Sneak Peek for 2023 Changes to Radiology & IR CPT Codes

 

 

Sneak Peek for 2023 Changes to Radiology & IR CPT Codes
More details to follow in December

The intent of this article is to provide updates for 2023 Radiology & IR CPT coding, which may impact your practice’s coding, billing, and reimbursement operations.   To avoid unnecessary denials, which can delay reimbursement, review the coding changes below to ensure your Radiology practice is ready to go for patients treated beginning January 1, 2023. 

New Category 1 Codes 

Interventional Radiology

Pulmonary Artery Revascularization

  • 33900 – Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral
  • 33901 – Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral
  • 33902 – Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral
  • 33903 – Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral
  • +33904 (add-on code) – Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (List separately in addition to code for primary procedure)

Fistula Creation

  • 36836 – Percutaneous arteriovenous fistula creation, upper extremity, single access of both the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radiologic supervision and interpretation.
  • 36837 – Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radiologic supervision and interpretation.

Diagnostic Radiology

Ultrasound

  • 76883 – Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity. 

New Category 3 Codes

  • 0691T – Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report.
  • 0721T – Quantitative computed tomography (CT) tissue characterization, including interpretation and report, obtained without concurrent CT examination of any structure contained in previously acquired diagnostic imaging.
  • +0722T (add-on code) – Quantitative computed tomography (CT) tissue characterization, including interpretation and report, obtained with concurrent CT examination of any structure contained in the concurrently acquired diagnostic imaging dataset (List separately in addition to code for primary procedure).
  • 0723T – Quantitative magnetic resonance cholangiopancreatography (QMRCP) including data preparation and transmission, interpretation, and report, obtained without diagnostic magnetic resonance imaging (MRI) examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session.
  • +0724T (add-on code) – Quantitative magnetic resonance cholangiopancreatography (QMRCP) including data preparation and transmission, interpretation, and report, obtained with diagnostic magnetic resonance imaging (MRI) examination of the same anatomy (eg, organ, gland, tissue, target structure) (List separately in addition to code for primary procedure).
    • (Use 0724T in conjunction with 74181, 74182, 74183, when also evaluating same organ, gland, tissue, or target structure).
  • +0742T (add-on code) – Absolute quantitation of myocardial blood flow (AQMBF), single-photon emission computed tomography (SPECT), with exercise or pharmacologic stress, and at rest, when performed (List separately in addition to code for primary procedure).
  • 0743T – Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (BMD), with concurrent vertebral fracture assessment, utilizing data from a computed tomography scan, retrieval and transmission of the scan data, measurement of bone strength and BMD and classification of any vertebral fractures, with overall fracture-risk assessment, interpretation, and report.
  • 0749T – Bone strength and fracture-risk assessment using digital X-ray radiogrammetry-bone mineral density (DXR-BMD) analysis of bone mineral density (BMD) utilizing data from a digital X ray, retrieval and transmission of digital X-ray data, assessment of bone strength and fracture risk and BMD, interpretation, and report.
  • 0750T – Bone strength and fracture-risk assessment using digital X-ray radiogrammetry-bone mineral density (DXR-BMD) analysis of bone mineral density (BMD) utilizing data from a digital X ray, retrieval and transmission of digital X-ray data, assessment of bone strength and fracture risk and BMD, interpretation, and report; with single-view digital X-ray examination of the hand taken for the purpose of DXR-BMD.
  • +0777T (add-on code) – Real-time pressure-sensing epidural guidance system (List separately in addition to code for primary procedure). 

Revisions Affecting Billing

  • Somatic Nerve Injections, CPTs 64415-64417 and 64445-64448 will all be inclusive of imaging guidance. 

Revisions Not Affecting Billing

Nuclear Medicine

  • 78803 – Radiopharmaceutical localization of tumor, inflammatory process, or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), single area (eg, head, neck, chest, pelvis), or acquisition, single day imaging.
  • 78830 – Radiopharmaceutical localization of tumor, inflammatory process, or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) with concurrently acquired computed tomography (CT) transmission scan for anatomical review, localization and determination/detection of pathology, single area (eg, head, neck, chest, pelvis), or acquisition, single day imaging.
  • 78831 – Radiopharmaceutical localization of tumor, inflammatory process, or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), minimum 2 areas (eg, pelvis and knees, chest, and abdomen) or separate acquisitions (eg, lung ventilation and perfusion), single day imaging, or single area or acquisition over 2 or more days.
  • 78832 – Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) with concurrently acquired computed tomography (CT) transmission scan for anatomical review, localization and determination/detection of pathology, minimum 2 areas (eg, pelvis and knees, chest and abdomen) or separate acquisitions (eg, lung ventilation and perfusion), single day imaging, or single area or acquisition over 2 or more days.

In Conclusion:

  • Make sure your teams are ready for these changes and that they understand the subtle nuances that may affect your practice.
  • Update or create new report templates to support the documentation for medical necessity for new/revised procedures, as appropriate.
  • Review CPT changes and latest information each year because it can have a major impact on your bottom line.
  • StreamlineMD is your resource for Radiology/IR coding and billing, and we have the answers to your questions.

Reference:

AMA CPT Professional Edition 2023

StreamlineMD provides EHR & RCM Software & Service to Imaging & Image-Guided Procedure Specialists. Our Mission is to Improve Healthcare for All Americans.  Our Core Values that guide us on our mission are Service Quality, Teamwork, Accountability, Efficiency, Adaptability, Communication, and Integrity. Learn more about us at streamlineMD.com.

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Cyber Incident Update – 9/28/25 at 6:00 pm EST:

StreamlineMD applications are up and live!

Access Client Portal Here

We are pleased to inform you that, following clearance from our cybersecurity experts, client access to our system has been restored. You may begin accessing the system starting at 6:00 PM EST today, Sunday, September 28, 2025.

Please note that while core functionality is fully restored, the following features are currently unavailable as we continue working to bring all components back online:

1. SMD Mobile App (viewing PDF chart)
2. Patient Portal
3. RxPhoto (inside the EHR)

We are working to restore these remaining services as quickly and securely as possible.

We will continue to monitor system performance closely and will provide updates as additional components become available.

If you experience any issues or require support, please contact our support team directly at 330-564-2641.

Thank you once again for your continued patience, understanding, and trust.

Cyber Incident Update – 9/28/25 at 2:00 pm EST:

Following our scheduled call with the cybersecurity team earlier today, we have been advised that additional security measures must be implemented before client access can be restored. Specifically, changes to our VPN configuration are required to ensure a more secure connection environment.

Our internal teams are actively working on these adjustments and will move as quickly and carefully as possible to complete the necessary changes.

Our next update will be at 4:00 PM EST.

Cyber Incident Update – 9/28/25 at 12:00 pm EST:

We are pleased to share that our internal teams currently have access to the system environment. In the interim, if needed, we are able to assist by running your patient appointment schedules for the week. Please contact our support team or email at smdhelpdesk@prcmedicalllc.zohosupport.com if you require this service.

We are scheduled to meet with our cybersecurity team at 1:00 PM EST today to review final clearance for restoring client access. We will provide another update following that discussion.

We appreciate your continued patience and partnership as we work to bring services back online safely and securely.

Cyber Incident Update – 9/27/25 at 10:00 pm EST:

We are pleased to report that our routine nightly processes have completed successfully, and the system environment remains stable and fully operational.

At this stage, we are awaiting final clearance from our cybersecurity partner before restoring client access.

However, our partner informed us that they need more time and so this clearance will not be available until after 1:00 PM EST tomorrow, Sunday, September 28, 2025.

Thank you for your patience while we maintain the highest standards of security and system integrity. 

Cyber Incident Update – 9/27/25 at 7:00 pm EST:

We are continuing to move forward with final preparations for restoring system access. Our internal teams have completed their validation processes, and the environment remains fully operational.

At this time, we are running our routine nightly processes to further confirm system stability and readiness. We continue to await final clearance from our cybersecurity experts to bring services fully back online.

We remain optimistic that systems will be accessible to clients by tomorrow morning, Sunday, September 29, 2025, at 7:00 AM EST.

As always, we are taking every measure to ensure a secure and controlled restoration.

Thank you again for your continued patience and support. Our next update will be provided by 10:00 PM EST.

Cyber Incident Update – 9/27/25 at 11:00 am EST:

We are pleased to share that our team has gained access to the system environment and is actively conducting testing—an important step toward the full restoration of services.

As part of this process, we have completed testing of the Practice Management (PM) and Coding software and are pleased to report that no issues have been identified with the software. Testing will continue across all system components to ensure overall stability and reliability.

Our teams will continue working throughout the day to validate all aspects of the system before bringing it back online.

We are deeply grateful for your continued patience, support, and trust as we proceed with restoration in a safe and controlled manner.

We will provide another update at 2:00 pm EST.

Cyber Incident Update – 9/26/25 at 7:00 pm EST:

We are pleased to share that our team is now gaining access to the system environment and actively conducting testing. This is an important step toward full restoration of services.

We again want to reassure you that there is no evidence of any compromise of Protected Health Information (PHI) or damage to our systems.

Our teams will continue to work throughout the evening and into the weekend to validate all aspects of the system before bringing it back online.

Thank you for your continued patience, support, and trust as we move forward with restoration in a safe and controlled manner.

We will provide another update at 10:00 am EST on Saturday, September 27, 2025.

Cyber Incident Update – 9/26/25 at 3:00 pm EST:

We continue to make steady progress in our restoration efforts. At this time, 95% of servers have been cleared; however, they remain behind protective firewalls as we work closely with our team of experts toward full restoration.

The StreamlineMD systems will remain unavailable for the rest of today, Friday, September 26, 2025. Our teams will begin comprehensive testing of all aspects of the system as soon as possible, likely this evening and over the weekend.

Importantly, there is no evidence of any compromise of Protected Health Information (PHI) or damage to our systems.

We truly appreciate your support and understanding during this process. You are important to us, and we remain committed to restoring services safely and securely.

We will provide another update at 6:00 pm EST.

Cyber Incident Update – 9/26/25 at 2:00 pm EST:

We continue to work diligently this afternoon with our cybersecurity team and are making steady progress.   

We anticipate the StreamlineMD systems will remain inaccessible for the remainder of today, Friday, September 26, 2025.  

We will provide another update at 6:00 pm EST.

We appreciate your continued patience and understanding as we work to restore services in a secure and controlled manner.

Cyber Incident Update – 9/26/25 at 11:00 am EST:

We continue to work throughout the day with our cybersecurity team and continue to make progress.  

We anticipate the StreamlineMD systems will not be accessible before 3:00 pm EST on Friday, September 26, 2025

We will provide another update at 2:00 pm EST.

We appreciate your continued patience and understanding as we work to restore services in a secure and controlled manner.

Cyber Incident Update – 9/26/25 at 09:00 am EST:

We continue to work this morning with our cybersecurity team and continue to make progress.   

We still don’t anticipate StreamlineMD systems to be fully operational before 12:00 pm EST on Friday, September 26, 2025.  

We will provide another update at 12:00 pm EST.

We appreciate your continued patience and understanding as we work to restore services in a secure and controlled manner.

Cyber Incident Update – 9/26/25 at 07:00 am EST:

We have continued to work through the night with our cybersecurity team and continue to make progress.  

We will continue restoring servers to service and testing internally. 

We still don’t anticipate StreamlineMD systems to be fully operational before 12:00 pm EST on Friday, September 26, 2025. 

We will provide another update at 9:00 am EST.

We appreciate your continued patience and understanding as we work to restore services in a secure and controlled manner.

Cyber Incident Update – 9/25/25 at 11:00 pm EST:

So far, we are making great progress, and our systems are internally coming back online. At this time, there is no evidence of system damage or PHI compromise.

Throughout the night, we will continue restoring servers to service and testing internally.

We don’t anticipate StreamlineMD systems to be fully operational before 12:00 pm EST on Friday, September 26, 2025.

We will provide another update on Friday, September 26, at 6:00 am EST


Cyber Incident Update –9/25/25 at 7:00 pm EST:

We are currently in the process of restoring our servers and anticipate determining a timeline for resuming full operations by 10:00 PM EST this evening, September 25, 2025.

Our team continues to work diligently and in close coordination with our security partners in response to the cybersecurity incident that occurred during the overnight hours of September 24, 2025. As a precaution, our systems remain offline to prevent any potential data compromise. We continue to follow our established cybersecurity protocols to ensure the protection and integrity of your data.

We will provide our next update by 10:00 PM EST today.

We appreciate your continued patience and understanding as we work to bring our systems back online safely.

Incident Update – 9/25/25 at 12:00 pm EST:

StreamlineMD is currently working closely with our security team to address a cybersecurity incident that occurred during the overnight hours of September 24, 2025. As a precautionary measure, we proactively shut down our systems to prevent any potential data compromise.

Our team is actively following established cybersecurity protocols to ensure the continued protection of your data. At this time, the software will remain inaccessible for the remainder of the day, September 25, 2025.

We understand the impact this may have on your operations and sincerely appreciate your patience and understanding. We are committed to providing updates as frequently as possible and will keep you informed of our progress.

StreamlineMD is experiencing a cyber incident

Our security software detected malicious behavior and our team of internal and external experts are working to resolve the issue. The security team has made it clear that we need to shut down our services altogether, pending a more detailed analysis.