Each year the CPT code set undergoes significant changes. Physicians and their office staff need to be aware of the changes in order to ensure a smooth transition into 2023. Join us for a discussion of the new, deleted and revised CPT codes and associated guidelines for 2023. This presentation will focus on the changes to the CPT dataset and the associated work RVU value changes that impact physicians. This is part three in a three part series.

1. Current Procedural
Terminology (CPT®)
Updates for 2023
Professional Services Focus

4. Ardith Campbell
COC, CPC
Director, Product Content

5. Agenda
• Summary of CPT® changes effective January 1, 2023
• Not including codes released and already available for use
• Sectional review of changes
• Category III codes will be discussed within related section
• CPT® code 0499T originally deactivated, but change
rescinded

6. Summary of Changes

7. Summary of Changes
Section Added Deleted Revised
Evaluation and
Management (E/M)
1 26 50
Surgery 33 19 22
Radiology 1 0 5
Path/Lab 11 0 3
Medicine 10 0 7
Category III 46 22 2
Proprietary Laboratory
Analysis (PLA)
9 0 0
Totals 111 67 89

8. Sectional Review of
Changes

9. Surgical Sections
33 New, 19 Deleted, 22 Revised

10. Integumentary
System
CPT® Codes 10000-19999

11. Deleted & Revised Codes
• Deleted: 15850 Removal of sutures under anesthesia (other
than local), same surgeon
• Revised: 15851
• 2022 Removal of sutures under anesthesia (ie, general anesthesia,
moderate sedation)(other than local), other surgeon
• 2023 Removal of sutures or staples requiring anesthesia (ie,
general anesthesia, moderate sedation)

12. New Codes
CPT®
Code
Description
15778 Implantation of absorbable mesh or other prosthesis for delayed
closure of defect(s) (ie, external genitalia, perineum, abdominal
wall) due to soft tissue infection or trauma
15853 Removal of sutures or staples not requiring anesthesia (List
separately in addition to E/M code)
15854 Removal of sutures and staples not requiring anesthesia (List
separately in addition to E/M code)

13. Musculoskeletal
System
CPT® Codes 20000-29999

14. Revised Codes
• 22630 Arthrodesis, posterior interbody technique, including
laminectomy and/or discectomy to prepare interspace (other
than for decompression), single interspace, lumbar;
• 22633 Arthrodesis, combined posterior or posterolateral
technique with posterior interbody technique including
laminectomy and/or discectomy sufficient to prepare
interspace (other than for decompression), single interspace,
lumbar;
• Both have the semi-colon at the end

15. Revised Codes
• 22857 Total disc arthroplasty (artificial disc), anterior
approach, including discectomy to prepare interspace (other
than for decompression); single interspace, lumbar
• 27280 Arthrodesis, sacroiliac joint, open, includes obtaining
bone graft, including instrumentation, when performed

16. New Code
• 22860 Total disc arthroplasty (artificial disc), anterior
approach, including discectomy to prepare interspace (other
than for decompression); second interspace, lumbar (List
separately in addition to code for primary procedure)
• Replaces 0163T
• Two or more interspaces treated, use the unlisted code 22899

17. Dorsal Sacroiliac
Joint Arthrodesis
Category III

18. • 0775T Arthrodesis, sacroiliac joint, percutaneous, with image
guidance, includes placement of intra-articular implant(s) (eg,
bone allograft[s], synthetic device[s])
• Unique method of stabilizing sacroilicac (SI) joint using a
distracting intra-articular implant placed between the two bony
surfaces of the iliac and sacral bones
• Tensioning accomplishes the stabilization
• Different work and different approach than 27279

19. Computer-Based
Musculoskeletal
Assessment
Category III

20. Surface Mechanomyography
• 0778T Surface mechanomyography (sMMG) with concurrent
application of inertial measurement unit (IMU) sensors for
measurement of multi-joint range of motion, posture, gait, and
muscle function
• To report measurement and recording of dynamic joint motion
and muscle function
• Not a remote service

21. Respiratory System
CPT® Codes 30000-32999

22. New Code
• 30469 Repair of nasal valve collapse with low energy,
temperature-controlled (ie, radiofrequency)
subcutaneous/submucosal remodeling

23. Cardiovascular
System
CPT® Codes 33000-39999

24. Revised Code - 35883
•2023
•Revision, femoral anastomosis
of synthetic arterial bypass
graft in groin, open; with
nonautogenous patch graft (eg,
polyester, ePTFE, bovine
pericardium)
•2022
•Revision, femoral anastomosis
of synthetic arterial bypass
graft in groin, open; with
nonautogenous patch graft (eg,
Dacron, ePTFE, bovine
pericardium)

25. New Codes
CPT®
Code
Description
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

26. Percutaneous Arteriorvenous (AV)
Fistula Creation
• 36836 single access site, usually via arm vein
• 36837 two separate access sites into peripheral artery & vein
• Use unlisted code for lower extremity

27. New Codes
CPT® Code Description
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 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)

28. Different Codes Based On
Normal
Connections
Abnormal
Connections
Unilateral
Stent
33900 33902
Bilateral Stent 33901 33903
Additional
Stent
33904 33904
Code 33904 to report stent placement in additional pulmonary arteries or a
separate lesion in the same pulmonary artery

29. Abnormal Connections
• Blalock-Taussig Shunt
• Subclavian artery to pulmonary artery (PA) shunt
• Sano Shunt
• Extracardiac conduit between the right ventricle and main PA stump
• Used as a step in the Norwood procedure for hypoplastic left heart
syndrome
• Glenn Shunt
• Variation of a superior vena cava to PA shunt

30. Guidelines
• Balloon angioplasty (92997, 92998) within same target lesion
not separately reported
• Either before or after stent deployment
• Diagnostic cardiac catheterization and diagnostic angiography
codes (93451, 93452, 93453, 93454, 93455, 93456, 93457,
93458, 93459, 93460, 93461, 93563, 93566, 93567, 93568,
93593, 93594, 93596, 93597, 93598) should not be used with
33900, 33901, 33902, 33903, 33904 to report:
• Contrast injections, angiography, roadmapping , and/or fluoroscopic
guidance for the TPVI,
• Pulmonary conduit angiography for guidance of TPVI, or
• Right heart catheterization for hemodynamic measurements before,
during, and after TPVI for guidance of TPVI.

31. Cardiology New
Technology
Category III

32. Absolute Quantification Myocardial
Blood Flow (AQBMF)
• 0742T 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)
• Detects reduced coronary flow reserve
• Identifies patients with high-risk coronary artery disease

33. Bioprosthetic Venous Valve
• 0744T Insertion of bioprosthetic valve, open, femoral vein,
including duplex ultrasound imaging guidance, when
performed, including autogenous or nonautogenous patch
graft (eg, polyester, ePTFE, bovine pericardium), when
performed
• Includes imaging guidance using duplex ultrasound
• Support blood flow from lower extremities despite absence of native
deep venous valvular function

34. Cardiac Functional Radioablation
CPT® Code Description
0745T Cardiac focal ablation utilizing radiation therapy for
arrhythmia; noninvasive arrhythmia localization and mapping
of arrhythmia site (nidus), derived from anatomical image data
(eg, CT, MRI, or myocardial perfusion scan) and electrical
data (eg, 12-lead ECG data), and identification of areas of
avoidance
0746T Cardiac focal ablation utilizing radiation therapy for
arrhythmia; conversion of arrhythmia localization and mapping
of arrhythmia site (nidus) into a multidimensional radiation
treatment plan
0747T Cardiac focal ablation utilizing radiation therapy for
arrhythmia; delivery of radiation therapy, arrhythmia

35. Digestive System
CPT® Codes 40000-49999

36. Gastroenterology

37. New Codes
• 43290 Esophagogastroduodenoscopy, flexible, transoral; with
deployment of intragastric bariatric balloon
• 43291 Esophagogastroduodenoscopy, flexible, transoral; with
removal of intragastric bariatric balloon(s)

38. Gastroenterology
Category III
New Technology

39. Fecal Microbiota, Bronchoscopy
• 0780T Instillation of fecal microbiota suspension via rectal enema into
lower gastrointestinal tract
• Describes a regulated live biotherapeutic agent
• 0781T Bronchoscopy, rigid or flexible, with insertion of esophageal
protection device and circumferential radiofrequency destruction of the
pulmonary nerves, including fluoroscopic guidance when performed;
bilateral mainstem bronchi
• 0782T Bronchoscopy, rigid or flexible, with insertion of esophageal
protection device and circumferential radiofrequency destruction of the
pulmonary nerves, including fluoroscopic guidance when performed;
unilateral mainstem bronchus

40. Myoelectrical Study
• 0779T Gastrointestinal myoelectrical activity study, stomach
through colon, with interpretation and report
• Noninvasive procedure to assess motility in the GI tract from stomach
through the colon
• Other codes do not assess motility all the way through
• 91020 only measures motility of stomach
• 91022 only measures motility of duodenum

41. Hernia Repair
No Global Days

42. Deleted Codes
CPT® Code Short Description Suggested Replacement(s)
49560 RPR VENTRAL HERN INIT REDUC 49591, 49593, 49595
49561 RPR VENTRAL HERN INIT BLOCK 49592, 49594, 49596
49565 REREPAIR VENTRL HERN REDUCE 49613, 49615, 49617
49566 REREPAIR VENTRL HERN BLOCK 49614, 49616, 49618
49568 HERNIA REPAIR W/MESH 49591, 49592, 49593, 49594, 49596, 49613,
49614, 49615, 49616, 49617, 49618
49570 RPR EPIGASTRIC HERN REDUCE 49591, 49593, 49595, 49613, 49615, 49617
49572 RPR EPIGASTRIC HERN BLOCKED 49592, 49594, 49596, 49614, 49616, 49618
49580 RPR UMBIL HERN REDUC < 5 YR 49591, 49593, 49595, 49613, 49615, 49617
49582 RPR UMBIL HERN BLOCK < 5 YR 49592, 49594, 49596, 49614, 49616, 49618
49585 RPR UMBIL HERN REDUC > 5 YR 49591, 49593, 49595, 49613, 49615, 49617
49587 RPR UMBIL HERN BLOCK > 5 YR 49592, 49594, 49596, 49614, 49616, 49618

43. Deleted Codes
CPT® Code Short Description Suggested Replacement(s)
49590 REPAIR SPIGELIAN HERNIA 49591, 49592, 49593, 49594, 49595,
49596, 49613, 49614, 49615, 49616,
49617, 49618
49652 LAP VENT/ABD HERNIA REPAIR 49591, 49593, 49595, 49613, 49615, 49617
49653 LAP VENT/ABD HERN PROC COMP 49592, 49594, 49596, 49614, 49616, 49618
49654 LAP INC HERNIA REPAIR 49591, 49593, 49595
49655 LAP INC HERN REPAIR COMP 49592, 49594, 49596
49656 LAP INC HERNIA REPAIR RECUR 49613, 49615, 49617
49657 LAP INC HERN RECUR COMP 49614, 49616, 49618

44. Overview
• Codes 49591-49596 initial repair of a reducible, incarcerated
or strangulated anterior abdominal hernia < 3cm to > 10cm
• Codes 49613-49618 recurrent repair of a reducible,
incarcerated or strangulated anterior abdominal hernia < 3cm
to > 10cm
• Codes 49621-49622 initial or recurrent repair of a reducible,
incarcerated or strangulated parastomal hernia
• Code 49623 removal of total or near total non-infected mesh
or other prosthesis during anterior abdominal or parastomal
hernia repair

45. Coding Help
Type Size Severity CPT® Code
Initial < 3 cm Reducible
Incarcerated/Strangulated
49591
49592
Recurrent < 3 cm Reducible
Incarcerated/Strangulated
49613
49614
Initial 3 cm to 10
cm
Reducible
Incarcerated/Strangulated
49593
49594
Recurrent 3 cm to 10
cm
Reducible
Incarcerated/Strangulated
49615
49616
Initial > 10 cm Reducible
Incarcerated/Strangulated
49595
49596
Recurrent > 10 cm Reducible
Incarcerated/Strangulated
49617
49618

46. New codes
CPT® Code Description
49591 Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical,
spigelian), any approach (ie, open, laparoscopic, robotic), initial, including
implantation of mesh or other prosthesis when performed, total length of defect(s);
less than 3 cm, reducible
49592 Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical,
spigelian), any approach (ie, open, laparoscopic, robotic), initial, including
implantation of mesh or other prosthesis when performed, total length of defect(s);
less than 3 cm, incarcerated or strangulated
49593 Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical,
spigelian), any approach (ie, open, laparoscopic, robotic), initial, including
implantation of mesh or other prosthesis when performed, total length of defect(s); 3
cm to 10 cm, reducible

47. New Codes
CPT® Code Description
49594 Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical,
spigelian), any approach (ie, open, laparoscopic, robotic), initial, including
implantation of mesh or other prosthesis when performed, total length of defect(s); 3
cm to 10 cm, incarcerated or strangulated
49595 Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical,
spigelian), any approach (ie, open, laparoscopic, robotic), initial, including
implantation of mesh or other prosthesis when performed, total length of defect(s);
greater than 10 cm, reducible
49596 Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical,
spigelian), any approach (ie, open, laparoscopic, robotic), initial, including
implantation of mesh or other prosthesis when performed, total length of defect(s);
greater than 10 cm, incarcerated or strangulated

48. New Codes
CPT® Code Description
49613 Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical,
spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including
implantation of mesh or other prosthesis when performed, total length of defect(s);
less than 3 cm, reducible
49614 Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical,
spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including
implantation of mesh or other prosthesis when performed, total length of defect(s);
less than 3 cm, incarcerated or strangulated
49615 Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical,
spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including
implantation of mesh or other prosthesis when performed, total length of defect(s); 3
cm to 10 cm, reducible

49. New Codes
CPT® Code Description
49616 Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical,
spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including
implantation of mesh or other prosthesis when performed, total length of defect(s); 3
cm to 10 cm, incarcerated or strangulated
49617 Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical,
spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including
implantation of mesh or other prosthesis when performed, total length of defect(s);
greater than 10 cm, reducible
49618 Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical,
spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including
implantation of mesh or other prosthesis when performed, total length of defect(s);
greater than 10 cm, incarcerated or strangulated

50. New Codes
CPT® Code Description
49621 Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or
recurrent, including implantation of mesh or other prosthesis, when performed;
reducible
49622 Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or
recurrent, including implantation of mesh or other prosthesis, when performed;
incarcerated or strangulated
49623 Removal of total or near total non-infected mesh or other prosthesis at the time of
initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any
approach (ie, open, laparoscopic, robotic) (List separately in addition to code for
primary procedure)

51. Hernia Repair
• Report once, based on the total defect size
• Measure prior to opening the defect
• The fascia typically retracts
• Measure as the maximal craniocaudal or transverse distance
between the outer margins of all defects repaired
• “Swiss cheese” defects measured from superior most aspect
of the upper defect to the inferior most aspect of the lowest
defect

52. Hernia Repair
• When both reducible and incarcerated or strangulated hernias
repaired at the same operative session, all hernias are
reported as incarcerated or strangulated
• Example: one 2 cm reducible initial incisional hernia and one 4 cm
incarcerated initial incisional hernia separated by 2 cm would be
reported with a maximum craniocaudal distance of 8 cm (49594)
• Inguinal, femoral, lumbar, omphalocele and/or parastomal
hernia repair may be reported separately
• Mesh or other prosthesis included in 49521-49622

53. Perianal Tissue
Injection
Category III

54. New Code
• 0748T Injections of stem cell product into perianal perifistular
soft tissue, including fistula preparation (eg, removal of setons,
fistula curettage, closure of internal openings)
• Report stem cell product separately

55. Urinary System
CPT® Codes 50000-53999

56. Revised Code 50080
•2023
•Percutaneous nephrolithotomy or
pyelolithotomy lithotripsy, stone
extraction, antegrade
ureteroscopy, antegrade stent
placement and nephrostomy tube
placement, when performed,
including imaging guidance;
simple (eg, stone[s] up to 2 cm in
single location of kidney or renal
pelvis, nonbranching stones)
•2022
•Percutaneous
nephrostolithotomy or
pyelostolithotomy, with or
without dilation, endoscopy,
lithotripsy, stenting, or basket
extraction up to 2 cm

57. Revised Code 50081
•2023
•Percutaneous nephrolithotomy or
pyelolithotomy lithotripsy, stone
extraction, antegrade
ureteroscopy, antegrade stent
placement and nephrostomy tube
placement, when performed,
including imaging guidance;
complex (eg, stone[s] > 2 cm,
branching stones, stones in
multiple locations, ureter stones,
complicated anatomy)
•2022
•Percutaneous
nephrostolithotomy or
pyelostolithotomy, with or
without dilation, endoscopy,
lithotripsy, stenting, or basket
extraction, over 2 cm

58. Male Genital System
CPT® Codes 54000-55999

59. New Code
• 55867 Laparoscopy, surgical prostatectomy, simple subtotal
(including control of postoperative bleeding, vasectomy,
meatotomy, urethral calibration and/or dilation, and internal
urethrotomy), includes robotic assistance, when performed

60. Magnetic Field
Induction Malignant
Prostate Tissue
Category III

61. Ablation of Malignant Prostate Tissue
CPT®
Code
Description
0738T Treatment planning for magnetic field induction ablation of
malignant prostate tissue, using data from previously performed
magnetic resonance imaging (MRI) examination
0739T Ablation of malignant prostate tissue by magnetic field induction,
including all intraprocedural, transperineal needle/catheter
placement for nanoparticle installation and intraprocedural
temperature monitoring, thermal dosimetry, bladder irrigation, and
magnetic field nanoparticle activation

62. Nervous System
CPT® Codes 61000-64999

63. Revised Codes
• 64415-64417, 64445-64448 adding including imaging
guidance, when performed
• Example: 64415 Injection(s), anesthetic agent(s) and/or
steroid; brachial plexus, including imaging guidance, when
performed

64. Revised Guidelines – 64490-64495
►Codes 64490, 64491, 64492, 64493, 64494, 64495 describe the
introduction/injection of a diagnostic or therapeutic agent into the
paravertebral facet joint or into the nerves that innervate that joint by level.
Facet joints are paired joints with one pair at each vertebral level. Imaging
guidance and localization are required for the performance of
paravertebral facet joint injections described by 64490, 64491, 64492,
64493, 64494, 64495. If imaging is not used, report 20552, 20553. If
ultrasound guidance is used, report 0213T, 0214T, 0215T, 0216T, 0217T,
0218T. ◄
►When determining a level, count the number of facet joints injected, not
the number of nerves injected. Therefore, if multiple nerves of the same
facet joint are injected, it would be considered as a single level. The add
on codes are reported when second, third, or additional levels are injected
during the same session. ◄

65. Mechanical
Hypothermic
Management
Pain Management

66. New Code
• 0776T Therapeutic induction of intra-brain hypothermia,
including placement of a mechanical temperature-controlled
cooling device to the neck over carotids and head, including
monitoring (eg, vital signs and sport concussion assessment
tool 5 [SCAT5]), 30 minutes of treatment
• For concussion, most likely a sports injury

67. Transcutaneous
Magentic Nerve
Stimulation
Pain Management

68. Transcutaneous Magnetic Stimulation
CPT® Code Description
0766T Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse,
peripheral nerve, initial treatment, with identification and marking of the treatment
location, including noninvasive electroneurographic localization (nerve conduction
localization), when performed; first nerve
0767T Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse,
peripheral nerve, initial treatment, with identification and marking of the treatment
location, including noninvasive electroneurographic localization (nerve conduction
localization), when performed; each additional nerve (List separately in addition to code
for primary procedure)
0768T Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse,
peripheral nerve, subsequent treatment, including noninvasive electroneurographic
localization (nerve conduction localization), when performed; first nerve
0769T Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse,
peripheral nerve, subsequent treatment, including noninvasive electroneurographic
localization (nerve conduction localization), when performed; each additional nerve
(List separately in addition to code for primary procedure)

69. Eye and Ocular
Adnexa
CPT® Codes 65000-68999

70. Revised codes
• 66174 Transluminal dilation of aqueous outflow canal (eg,
canaloplasty); without retention of device or stent
• 66175 Transluminal dilation of aqueous outflow canal (eg,
canaloplasty); with retention of device or stent
• Aligns with U.S. Food & Drug Administration (FDA)
terminology for approved form of transluminal dilation of
aqueous outflow canal

71. Auditory System
CPT® Codes 69000-69999

72. Revised Code 69716
•2023
•Implantation, osseointegrated
implant, skull; with magnetic
transcutaneous attachment to
external speech processor, within
the mastoid and/or resulting in
removal of less than 100 sq mm
surface area of bone deep to the
outer cranial cortex
•2022
•Implantation, osseointegrated
implant, skull; with magnetic
transcutaneous attachment to
external speech processor

73. Revised Codes
• Remove Revision or at the beginning of codes 69717 & 69719
• 69717 Replacement (including removal of existing device),
osseointegrated implant, skull; with percutaneous attachment
to external speech processor
• 69719 Replacement (including removal of existing device),
osseointegrated implant, skull; with magnetic transcutaneous
attachment to external speech processor, within the mastoid
and/or involving a bony defect less than 100 sq mm surface
area of bone deep to the outer cranial cortex
• 69726 Removal, entire osseointegrated implant, skull; with
percutaneous attachment to external speech processor

74. Revised Code 69727
•2023
•Removal, entire osseointegrated
implant, with magnetic
transcutaneous attachment to
external speech processor, within
the mastoid and/or involving a
bony defect less than 100 sq mm
surface area of bone deep to the
outer cranial cortex
•2022
•Removal, osseointegrated
implant, skull; with magnetic
transcutaneous attachment to
external speech processor

75. New Codes
CPT® Code Description
69728 Removal, entire osseointegrated implant, skull; with magnetic transcutaneous
attachment to external speech processor, outside the mastoid and involving a bony
defect greater than or equal to 100 sq mm surface area of bone deep to the outer
cranial cortex
69729 Implantation, osseointegrated implant, skull; with magnetic transcutaneous
attachment to external speech processor, outside of the mastoid and resulting in
removal of greater than or equal to 100 sq mm surface area of bone deep to the
outer cranial cortex
69730 Replacement (including removal of existing device), osseointegrated implant, skull;
with magnetic transcutaneous attachment to external speech processor, outside the
mastoid and involving a bony defect greater than or equal to 100 sq mm surface
area of bone deep to the outer cranial cortex

76. Radiology
CPT® Codes 70000-79999

77. Ultrasound of Nerve
• Revised code 76882 Ultrasound, limited, joint or focal
evaluation of other nonvascular extremity structure(s) (eg,
joint space, peri-articular tendon[s], muscle[s], nerve[s], other
soft-tissue structure[s], or soft-tissue mass[es]), real-time with
image documentation
• New code 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

78. Revised Codes
• 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

79. Revised Codes
• 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

80. Rationale
• Did not identify “acquisitions”
• Separately obtained images with different radiopharmaceuticals, even
if they were obtained on the same day and from the same anatomic
site
• Allows for more specific reporting
• Allows for better differentiation when reporting codes 78831 &
78832

81. Bone Strength and
Fracture Risk
Category III

82. Bone Strength and Fracture Risk
CPT® Code Description
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

83. Pathology/Laboratory
11 New, 3 Revised

84. Revised Code 81445
•2023
•Targeted genomic sequence
analysis panel, solid organ
neoplasm, 5-50 genes (eg, ALK,
BRAF, CDKN2A, EGFR, ERBB2,
KIT, KRAS, MET, NRAS, PDGFRA,
PDGFRB, PGR, PIK3CA, PTEN,
RET), interrogation for sequence
variants and copy number variants
or rearrangements, if performed;
DNA analysis or combined DNA
and RNA analysis
•2022
•Targeted genomic sequence
analysis panel, solid organ
neoplasm, DNA analysis, and RNA
analysis when performed, 5-50
genes (eg, ALK, BRAF, CDKN2A,
EGFR, ERBB2, KIT, KRAS, NRAS,
MET, PDGFRA, PDGFRB, PGR,
PIK3CA, PTEN, RET), interrogation
for sequence variants and copy
number variants or rearrangements,
if performed

85. Revised Code 81450
•2023
•Targeted genomic sequence analysis
panel, hematolymphoid neoplasm or
disorder, 5-50 genes (eg, BRAF, CEBPA,
DNMT3A, EZH2, FLT3, IDH1, IDH2, JAK2,
KIT, KRAS, MLL, NOTCH1, NPM1, NRAS),
interrogation for sequence variants, and
copy number variants or rearrangements, or
isoform expression or mRNA expression
levels, if performed; DNA analysis or
combined DNA and RNA analysis
•2022
•Targeted genomic sequence analysis
panel, hematolymphoid neoplasm or
disorder, DNA analysis, and RNA analysis
when performed, 5-50 genes (eg, BRAF,
CEBPA, DNMT3A, EZH2, FLT3, IDH1,
IDH2, JAK2, KRAS, KIT, MLL, NRAS,
NPM1, NOTCH1), interrogation for
sequence variants, and copy number
variants or rearrangements, or isoform
expression or mRNA expression levels, if
performed

86. Revised Code 81455
•2023
•Targeted genomic sequence analysis
panel, solid organ or hematolymphoid
neoplasm or disorder, 51 or greater genes
(eg, ALK, BRAF, CDKN2A, CEBPA,
DNMT3A, EGFR, ERBB2, EZH2, FLT3,
IDH1, IDH2, JAK2, KIT, KRAS, MET, MLL,
NOTCH1, NPM1, NRAS, PDGFRA,
PDGFRB, PGR, PIK3CA, PTEN, RET),
interrogation for sequence variants and
copy number variants or rearrangements, or
isoform expression or mRNA expression
levels, if performed; DNA analysis or
combined DNA and RNA analysis
•2022
•Targeted genomic sequence analysis
panel, solid organ or hematolymphoid
neoplasm, DNA analysis, and RNA analysis
when performed, 51 or greater genes (eg,
ALK, BRAF, CDKN2A, CEBPA, DNMT3A,
EGFR, ERBB2, EZH2, FLT3, IDH1, IDH2,
JAK2, KIT, KRAS, MLL, NPM1, NRAS, MET,
NOTCH1, PDGFRA, PDGFRB, PGR,
PIK3CA, PTEN, RET), interrogation for
sequence variants and copy number
variants or rearrangements, if performed

87. New Codes
CPT® Code Description
81418 Drug metabolism (eg, pharmacogenomics) genomic sequence analysis panel, must
include testing of at least 6 genes, including CYP2C19, CYP2D6, and CYP2D6
duplication/deletion analysis
81441 Inherited bone marrow failure syndromes (IBMFS) (eg, Fanconi anemia, dyskeratosis
congenita, Diamond-Blackfan anemia, Shwachman-Diamond syndrome, GATA2
deficiency syndrome, congenital amegakaryocytic thrombocytopenia) sequence
analysis panel, must include sequencing of at least 30 genes, including BRCA2,
BRIP1, DKC1, FANCA, FANCB, FANCC, FANCD2, FANCE, FANCF, FANCG, FANCI,
FANCL, GATA1, GATA2, MPL, NHP2, NOP10, PALB2, RAD51C, RPL11, RPL35A,
RPL5, RPS10, RPS19, RPS24, RPS26, RPS7, SBDS, TERT, and TINF2
81449 Targeted genomic sequence analysis panel, solid organ neoplasm, 5-50 genes (eg,
ALK, BRAF, CDKN2A, EGFR, ERBB2, KIT, KRAS, MET, NRAS, PDGFRA, PDGFRB,
PGR, PIK3CA, PTEN, RET), interrogation for sequence variants and copy number
variants or rearrangements, if performed; RNA analysis

88. New Codes
CPT® Code Description
81451 Targeted genomic sequence analysis panel, hematolymphoid neoplasm or disorder, 5-
50 genes (eg, BRAF, CEBPA, DNMT3A, EZH2, FLT3, IDH1, IDH2, JAK2, KIT, KRAS,
MLL, NOTCH1, NPM1, NRAS), interrogation for sequence variants, and copy number
variants or rearrangements, or isoform expression or mRNA expression levels, if
performed; RNA analysis
81456 Targeted genomic sequence analysis panel, solid organ or hematolymphoid neoplasm
or disorder, 51 or greater genes (eg, ALK, BRAF, CDKN2A, CEBPA, DNMT3A, EGFR,
ERBB2, EZH2, FLT3, IDH1, IDH2, JAK2, KIT, KRAS, MET, MLL, NOTCH1, NPM1,
NRAS, PDGFRA, PDGFRB, PGR, PIK3CA, PTEN, RET), interrogation for sequence
variants and copy number variants or rearrangements, or isoform expression or mRNA
expression levels, if performed; RNA analysis
84433 Thiopurine S-methyltransferase (TPMT)

89. New Codes
CPT® Code Description
87467 Hepatitis B surface antigen (HBsAg), quantitative
87468 Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma
phagocytophilum, amplified probe technique
87469 Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti, amplified
probe technique
87478 Infectious agent detection by nucleic acid (DNA or RNA); Borrelia miyamotoi, amplified
probe technique
87484 Infectious agent detection by nucleic acid (DNA or RNA); Ehrlichia chaffeensis,
amplified probe technique

90. Proprietary
Laboratory Analyses
PLA

91. New PLA Codes
• 0355U APOL1 (apolipoprotein L1) (eg, chronic kidney
disease), risk variants (G1, G2)
• 0356U Oncology (oropharyngeal), evaluation of 17 DNA
biomarkers using droplet digital PCR (ddPCR), cell-free DNA,
algorithm reported as a prognostic risk score for cancer
recurrence
• 0357U Oncology (melanoma), artificial intelligence (AI)-
enabled quantitative mass spectrometry analysis of 142
unique pairs of glycopeptide and product fragments, plasma,
prognostic, and predictive algorithm reported as likely, unlikely,
or uncertain benefit from immunotherapy agents

92. New PLA Codes
• 0358U Neurology (mild cognitive impairment), analysis of β-
amyloid 1-42 and 1-40, chemiluminescence enzyme
immunoassay, cerebral spinal fluid, reported as positive, likely
positive, or negative
• 0359U Oncology (prostate cancer), analysis of all prostate-
specific antigen (PSA) structural isoforms by phase separation
and immunoassay, plasma, algorithm reports risk of cancer
• 0360U Oncology (lung), enzyme-linked immunosorbent assay
(ELISA) of 7 autoantibodies (p53, NY-ESO-1, CAGE, GBU4-5,
SOX2, MAGE A4, and HuD), plasma, algorithm reported as a
categorical result for risk of malignancy

93. New PLA Codes
• 0361U Neurofilament light chain, digital immunoassay,
plasma, quantitative
• 0362U Oncology (papillary thyroid cancer), gene-expression
profiling via targeted hybrid capture–enrichment RNA
sequencing of 82 content genes and 10 housekeeping genes,
formalin-fixed paraffin embedded (FFPE) tissue, algorithm
reported as one of three molecular subtypes
• 0363U Oncology (urothelial), mRNA, gene-expression profiling
by real-time quantitative PCR of 5 genes (MDK, HOXA13,
CDC2 [CDK1], IGFBP5, and CXCR2), utilizing urine, algorithm
incorporates age, sex, smoking history, and macrohematuria
frequency, reported as a risk score for having urothelial
carcinoma

94. Digitization of Slides
Category III Codes

95. New Cat III Codes
• 0751T Digitization of glass microscope slides for level II,
surgical pathology, gross and microscopic examination (List
separately in addition to code for primary procedure)
• 0752T Digitization of glass microscope slides for level III,
surgical pathology, gross and microscopic examination (List
separately in addition to code for primary procedure)
• 0753T Digitization of glass microscope slides for level IV,
surgical pathology, gross and microscopic examination (List
separately in addition to code for primary procedure)

96. New Cat III Codes
• 0754T Digitization of glass microscope slides for level V,
surgical pathology, gross and microscopic examination (List
separately in addition to code for primary procedure)
• 0755T Digitization of glass microscope slides for level VI,
surgical pathology, gross and microscopic examination (List
separately in addition to code for primary procedure)
• 0756T Digitization of glass microscope slides for special stain,
including interpretation and report, group I, for microorganisms
(eg, acid fast, methenamine silver) (List separately in addition
to code for primary procedure)

97. New Cat III Codes
• 0757T Digitization of glass microscope slides for special stain,
including interpretation and report, group II, all other (eg, iron,
trichrome), except stain for microorganisms, stains for enzyme
constituents, or immunocytochemistry and
immunohistochemistry (List separately in addition to code for
primary procedure)
• 0758T Digitization of glass microscope slides for special stain,
including interpretation and report, histochemical stain on
frozen tissue block (List separately in addition to code for
primary procedure)

98. New Cat III Codes
• 0759T Digitization of glass microscope slides for special stain,
including interpretation and report, group III, for enzyme
constituents (List separately in addition to code for primary
procedure)
• 0760T Digitization of glass microscope slides for
immunohistochemistry or immunocytochemistry, per
specimen, initial single antibody stain procedure (List
separately in addition to code for primary procedure)
• 0761T Digitization of glass microscope slides for
immunohistochemistry or immunocytochemistry, per
specimen, each additional single antibody stain procedure
(List separately in addition to code for primary procedure)

99. New Cat III Codes
• 0762T Digitization of glass microscope slides for
immunohistochemistry or immunocytochemistry, per
specimen, each multiplex antibody stain procedure (List
separately in addition to code for primary procedure)
• 0763T Digitization of glass microscope slides for
morphometric analysis, tumor immunohistochemistry (eg, Her-
2/neu, estrogen receptor/progesterone receptor), quantitative
or semiquantitative, per specimen, each single antibody stain
procedure, manual (List separately in addition to code for
primary procedure)

100. Medicine
10 New, 7 Revised

101. New Vaccine Code
• 90678 Respiratory syncytial virus vaccine, preF, subunit,
bivalent, for intramuscular use
• Pfizer’s RSVpreF vaccine
• Submitting a biologics license application (BLA) by end of year
• Watch for U.S. Food & Drug Administration (FDA) approval
next year

102. Orthoptic Training
• Revised 92065 Orthoptic training; performed by a physician
or other qualified health care professional
• New code 92066 Orthoptic training; under supervision of a
physician or other qualified health care professional

103. The Eyes Have It
• Revised code 92229 Imaging of retina for detection or
monitoring of disease; point-of-care autonomous analysis
and report, unilateral or bilateral
• Revised code 92284 Diagnostic dark adaptation examination
with interpretation and report
• New code 95919 Quantitative pupillometry with physician or
other qualified health care professional interpretation and
report, unilateral or bilateral

104. Injection Procedure
During Cardiac Cath
CPT® Codes 93568-93575

105. One Revised, Four New Codes
CPT® Code Description
93568 Injection procedure during cardiac catheterization including imaging
supervision, interpretation, and report; for nonselective pulmonary
arterial angiography (List separately in addition to code for primary
procedure)
93569 Injection procedure during cardiac catheterization including imaging
supervision, interpretation, and report; for selective pulmonary
arterial angiography, unilateral (List separately in addition to code for
primary procedure)
93573 Injection procedure during cardiac catheterization including imaging
supervision, interpretation, and report; for selective pulmonary
arterial angiography, bilateral (List separately in addition to code for
primary procedure)

106. One Revised, Four New Codes
CPT® Code Description
93574 Injection procedure during cardiac catheterization including imaging
supervision, interpretation, and report; for selective pulmonary
venous angiography of each distinct pulmonary vein during cardiac
catheterization (List separately in addition to code for primary
procedure)
93575 Injection procedure during cardiac catheterization including imaging
supervision, interpretation, and report; for selective pulmonary
angiography of major aortopulmonary collateral arteries (MAPCAs)
arising off the aorta or its systemic branches, during cardiac
catheterization for congenital heart defects, each distinct vessel (List
separately in addition to code for primary procedure)

107. Caregiver Behavior
Management
CPT® Codes 96202-96203

108. Two New Codes
• 96202 Multiple-family group behavior management/modification training
for parent(s)/guardian(s)/caregiver(s) of patients with a mental or
physical health diagnosis, administered by physician or other qualified
health care professional (without the patient present), face-to-face with
multiple sets of parent(s)/guardian(s)/caregiver(s); initial 60 minutes
• 96203 Multiple-family group behavior management/modification training
for parent(s)/guardian(s)/caregiver(s) of patients with a mental or
physical health diagnosis, administered by physician or other qualified
health care professional (without the patient present), face-to-face with
multiple sets of parent(s)/guardian(s)/caregiver(s); each additional 15
minutes (List separately in addition to code for primary service)

109. Cognitive Behavioral
Therapy Monitoring
CPT® Codes 98975-98978

110. Three Revised Codes, One New
• Revised codes 98975-98977
• 2022 Remote therapeutic monitoring (eg, respiratory system
status, musculoskeletal system status, therapy adherence,
therapy response);
• 2023 Remote therapeutic monitoring (eg, therapy adherence,
therapy response);
• New code 98978 Remote therapeutic monitoring (eg, therapy
adherence, therapy response); device(s) supply with
scheduled (eg, daily) recording(s) and/or programmed alert(s)
transmission to monitor cognitive behavioral therapy, each 30
days

111. Transcutaneous
Auricular
Neurostimulation
Category III

112. Transcutaneous Auricular
Neurostimulation
• 0783T Transcutaneous auricular neurostimulation, set-up,
calibration, and patient education on use of equipment
• Sends electrical stimulation to the vagus and trigeminal nerves
• Aids in the relief of opioid-withdrawal symptoms

113. Remote Therapeutic
Activity
Category III Codes

114. Revised Code – 0733T
•2023
•Remote real-time, motion
capture–based
neurorehabilitative therapy
ordered by a physician or other
qualified health care
professional; supply and
technical support, per 30 days
•2022
•Remote body and limb
kinematic measurement-based
therapy ordered by a physician
or other qualified health care
professional; supply and
technical support, per 30 days

115. Revised Code – 0734T
•2023
•Remote real-time, motion
capture–based
neurorehabilitative therapy
ordered by a physician or other
qualified health care
professional; treatment
management services by a
physician or other qualified
health care professional, per
calendar month
•2022
•Remote body and limb
kinematic measurement-based
therapy ordered by a physician
or other qualified health care
professional; treatment
management services by a
physician or other qualified
health care professional, per
calendar month

116. Artificial Intelligence (AI) Insulin Dose
CPT® Code Description
0740T Remote autonomous algorithm-based recommendation system for insulin dose
calculation and titration; initial set-up and patient education
0741T Remote autonomous algorithm-based recommendation system for insulin dose
calculation and titration; provision of software, data collection, transmission, and
storage, each 30 days
Technology provides the appropriate adjusted insulin dose in real time

117. AI Cardiac Function Services
CPT® Code Description
0764T Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction
(eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy);
related to concurrently performed electrocardiogram (List separately in addition to code
for primary procedure)
0765T Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction
(eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy);
related to previously performed electrocardiogram
EKG is software analysis (algorithm is run to look for dx in description of code)
Code selection based on whether concurrent with electrocardiogram tracing.

118. AI Epidural Placement
• 0777T Real-time pressure-sensing epidural guidance
system (List separately in addition to code for primary
procedure)
• Software analyzes epidural pressure to detail anatomical
needle placement
• Measures precise saline volume
• Report in conjunction with CPT® codes 62320-62327

119. Virtual-Reality (VR) Mediated Therapy
• 0770T Virtual reality technology to assist therapy (List
separately in addition to code for primary procedure)
• Used for skill building in
• Social communication
• Emotional regulation
• Daily functions
• This is practice expense and coded once per therapy session
• Watch parenthetical notes

120. VR Procedural Dissociation Services
• VR-based state of altered consciousness
• Supports and optimizes patient comfort
• Increases procedural tolerance
• Decreases pain
• Computer-generated audio, visual proprioceptive environment
• Can still respond to verbal commands, maybe with light tactile
stimulation
• Does not involve interventions to maintain cardiovascular
function, patent airway, or spontaneous ventilation

121. VR Procedural Dissociation Services
CPT® Code Description
0771T Virtual reality (VR) procedural dissociation services provided by the same physician or
other qualified health care professional performing the diagnostic or therapeutic service
that the VR procedural dissociation supports, requiring the presence of an independent,
trained observer to assist in the monitoring of the patient's level of dissociation or
consciousness and physiological status; initial 15 minutes of intraservice time, patient age
5 years or older
0772T Virtual reality (VR) procedural dissociation services provided by the same physician or
other qualified health care professional performing the diagnostic or therapeutic service
that the VR procedural dissociation supports, requiring the presence of an independent,
trained observer to assist in the monitoring of the patient's level of dissociation or
consciousness and physiological status; each additional 15 minutes intraservice time (List
separately in addition to code for primary service)

122. VR Procedural Dissociation Services
CPT® Code Description
0773T Virtual reality (VR) procedural dissociation services provided by a physician or other
qualified health care professional other than the physician or other qualified health care
professional performing the diagnostic or therapeutic service that the VR procedural
dissociation supports; initial 15 minutes of intraservice time, patient age 5 years or older
0774T Virtual reality (VR) procedural dissociation services provided by a physician or other
qualified health care professional other than the physician or other qualified health care
professional performing the diagnostic or therapeutic service that the VR procedural
dissociation supports; each additional 15 minutes intraservice time (List separately in
addition to code for primary service)
Not used for services under 10 minutes
Patient must be 5 years of age or older

123. Evaluation and
Management (E/M)
Other E/M Codes take on 2021 Updates

124. Overview of Updates
• Evaluation and Management (E/M) Introductory Guidelines
• Hospital Inpatient and Observation Care Services codes 99221-
99223, 99231-99239
• Consultations codes 99242-99245, 99252-99255,
• Emergency Department Services codes 99281-99285,
• Nursing Facility Services codes 99304-99310, 99315, 99316,
• Home or Residence Services codes 99341, 99342, 99344, 99345,
99347-99350

125. Overview of Updates
• Deletion of Hospital Observation Services E/M codes 99217-
99220
• Revision of Hospital Inpatient and Observation Care Services
E/M codes 99221-99223, 99231-99239 and guidelines
• Deletion of Consultations E/M codes 99241 and 99251
• Revision of Consultations E/M codes 99242-99245, 99252-
99255 and guidelines

126. Overview of Updates
• Revision of Emergency Department Services E/M codes
99281-99285 and guidelines
• Deletion of Nursing Facility Services E/M code 99318
• Revision of Nursing Facility Services E/M codes 99304-99310,
99315, 99316 and guidelines
• Deletion of Domiciliary, Rest Home (eg, Boarding Home), or
Custodial Care Services E/M codes 99324-99238, 99334-
99337, 99339, 99340

127. Overview of Updates
• Deletion of Home or Residence Services E/M code 99343
• Revision of Home or Residence Services E/M codes 99341,
99342, 99344, 99345, 99347-99350 and guidelines
• Deletion of Prolonged Services E/M codes 99354-99357
• Revision of guidelines for Prolonged Services E/M codes
99358, 99359, 99415, 99416
• Revision of Prolonged Services E/M code 99417 and
guidelines
• Establishment of Prolonged Services E/M code 99418 and
guidelines

128. Levels of E/M Services
• No longer based on examination
• Medically appropriate history and/or physical examination, when
performed
• Extent of history & exam is not an element used in selection of E/M
• Levels of E/M selection
• Based on the level of Medical Decision Making (MDM) OR
• Total time for E/M services performed on the date of the encounter
• Minimal Updates to MDM Table

129. Hospital Inpatient
and Observation
Services
Hosp IP/Obsv Services

130. Observation Care Deletions
• Initial hospital care codes revised to include observation
CPT® Code Description Suggested Replacement(s)
99217
OBSERVATION CARE DISCHARGE
99238, 99239
99218
INITIAL OBSERVATION CARE
99221, 99222, 99223
99219
INITIAL OBSERVATION CARE
99221, 99222, 99223
99220
INITIAL OBSERVATION CARE
99221, 99222, 99223
99224
SUBSEQUENT OBSERVATION CARE
99231, 99232, 99233
99225
SUBSEQUENT OBSERVATION CARE
99231, 99232, 99233
99226
SUBSEQUENT OBSERVATION CARE
99231, 99232, 99233

131. Initial Hospital or Observation Care
CPT® Code Revised Description
99221 Initial hospital inpatient or observation care, per day, for the evaluation and
management of a patient, which requires a medically appropriate history and/or
examination and straightforward or low level medical decision making. When using
total time on the date of the encounter for code selection, 40 minutes must be met
or exceeded.
99222 Initial hospital inpatient or observation care, per day, for the evaluation and
management of a patient, which requires a medically appropriate history and/or
examination and moderate level medical decision making. When using total time
on the date of the encounter for code selection, 55 minutes must be met or
exceeded.
99223 Initial hospital inpatient or observation care, per day, for the evaluation and
management of a patient, which requires a medically appropriate history and/or
examination and high level medical decision making. When using total time on the
date of the encounter for code selection, 75 minutes must be met or exceeded.

132. Subsequent Hospital Inpatient or
Observation Care
CPT® Code Revised Description
99231 Subsequent hospital inpatient or observation care, per day, for the evaluation and
management of a patient, which requires a medically appropriate history and/or
examination and straightforward or low level of medical decision making. When using
total time on the date of the encounter for code selection, 25 minutes must be met or
exceeded.
99232 Subsequent hospital inpatient or observation care, per day, for the evaluation and
management of a patient, which requires a medically appropriate history and/or
examination and moderate level of medical decision making. When using total time on
the date of the encounter for code selection, 35 minutes must be met or exceeded.
92233 Subsequent hospital inpatient or observation care, per day, for the evaluation and
management of a patient, which requires a medically appropriate history and/or
examination and high level of medical decision making. When using total time on the
date of the encounter for code selection, 50 minutes must be met or exceeded.

133. Revised Admit/Discharge on the Same
Day
CPT® Code Revised Description
99234 Hospital inpatient or observation care, for the evaluation and management of a patient
including admission and discharge on the same date, which requires a medically
appropriate history and/or examination and straightforward or low level of medical
decision. When using total time on the date of the encounter for code selection, 45
minutes must be met or exceeded.
99235 Hospital inpatient or observation care, for the evaluation and management of a patient
including admission and discharge on the same date, which requires a medically
appropriate history and/or examination and moderate level of medical decision. When
using total time on the date of the encounter for code selection, 70 minutes must be met
or exceeded.
99236 Hospital inpatient or observation care, for the evaluation and management of a patient
including admission and discharge on the same date, which requires a medically
appropriate history and/or examination and high level of medical decision. When using
total time on the date of the encounter for code selection, 85 minutes must be met or
exceeded.

134. Revised Hospital Discharge Day
Management
CPT® Code Revised Description
99238 Hospital inpatient or observation discharge day management; 30 minutes or less on
the date of the encounter
99239 Hospital inpatient or observation discharge day management; more than 30 minutes on
the date of the encounter

135. Consultations
99241-99255

136. Deleted Consultation Codes
CPT® Code Short Description Suggested Replacement(s)
99241 OFFICE CONSULTATION 99242, 99243, 99244, 99245
99251 INPATIENT CONSULTATION 99252, 99253, 99254, 99255

137. Initial and Subsequent Services
• Some categories may apply to both new or established
patients (hospital inpatient or observation care)
• Initial service is when the patient has not received any
professional services from the physician or QHP of the exact
same specialty/subspecialty in the same group practice during
the inpatient, observation or nursing facility admission and
stay
• Subsequent service reported when the patient has received
professional services from the physician or QHP of the exact
same specialty/subspecialty in the same group practice during
the inpatient, observation or nursing facility admission and
stay

138. Initial and Subsequent Services
• If provider is on call, the patient’s encounter is classified as if
the unavailable physician or QHP provided the visit
• When QHPs are working with physicians, they are considered
as working in the exact same specialty and subspecialty
• Single stay
• Inpatient or observation services that transition to inpatient
• Skilled nursing facility level of care transitions to nursing facility level
of care

139. Revised Office or Other Outpatient
Consultation
CPT® Code Revised Description
99242 Office or other outpatient consultation for a new or established patient, which requires a
medically appropriate history and/or examination and straightforward medical decision
making. When using total time on the date of the encounter for code selection, 20 minutes
must be met of exceeded.
99243 Office or other outpatient consultation for a new or established patient, which requires a
medically appropriate history and/or examination and low level of medical decision making.
When using total time on the date of the encounter for code selection, 30 minutes must be
met of exceeded.
99244 Office or other outpatient consultation for a new or established patient, which requires a
medically appropriate history and/or examination and moderate level of medical decision
making. When using total time on the date of the encounter for code selection,40 minutes
must be met of exceeded.
99245 Office or other outpatient consultation for a new or established patient, which requires a
medically appropriate history and/or examination and high level of medical decision
making. When using total time on the date of the encounter for code selection, 55 minutes
must be met of exceeded.

140. Revised Inpatient/Obsv Consultation
CPT® Code Revised Description
99252 Inpatient or observation consultation for a new or established patient, which requires a
medically appropriate history and/or examination and straightforward medical decision making.
When using total time on the date of the encounter for code selection, 35 minutes must be met
or exceeded.
99253 Inpatient or observation consultation for a new or established patient, which requires a
medically appropriate history and/or examination and low level of medical decision making.
When using total time on the date of the encounter for code selection, 45 minutes must be met
or exceeded.
99254 Inpatient or observation consultation for a new or established patient, which requires a
medically appropriate history and/or examination and moderate level of medical decision
making. When using total time on the date of the encounter for code selection, 60 minutes
must be met or exceeded.
99255 Inpatient or observation consultation for a new or established patient, which requires a
medically appropriate history and/or examination and high level of medical decision making.
When using total time on the date of the encounter for code selection, 80 minutes must be met
or exceeded.

141. Emergency
Department (E/D)
Revisions
CPT® Codes 99281-99285

142. Revised ED Visits
CPT® Code Revised Description
99281 Emergency department visit for the evaluation and management of a patient that may
not require the presence of a physician or other qualified health care professional
99282 Emergency department visit for the evaluation and management of a patient, which
requires a medically appropriate history and/or examination and straightforward
medical decision making.
99283 Emergency department visit for the evaluation and management of a patient, which
requires a medically appropriate history and/or examination and low level of medical
decision making.

143. Revised ED Visits
CPT® Code Revised Description
99284 Emergency department visit for the evaluation and management of a patient, which
requires a medically appropriate history and/or examination and moderate level of
medical decision making.
99285 Emergency department visit for the evaluation and management of a patient, which
requires a medically appropriate history and/or examination and high level of medical
decision making.

144. Documentation Tips
• Review of external notes (nursing home, emergency medical
services, discharge summary)
• Independent historian (parent, guardian, spouse)
• Independent interpretation of test (EKG, x-ray, CT scan)
• Decision regarding hospitalization
• Testing considered but not performed (CT scan)
• Treatment considered but not performed (antibiotics)

145. Nursing Facility
Visits
99304-99318

146. Deleted Code
CPT® Code Short Description Suggested Replacement(s)
99318 ANNUAL NURSING FAC ASSESSMNT 99307, 99308, 99309, 99310

147. Revised Nursing Facility Visits
CPT® Code Revised Description
99304 Initial nursing facility care, per day, for the evaluation and management of a patient,
which requires a medically appropriate history and/or examination and straightforward
or low level of medical decision making. When using total time on the date of the
encounter for code selection, 25 minutes must be met or exceeded.
99305 Initial nursing facility care, per day, for the evaluation and management of a patient,
which requires a medically appropriate history and/or examination and moderate level
of medical decision making. When using total time on the date of the encounter for
code selection, 35 minutes must be met or exceeded.
99306 Initial nursing facility care, per day, for the evaluation and management of a patient,
which requires a medically appropriate history and/or examination and high level of
medical decision making. When using total time on the date of the encounter for code
selection, 45 minutes must be met or exceeded.

148. Revised Nursing Facility Visits
CPT® Code Revised Description
99307 Subsequent nursing facility care, per day, for the evaluation and management of a
patient, which requires a medically appropriate history and/or examination and
straightforward medical decision making. When using total time on the date of the
encounter for code selection, 10 minutes must be met or exceeded.
99308 Subsequent nursing facility care, per day, for the evaluation and management of a
patient, which requires a medically appropriate history and/or examination and low level
of medical decision making. When using total time on the date of the encounter for
code selection, 15 minutes must be met or exceeded.
99309 Subsequent nursing facility care, per day, for the evaluation and management of a
patient, which requires a medically appropriate history and/or examination and
moderate level of medical decision making. When using total time on the date of the
encounter for code selection, 30 minutes must be met or exceeded.
99310 Subsequent nursing facility care, per day, for the evaluation and management of a
patient, which requires a medically appropriate history and/or examination and high
level of medical decision making. When using total time on the date of the encounter
for code selection, 45 minutes must be met or exceeded.

149. Revised Nursing Facility Visits
CPT® Code Revised Description
99315 Nursing facility discharge day management; 30 minutes or less total time on the date of
the encounter
99316 Nursing facility discharge day management; more than 30 minutes total time on the
date of the encounter
Check guidelines to assist in determining time spent. The discharge services do not need to be
completed on the day the patient leaves the facility.

150. Home or Residence
Services
Removal of Domiciliary or Rest Home Codes

151. Deleted Codes
CPT® Codes Short Description Suggested Replacement(s)
99324 DOMICIL/R-HOME VISIT NEW PAT 99341, 99342, 99344, 99345
99325 DOMICIL/R-HOME VISIT NEW PAT 99341, 99342, 99344, 99345
99326 DOMICIL/R-HOME VISIT NEW PAT 99341, 99342, 99344, 99345
99327 DOMICIL/R-HOME VISIT NEW PAT 99341, 99342, 99344, 99345
99328 DOMICIL/R-HOME VISIT NEW PAT 99341, 99342, 99344, 99345

152. Deleted Codes
CPT® Code Short Description Suggested Replacement(s)
99334 DOMICIL/R-HOME VISIT EST PAT 99347, 99348, 99349, 99350
99335 DOMICIL/R-HOME VISIT EST PAT 99347, 99348, 99349, 99350
99336 DOMICIL/R-HOME VISIT EST PAT 99347, 99348, 99349, 99350
99337 DOMICIL/R-HOME VISIT EST PAT 99347, 99348, 99349, 99350

153. Deleted Codes
CPT® Code Short Description Suggested Replacement(s)
99339 DOMICIL/R-HOME CARE SUPERVIS 99242, 99491
99340 DOMICIL/R-HOME CARE SUPERVIS 99242, 99491
99343 HOME VISIT NEW PATIENT 99341, 99342, 99344, 99355
Home care supervision may be reported with the chronic care management or principal care
management codes.

154. Revised Codes
CPT® Code Description
99341 Home or residence visit for the evaluation and management of a new patient, which requires
a medically appropriate history and/or examination and straightforward medical decision
making. When using total time on the date of the encounter for code selection, 15 minutes
must be met or exceeded.
99342 Home or residence visit for the evaluation and management of a new patient, which requires
a medically appropriate history and/or examination and low level of medical decision making.
When using total time on the date of the encounter for code selection, 30 minutes must be
met or exceeded.
99344 Home or residence visit for the evaluation and management of a new patient, which requires
a medically appropriate history and/or examination and moderate level of medical decision
making. When using total time on the date of the encounter for code selection, 60 minutes
must be met or exceeded.
99345 Home or residence visit for the evaluation and management of a new patient, which requires
a medically appropriate history and/or examination and high level of medical decision making.
When using total time on the date of the encounter for code selection, 75 minutes must be
met or exceeded.

155. Revised Codes
CPT® Code Description
99347 Home or residence visit for the evaluation and management of an established patient,
which requires a medically appropriate history and/or examination and straightforward
medical decision making. When using total time on the date of the encounter for code
selection, 20 minutes must be met or exceeded.
99348 Home or residence visit for the evaluation and management of an established patient,
which requires a medically appropriate history and/or examination and low level of
medical decision making. When using total time on the date of the encounter for code
selection, 30 minutes must be met or exceeded.
99349 Home or residence visit for the evaluation and management of an established patient,
which requires a medically appropriate history and/or examination and moderate level
of medical decision making. When using total time on the date of the encounter for
code selection, 40 minutes must be met or exceeded.
99350 Home or residence visit for the evaluation and management of an established patient,
which requires a medically appropriate history and/or examination and high level of
medical decision making. When using total time on the date of the encounter for code
selection, 60 minutes must be met or exceeded.

156. Prolonged Services
Healthcare Common Procedure Coding System (HCPCS) Codes

157. Deleted Codes
CPT®
Codes
Short Description Suggested
Replacement(s)
99354 PROLNG SVC O/P 1ST HOUR 99417
99355 PROLNG SVC O/P EA ADDL 30 99417
99356 PROLNG SVC I/P/OBS 1ST
HOUR
99418
99357 PROLNG SVC I/P/OBS EA
ADDL
99418

158. Revised Code 99417
•2023
•Prolonged outpatient evaluation and
management service(s) time with or
without direct patient contact beyond
the required time of the primary
service when the primary service
level has been selected using total
time, each 15 minutes of total time
(List separately in addition to the
code of the outpatient Evaluation
and Management services)
•2022
•Prolonged office or other outpatient
evaluation and management service(s)
beyond the minimum required time of the
primary procedure which has been selected
using total time, requiring total time with or
without direct patient contact beyond the
usual service, on the date of the primary
service, each 15 minutes of total time (List
separately in addition to codes 99205,
99215 for office or other outpatient
Evaluation and Management services)

159. New Code
99418 Prolonged inpatient or observation evaluation and
management service(s) time with or without direct patient
contact beyond the required time of the primary service when
the primary service level has been selected using total time,
each 15 minutes of total time (List separately in addition to the
code of the inpatient and observation Evaluation and
Management service)

160. CMS Coding – GXXX1
• G0316 Prolonged hospital inpatient or observation care
evaluation and management service(s) beyond the total time
for the primary service (when the primary service has been
selected using time on the date of the primary service); each
additional 15 minutes by the physician or qualified healthcare
professional, with or without direct patient contact (List
separately in addition to CPT codes 99223, 99233, and 99236
for hospital inpatient or observation care evaluation and
management services). (Do not report G0316 on the same
date of service as other prolonged services for evaluation and
management 99358, 99359, 99418). (Do not report G0316 for
any time unit less than 15 minutes)

161. CMS Coding – GXXX2
• G0317 (Prolonged nursing facility evaluation and management
service(s) beyond the total time for the primary service (when
the primary service has been selected using time on the date
of the primary service); each additional 15 minutes by the
physician or qualified healthcare professional, with or without
direct patient contact (List separately in addition to CPT codes
99306, 99310 for nursing facility evaluation and management
services). (Do not report G0317 on the same date of service
as other prolonged services for evaluation and management
99358, 99359, 99418). (Do not report G0317 for any time unit
less than 15 minutes)

162. CMS Coding – GXXX3
• G0318 (Prolonged home or residence evaluation and
management service(s) beyond the total time for the primary
service (when the primary service has been selected using
time on the date of the primary service); each additional 15
minutes by the physician or qualified healthcare professional,
with or without direct patient contact (List separately in
addition to CPT codes 99345, 99350 for home or residence
evaluation and management services). (Do not report G0318
on the same date of service as other prolonged services for
evaluation and management 99358, 99359, 99417). (Do not
report G0318 for any time unit less than 15 minutes)

163. Initial Hospital Inpatient or Observation
Care
CPT® Time (In minutes)
Must meet or exceeded
99221 40
99222 55
99223 75
99418 90 minutes or longer
G0316 105 minutes or longer

164. Subsequent Hospital Inpatient or
Observation Care
CPT® Time (in minutes)
Must meet or exceeded
99231 25
99232 35
99233 50
99418 65 minutes or longer
G0316 80 minutes or longer

165. Admit/Discharge Same Day
CPT® Code Time (in minutes)
Must meet or exceed
99234 45
99235 70
99236 85
99418 100 minutes or longer
G0316 125 minutes or longer

166. Office/Other Outpatient Consultations
CPT® Code Time (in minutes)
Must meet or exceed
99242 20
99243 30
99244 40
99245 55
99417 70 minutes or longer
No Code CMS doesn’t cover

167. Inpatient or Observation Consultations
CPT® Code Time (in minutes)
Must meet or exceed
99252 35
99253 45
99254 60
99255 80
99418 95 minutes or longer
No Code CMS doesn’t cover

168. CMS Time Thresholds to Report Other
E/M Prolonged Services
Primary E/M Prolonged Code Time Threshold
Initial IP/OBS
(99223)
G0316 105 minutes
Subsequent
IP/OBS (99233)
G0316 80 minutes
Admit/Discharge
Same Day (99236)
G0316 125 minutes
Initial NF Visit
(99306)
G0317 95 minutes

169. CMS Time Thresholds to Report Other
E/M Prolonged Services
Primary E/M Prolonged Code Time Threshold
Subsequent NF Visit
(99310)
G0317 85 minutes
Home/Residence
Visit New Pt (99345)
G0318 141 minutes
Home/Residence
Visit Est Pt
(99350)
G0318 112 minutes

170. Revised Codes
Other E/M Services

171. Revisions
• 99446-99451 adding “or other qualified health care
professional” to description
• 99483 assessment & care planning for a patient with cognitive
impairment updating to 60 minutes of total time on the date of
the encounter
• 99495-99496 transitional care management services cosmetic
change to language
• Medical decision making of at least moderate….
• At least moderate level of medical decision making….

172. Category III
New Technology

173. Deleted Codes – Use 64999
CPT® Code Description
0312T Vagus nerve blocking therapy (morbid obesity); laparoscopic implantation of
neurostimulator electrode array, anterior and posterior vagal trunks adjacent to
esophagogastric junction (EGJ), with implantation of pulse generator, includes
programming
0313T Vagus nerve blocking therapy (morbid obesity); laparoscopic revision or replacement
of vagal trunk neurostimulator electrode array, including connection to existing pulse
generator
0314T Vagus nerve blocking therapy (morbid obesity); laparoscopic removal of vagal trunk
neurostimulator electrode array and pulse generator
0315T Vagus nerve blocking therapy (morbid obesity); removal of pulse generator
0316T Vagus nerve blocking therapy (morbid obesity); replacement of pulse generator
0317T Vagus nerve blocking therapy (morbid obesity); neurostimulator pulse generator
electronic analysis, includes reprogramming when performed

174. Deleted Codes
CPT® Code Description
0470T Optical coherence tomography (OCT) for microstructural and morphological imaging
of skin, image acquisition, interpretation, and report; first lesion
0471T Optical coherence tomography (OCT) for microstructural and morphological imaging
of skin, image acquisition, interpretation, and report; each additional lesion (List
separately in addition to code for primary procedure)
OCT for microstructural and morphological imaging of skin, use CPT® code 96999

175. Deleted Codes – Use 93799
CPT® Code Description
0475T Recording of fetal magnetic cardiac signal using at least 3 channels; patient
recording and storage, data scanning with signal extraction, technical analysis and
result, as well as supervision, review, and interpretation of report by a physician or
other qualified health care professional
0476T Recording of fetal magnetic cardiac signal using at least 3 channels; patient
recording, data scanning, with raw electronic signal transfer of data and storage
0477T Recording of fetal magnetic cardiac signal using at least 3 channels; signal
extraction, technical analysis, and result
0478T Recording of fetal magnetic cardiac signal using at least 3 channels; review,
interpretation, report by physician or other qualified health care professional

176. Deleted Codes
CPT® Code Description
0487T Biomechanical mapping, transvaginal, with report
0491T Ablative laser treatment, non-contact, full field and fractional ablation, open wound,
per day, total treatment surface area; first 20 sq cm or less
0492T Ablative laser treatment, non-contact, full field and fractional ablation, open wound,
per day, total treatment surface area; each additional 20 sq cm, or part thereof (List
separately in addition to code for primary procedure)
0493T Contact near-infrared spectroscopy studies of lower extremity wounds (eg, for
oxyhemoglobin measurement)

177. Deleted Codes – Use 93799
CPT® Code Description
0497T External patient-activated, physician- or other qualified health care professional-
prescribed, electrocardiographic rhythm derived event recorder without 24-hour
attended monitoring; in-office connection
0498T External patient-activated, physician- or other qualified health care professional-
prescribed, electrocardiographic rhythm derived event recorder without 24-hour
attended monitoring; review and interpretation by a physician or other qualified health
care professional per 30 days with at least one patient-generated triggered event

178. Deleted Codes
CPT® Code Description
0514T Intraoperative visual axis identification using patient fixation (List separately in
addition to code for primary procedure)
0702T Remote therapeutic monitoring of a standardized online digital cognitive behavioral
therapy program ordered by a physician or other qualified health care professional;
supply and technical support, per 30 days
0703T Remote therapeutic monitoring of a standardized online digital cognitive behavioral
therapy program ordered by a physician or other qualified health care professional;
management services by physician or other qualified health care professional, per
calendar month

179. References
CPT Errata & Technical Corrections:
https://www.ama-assn.org/practice-management/cpt/cpt-errata-
technical-corrections
E/M Microsite:
https://www.ama-assn.org/practice-management/cpt/cpt-
evaluation-and-management