Newly released 2025 CPT Changes for Radiology, Interventional, and Cardiology Specialists have increased in comparison to the last few years. Make sure your radiology coding, interventional coding, and cardiology coding service teams are current on these changes. StreamlineMD is ready and here to help!
The biggest changes apply to Diagnostic Radiology and Cardiology and include:
- Diagnostic Radiology – MR Safety code series, detailed below.
- Cardiology – quite a few Category III codes again this year for invasive and non-invasive procedures, including drug-delivering balloons.
Category III CPT codes are developed to report new and emerging technologies/procedures. These codes do not have RVUs assigned and insurance carriers, including CMS MACs, determine their payment policies for these codes. These codes begin with a ‘0’ (zero) and end with a ‘T’. It is important to bill these codes for data collection which supports usage and increases chances of becoming a category I CPT code which is then assigned RVUs and reimbursement policies. CPT instructions are to use these codes to report services as described; do not use unlisted CPT or a similar CPT to report services accurately described by category III codes.
Review the following changes and share with your practice team members and hospital partners, to ensure all associates are ready for these changes before 1/1/25.
New Imaging and Interventional Radiology Codes
MR Safety Implant/Foreign Body Procedures
These codes are specifically intended for the evaluation of complex implants or foreign bodies, such as cochlear implants, artificial valves, deep vagal stimulators, pacemakers, apnea devices, etc. These codes should not be routinely submitted for every patient with an implant or foreign body undergoing MR imaging.
The MR interpretation does not have to be performed by the same provider doing the safety assessment.
It is recommended to have different reports for safety assessment and MR imaging interpretation.
Due to many inquiries regarding these codes during the AMA presentation, there will be a CPT Assistant article regarding these codes as well as further information from CMS after the first of the year.
- 76014-76016 These codes are performed days or weeks before MRI unless performed emergently.
- 76014-76015 These are time-based codes that may be performed prior to the MRI DOS. These codes will be performed by clinical staff, e.g., radiology technologists or MR safety-trained clinical staff.
- Time-based codes require that at least half of the stated time is completed to qualify for billing. For example, 76014 requires a minimum of 8 minutes must be performed and documented to support medical necessity. 76015 must have a minimum of 16 minutes to report. Multiple devices would be a complex example of the time needed for research.
- Determining if safe/not safe, is a billable service.
- To support this service, new workflows must be developed to capture charges for billing. Since radiology technologists do not typically generate reports within an EHR for billing purposes, an internal process within radiology will be necessary. Additionally, effective collaboration among radiology, billing, and EHR IT teams will be critical for a successful launch.
- 76016 This is a risk-benefit analysis performance. Review literature, devices that lack labeling, and/or have contraindications to MRI. Examples are what the issue is, indication, risk, benefit, and whether the benefit outweighs the risk.
- 76017-76019 These codes must be provided on the same DOS, in conjunction with the MRI. All three codes can be billed separately or together without a reduction in payment.
- 76017 Physicists do not report this code. The physician or QHP bills the code via written report after consulting with a physicist. The service is customized for the patient in real-time in the MR control room during imaging. This code is not reportable if MR is not performed.
- 76018 This code includes turning the device to manufacturer-safe mode in the MR workspace. If a cardiologist or neurologist comes to the MRI department to turn the device on or off, that provider reports this code. The service MUST BE performed in the MR department.
- If programming outside of MR or days before MR, the code is not reportable. The code may only be reported once if the device is turned off and on.
- 76019 This code is applicable when interacting with the patient to position, immobilize, or wrap the device before MR.
- If the exam is canceled these codes can still be reported including 76018.
| CPT | DESCRIPTION | WRVU |
| 76014 | MR safety implant &/or foreign body assessment by trained clinical staff, including identification and verification of implants components from appropriate sources analyzing current MR conditional status of individual components and systems, and consulting published professional guidance with written report initial 15 minutes | PE Only |
| +76015 | MR safety implant &/or foreign body assessment by trained clinical staff, including identification and verification of implants components from appropriate sources analyzing current MR conditional status of individual components and systems, and consulting published professional guidance with written report, each add’l 30 minutes | PE Only |
| 76016 | MR safety determination by a physician or other QHP responsible for the safety of MR procedure, including review of implant MRI conditions for indicated MR exam, analysis of risk versus clinical benefit of performing MRI exam, and determination of MR equipment, accessory equipment and expertise required to perform exam with written report | .60 |
| 76017 | MR safety medical physics exam customization planning and performance monitoring by medical physicist or MR safety expert, with review and analysis by physician or other QHP to prioritize and select views and imaging sequence, to tailor MR acquisition specific to restrictive requirements or artifacts associated with MR conditional implants or to mitigate risk of non-conditional implants or foreign bodies, with written report | .76 |
| 76018 | MR safety implant electronics preparation under supervision of physician or other QHP including MR-specific programming of pulse generator and or transmitter to verify device integrity, protection a device internal circuitry from MR electromagnetic fields and protection of patient from risk of unintended stimulation or heating while in the MR room with written report | .75 |
| 76019 | MR safety implant positioning &/or immobilization under supervision of physician or QHP, including application of physical protection to secure implanted medical device from MR induced translational or vibrational forces magnetically included functional changes &/or prevention of radiofrequency burns from inadvertent tissue contact while in the MR room with written report | .60 |
New Transcranial Doppler Add-on Codes
These new add-on codes are used in conjunction with CPT 93886, Transcranial Doppler study of the intracranial arteries; complete study.
CPT 93886 includes US evaluation of the right and left anterior circulation territories and the posterior circulation territory (to include vertebral and basilar arteries).
| CPT | DESCRIPTION | WRVU |
| +93896 | Vasoreactivity study with transcranial Doppler of intracranial arteries complete | .81 |
| +93897 | Emboli detection without intravenous microbubble injection performed with transcranial Doppler complete | .73 |
| +93898 | Venous- arterial shunt detection with intravenous microbubble injection performed with transcranial Doppler study complete | .85 |
CPT +75774 Revision
Angiography, selective, each additional vessel studied after basic examination, radiological supervision, and interpretation.
- As of 1/1/2025 CPT +75774 is reportable for venous procedures.
New Interventional Radiology Codes
Radiofrequency Thyroid Ablation
For benign thyroid nodule(s) use 0673T
| CPT | DESCRIPTION | WRVU |
| 60660 | Ablation of one or more thyroid nodule(s), one lobe or the isthmus percutaneous, including imaging guidance, radiofrequency | 5.75 |
| 60661 | Ablation of one or more thyroid nodule(s), each additional lobe, percutaneous, including imaging guidance, radiofrequency | 4.25 |
New Imaging Category III Codes
| CPT | DESCRIPTION | WRVU |
| 0901T | Placement of bone marrow sampling port, including imaging guidance when performed | 0 |
| 0944T | 3D contour simulation of target liver lesion(s) and margins for image guided percutaneous microwave ablation | 0 |
| 0946T | Orthopedic implant movement analysis using paired CT exam of the target structure, including data acquisition, data preparation and transmission, interpretation, and report (including CT scan of the joint or extremity performed with paired views) | 0 |
New Fascial Plane Block Codes
| CPT | DESCRIPTION | WRVU |
| 64466 | Thoracic fascial pain block, unilateral; by injection(s) including imaging guidance when performed | 1.50 |
| 64467 | Thoracic fascial pain block, unilateral; by infusion(s) including imaging guidance when performed | 1.74 |
| 64468 | Thoracic fascial plane block, bilateral; by injection(s) including imaging guidance when performed | 1.67 |
| 64469 | Thoracic fascial plane block, bilateral; by infusion(s) including imaging guidance when performed | 1.83 |
| 64473 | Lower extremity fascial plane block, unilateral; by injections, including imaging guidance when performed | 1.34 |
| 64474 | Lower extremity fascial plane block, unilateral; by infusion(s), including imaging guidance when performed | 1.67 |
UROLOGY
| CPT | DESCRIPTION | WRVU |
| 51721 | Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation inclds supra pubic tube placement during the same session and placement of an endorectal cooling device when performed | 4.05 |
| 55881 | Ablation of prostate tissue, transurethral, using thermal ultrasound, including MRI guidance for, and monitoring of, tissue ablation | 9.80 |
| 55882 | Ablation of prostate tissue, transurethral, using thermal ultrasound, including MRI guidance for, and monitoring of, tissue ablation with insertion of transurethral ultrasound transducer for delivery of thermal ultrasound, including suprapubic tube placement and placement of an endorectal cooling device, when performed | 11.50 |
CPTs 55881 and 55882 are performed on an MRI scanner table.
NEW CARDIOLOGY
New Category III Cardiology and Interventional Cardiology Codes
Transcatheter Therapeutic Drug Delivery by Intracoronary Drug-Delivery Balloon
| CPT | Description | WRVU |
| 0913T | Percutaneous transcatheter therapeutic drug delivery by intracoronary drug delivery balloon (eg, drug-coated, drug-eluting), including mechanical dilation by non-drug delivery balloon angioplasty, endoluminal imaging using intravascular ultrasound or optical coherence tomography (OCT) when performed, imaging supervision, interpretation, and report, single major coronary artery, or branch | 0 |
| +0914T | Percutaneous transcatheter therapeutic drug delivery by intracoronary drug delivery balloon (eg, drug-coated, drug-eluting) performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement or coronary atherectomy, including mechanical dilation by non-drug delivery balloon angioplasty, endoluminal imaging using intravascular ultrasound or optical (OCT) coherence tomography when performed, imaging supervision, interpretation, and report, single major coronary artery or branch (List separately in addition to code for percutaneous coronary stent or atherectomy intervention) | 0 |
Cardiac Contractility Modulation-Defibrillation
| CPT | Description | WRVU |
| 0915T | Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual transvenous electrodes/leads (pacing and defibrillation) | 0 |
| 0916T | Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator only | 0 |
| 0917T | Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; single transvenous lead (pacing and defibrillation) only | 0 |
| 0918T | Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual transvenous leads (pacing and defibrillation) only | 0 |
| 0919T | Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only | 0 |
| 0920T | Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only | 0 |
| 0921T | Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only | 0 |
| 0922T | Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only | 0 |
| 0923T | Removal and replacement of permanent cardiac contractility modulation defibrillation pulse generator only | 0 |
| 0924T | Repositioning of previously implanted cardiac contractility modulation defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic parameters | 0 |
| 0925T | Relocation of skin pocket for implanted cardiac contractility modulation defibrillation pulse generator | 0 |
| 0933T | Transcatheter implantation of wireless left atrial pressure sensor for long term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological supervision and interpretation | 0 |
Noninvasive Cardiology
| CPT | DESCRIPTION | WRVU |
| 0893T | Noninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified care professional interpretation and report | 0 |
| 0897T | Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation and report | 0 |
| 0899T | Noninvasive determination of absolute quantitation of myocardial blood flow (AQMBF), derived from augmentative algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance, pharmacologic stress, with interpretation and report by a physician or other qualified professional (List separately in addition to code for primary procedure) | 0 |
| 0900T | Noninvasive estimate of absolute quantitation of myocardial blood flow (AQMBF), derived from assistive algorithmic analysis of the dataset acquired the contrast cardiac magnetic resonance, pharmacologic stress, with interpretation and report by a physician or other qualified healthcare professional (List separately in addition to code for primary procedure) | 0 |
| 0926T | Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including review and report, implantable cardiac contractility modulation-defibrillation system | 0 |
| 0927T | Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-defibrillation system | 0 |
| 0928T | Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim analysis and report(s) by a physician or other qualified health care professional | 0 |
| 0929T | Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results | 0 |
| 0930T | Electrophysiologic evaluation of cardiac contractility modulation defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial implantation or replacement with testing of cardiac contractility modulation-defibrillator pulse generator | 0 |
| 0931T | Electrophysiologic evaluation of cardiac contractility modulation defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial implantation or replacement with testing of cardiac contractility modulation-defibrillator pulse generator | 0 |
| 0932T | Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved ejection fraction, with interpretation and report by a physician or other qualified health care professional | 0 |
| 0934T | Remote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left atrial pressure recordings, interpretation(s) and trend analysis, with adjustments to the diuretics plan, treatment paradigm thresholds, medications or lifestyle modifications, when performed, and report(s) by a physician or other qualified health care professional | 0 |
| 0937T | External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional | 0 |
| 0938T | External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; recording (including connection and initial recording) | 0 |
| 0939T | External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; scanning analysis with report | 0 |
| 0940T | External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; review and interpretation by a physician or other qualified health care professional | 0 |
Deleted Cardiology Category III Code
For percutaneous transcatheter placement of iliac arteriovenous anastomosis implant, use 37799.
| CPT | DESCRIPTION | WRVU |
| 0553T | Percutaneous transcatheter placement of iliac arteriovenous anastomosis implant, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention | 0 |
Ensure all collaborative team members are up to date with these changes to avoid unnecessary pre-authorization denials.
References:
AMA/CPT and CMS
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