2018 brings a number of CPT® code changes to diagnostic radiology and interventional radiology. From new chest and abdominal X-ray codes, to deleted codes for endovascular repair, the new year has many changes in store. Get up to speed quickly with the changes to ensure your claims are paid in the new year!
Coding expert Stacie L. Buck recently explained the 2018 CPT® coding updates for radiology in an audio conference for ProfEdOnDemand, including new X-ray codes in diagnostic radiology, and coding changes for interventional radiology. Here’s a look at the new CPT® codes that will be required for reimbursement in 2018.
Diagnostic Radiology
The new codes for radiologic examination chest (chest X-rays) include:
- 71045, single view
- 71010 (frontal)
- 71015 (stereo frontal)
- 71035 (special views)
- 71046, two views
- 71020 (AP & Lat)
- 71035 (special views)
- 71047, three views
- 71021 (2 v w/ apical lordotic)
- 71022 (2v w/ oblique)
- 71035 (special views)
- 71048, four or more views
- 71030 (min 4 v)
- 71034 (min 4 v w/ fluoro)
- 71035 (special views)
The new codes for radiological examination abdomen (abdominal X-rays) include:
- 74018, single view
- 74000 (AP)
- 74019, two views
- 74010 (AP & addl oblique/cone)
- 74021, three or more views
- 74020 (complete inc. decubitus and/or erect)
Interventional Radiology
Codes 36120 and 75658 have been deleted. Instead, use:
- Use 36140 and 75710, 75716
- 36140 revised from “extremity artery” to “upper or lower extremity artery”
New codes 36465 and 36466 for foam sclerotherapy vein have been added. These codes use ultrasound guided compression maneuvers of the junction of the central vein to limit dispersion of the foam sclerosant.
- For injection of a sclerosant into an incompetent vein without compression maneuvers to guide dispersion of the injectate, see codes 36470 and 36471
- Codes 36465 and 36466 may be reported once for each leg
- Do not report 36465 or 36466 for injection of compounded foam sclerosant
- Compounding is a practice in which ingredients of a drug are combined, mixed or altered by the physician or qualified health care professional to create a medication tailored to specific patient needs
- When a compounded sclerosant foam is utilized, see codes 36470 and 36471
- Do not report 36465 and 36466 in conjunction with 37241 in the same surgical field
- Ultrasound guidance and monitoring are inherent to codes 36465 and 36466
- When performed in the office setting, all required supplies and equipment are inherent to the procedure and not separately reportable
New codes 36482 and +36483 have been added for vein ablation chemical adhesive. These codes are assigned for transcatheter delivery of a chemical adhesive into incompetent veins.
Endovascular Procedures
The following endovascular repair codes have been deleted:
- 34800 to 34804
- 34805 and 75952
- 34900 and 75954
- 34825
- +34826
- 0255T
- 75953
- +34806
The following new codes for endovascular repair have been added:
- 34701 replaces 34800, 75952
- 34702 replaces 34800, 75952
- 34703 replaces 34802, 34805, 75952
- 34704
- 34705 replaces 34803 and 34804,75952
- For isolated bilateral iliac repair assign 34707 or 34708 with modifier -50
- 34706
- 34707 for iliac artery replaces 34900,75954
- 34708 for iliac artery replaces 34900, 75954
- +34709 replaces 34825, 34826, 75953
- 34710 and 34711 replace 34825, 34826, 75953
Apart from these, new codes have been added for open arterial exposure, for percutaneous access, large sheath and for endograft fixation device. Iliac aneurysm repair codes have been revised and a number of codes have been deleted. There are also a number of NCCI policy manual changes for both diagnostic and interventional radiology, noted Buck, who discussed deleted, new and revised codes, as well as those key guideline changes.
