MDM).
When time is used for code selection for an E/M share-visit service, the E/M service is reported by the professional who spent the majority of the time performing the service.
When MDM is used for code selection for an E/M shared-visit service, the E/M service is reported by the professional who made or approved the patient’s management plan for the number and complexity of problems addressed at the encounter and also takes responsibility for that plan with its inherent risk of complications of patient management.
Deleted Codes
74710 Pelvimetry, with or without placental localization
0775T Arthrodesis, sacroiliac joint, percutaneous, with image guidance, includes placement of intra-articular implant(s) (e.g., bone allograft[s], synthetic device[s])
Disclaimer: SIR is providing this billing and coding guide for educational and information purposes only. It is not intended to provide legal, medical or any other kind of advice. The guide is meant to be an adjunct to the American Medical Association’s (AMA’s) Current Procedural Terminology (2023/CPT®). It is not comprehensive and does not replace CPT®. Our intent is to assist physicians, business managers and coders. Therefore, a precise knowledge of the definitions of the CPT descriptors and the appropriate services associated with each code is mandatory for proper coding of physician service. Please refer to 2023 CPT® for full and complete guidelines.
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