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© Health Catalyst. Confidential and Proprietary.
2024 CPT® Code Updates
(CDM Focused)
Jennifer Bishop, RHIT, CCS, CCS-P, CHRI
© Health Catalyst. Confidential and Proprietary.
Disclaimer Statement
This webinar/presentation was current at the time it was published or provided
via the web and is designed to provide accurate and authoritative information
regarding the subject matter covered. The information provided is only
intended to be a general overview with the understanding that neither the
presenter nor the event sponsor is engaged in rendering specific coding advice.
It is not intended to take the place of either the written policies or regulations.
We encourage participants to review the specific regulations and other
interpretive materials, as necessary.
© Health Catalyst. Confidential and Proprietary.
Overview of 2024 Changes
CPT® Section Additions Deletions Revisions
Evaluation &
Management
1 0 10
Anesthesia 0 0 0
Surgery 23 0 10
Radiology 5 1 0
Pathology & Laboratory 13 0 16
PLA & MAAA 19 1 2
Medicine 21 0 4
Category II 0 0 0
Category III 63 32 13
Totals 145 34 55
• Totals do not include codes added, deleted, or revised in CY 2023 but appearing for the first time in the CY 2024 book
• Revised totals do not include codes with changes to short or medium descriptions only
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Changes to
Radiology Section
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Added Codes - Radiology Section
 75580 - Noninvasive estimate of coronary fractional flow reserve (FFR) derived from
augmentative software analysis of the data set from a coronary computed
tomography angiography, with interpretation and report by a physician or other
qualified health care professional
– Code falls into augmentative category of artificial intelligence (AI)
– Replacement code for Category III code 0501T-0504T
– Report in conjunction with 75574 is CCTA is performed on the same date of service
– Report only once per CCTA analysis
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New Guidelines for AI (Appendix S)
Service Components Assistive Augmentative Autonomous
Primary Objective Detects Data Analyzes or Quantifies Data to
Yield Output
Interprets Data and Generates
Conclusions
Provides Independent Diagnosis
and/or Management
No No Yes
Analyzes Data No Yes Yes
Requires Physician Interpretation Yes Yes No
Examples 0764T, 0765T 75580 92229
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Added Codes - Radiology Section
 76984 - Ultrasound, intraoperative thoracic aorta (e.g., epiaortic), diagnostic
 76987 - Intraoperative epicardial cardiac ultrasound (i.e., echocardiography) for
congenital heart disease, diagnostic; including placement and manipulation of
transducer, image acquisition, interpretation and report
 76988 - Intraoperative epicardial cardiac ultrasound (i.e., echocardiography) for
congenital heart disease, diagnostic; placement, manipulation of transducer, and
image acquisition only
 76989 - Intraoperative epicardial cardiac ultrasound (i.e., echocardiography) for
congenital heart disease, diagnostic; interpretation and report only
– Codes broken out upon review of CPT code 76998 (Intraoperative US guidance) which was used by
multiple different specialty groups for multiple different purposes
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Added Codes - Radiology Section
 76984 - Ultrasound, intraoperative
thoracic aorta (e.g., epiaortic), diagnostic
– Limits exposure to radiation and iodinated
contrast
– Allows physician to “see” and avoid aortic
disease
– Also used to assess for leaks following EVAR
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Added Codes - Radiology Section
 76987 – Complete procedure when
done intraoperatively to assess
congenital heart disease
 76988 – Placement and manipulation
of device with image acquisition
 76989 – Physician review and
interpretation of images
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Deleted Code – Radiology Section
Deleted Code Suggested Replacement Codes
74710 – Pelvimetry, with or without placental localization 76499
Code is obsolete and therefore no longer needed
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Changes to
Laboratory &
Pathology Section
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Guidelines for Genomic Sequencing Procedures
 GSPs are DNA/RNA sequence analysis methods that simultaneously assay
multiple genes or regions from germline or neoplastic sample
 MPS/NGS technology is typically used, but other technologies may be used –
Code selection should be based on components
 If all components are not performed, see Tier I or Tier II codes
 When GSP assay includes a gene listed in more than one code descriptor, choose
code based on primary disorder
 Testing for somatic alterations in neoplasms is reported differently based on
methods and analytes (DNA and/or RNA)
 See Table on page 661 of code book for more details
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Definitions for Genomic Sequencing Procedures
 Cell-free nucleic acid – DNA or RNA released into the blood and other body fluids.
Sometimes referred to as “liquid biopsy”
 Copy number variants – Structural changes in the genome which are composed
of large deletions or duplications
 Duplication/Deletion – Used in molecular testing to assess the dosage of a
particular genomic regions; 0-1 copy represents a deletion, while 3+ copies
represent a duplication
 Massively parallel sequencing (MPS) – Method used to determine a portion of
the nucleotide sequences in an individual patient’s genome utilizing advanced
sequencing technologies that can process multiple DNA/RNA sequences in
parallel; NGS is a common technique to achieve MPS
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Definitions for Genomic Sequencing Procedures
 Microsatellite instability (MSI) – A type of DNA hypermutation or predisposition
to mutation in which replication errors are not corrected due to defective DNA
mismatch repair
 Rearrangements– Structural chromosomal variations such as deletions, insertion,
inversions, or translocations that bring together genetic material that is not
normally adjacent
 Tumor mutational burden – The number of somatic mutations detected per
million bases of genomic sequence investigated from a neoplasm specimen
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Added Codes – Genomic Sequencing Procedures (GSPs)
 81457 – Solid organ neoplasm, genomic sequence analysis panel, interrogation for
sequence variants; DNA analysis, microsatellite instability
 81458 - Solid organ neoplasm, genomic sequence analysis panel, interrogation for
sequence variants; DNA analysis, copy number variants and microsatellite instability
 81459 - Solid organ neoplasm, genomic sequence analysis panel, interrogation for
sequence variants; DNA analysis or combined DNA and RNA analysis, copy number
variants, microsatellite instability, tumor mutation burden, and rearrangements
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Added Codes – Genomic Sequencing Procedures (GSPs)
 81462 - Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid
(eg, plasma), interrogation for sequence variants; DNA analysis or combined DNA and
RNA analysis, copy number variants and rearrangements
 81463 - Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid
(eg, plasma), interrogation for sequence variants; DNA analysis, copy number
variants, and microsatellite instability
 81464 - Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid
(eg, plasma), interrogation for sequence variants; DNA analysis or combined DNA and
RNA analysis, copy number variants, microsatellite instability, tumor mutation
burden, and rearrangements
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Revised Codes – Genomic Sequencing Panels
Code 2024 Long Description 2023 Long Description
81445 Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes,
interrogation for sequence variants and copy number variants or
rearrangements, if performed; DNA analysis or combined DNA and RNA
analysis
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
81449 Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes,
interrogation for sequence variants and copy number variants or
rearrangements, if performed; RNA analysis
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
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Revised Codes – Genomic Sequencing Panels
Code 2024 Long Description 2023 Long Description
81450 Hematolymphoid neoplasm or disorder, genomic sequence analysis
panel, 5-50 genes, 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
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
81451 Hematolymphoid neoplasm or disorder, genomic sequence analysis
panel, 5-50 genes, interrogation for sequence variants, and copy
number variants or rearrangements, or isoform expression or mRNA
expression levels, if performed; RNA analysis
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
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Revised Codes – Genomic Sequencing Panels
Code 2024 Long Description 2023 Long Description
81455 Solid organ or hematolymphoid neoplasm or disorder, 51 or greater
genes, genomic sequence analysis panel, 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
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
81456 Solid organ or hematolymphoid neoplasm or disorder, 51 or greater
genes, genomic sequence analysis panel, interrogation for sequence
variants and copy number variants or rearrangements, or isoform
expression or mRNA expression levels, if performed; RNA analysis
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
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Revised Codes – Tier I Molecular Pathology
Code 2024 Long Description 2023 Long Description
81171 AFF2 (ALF transcription elongation factor 2 [FMR2]) (e.g., fragile X
intellectual disability 2 [FRAXE]) gene analysis; evaluation to detect
abnormal (e.g., expanded) alleles
AFF2 (AF4/FMR2 family, member 2 [FMR2]) (e.g., fragile X mental
retardation 2 [FRAXE]) gene analysis; evaluation to detect abnormal
(e.g., expanded) alleles
81172 AFF2 (ALF transcription elongation factor 2 [FMR2]) (e.g., fragile X
intellectual disability 2 [FRAXE]) gene analysis; characterization of
alleles (e.g., expanded size and methylation status)
AFF2 (AF4/FMR2 family, member 2 [FMR2]) (e.g., fragile X mental
retardation 2 [FRAXE]) gene analysis; characterization of alleles
(e.g., expanded size and methylation status)
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Revised Codes – Tier I Molecular Pathology
Code 2024 Long Description 2023 Long Description
81243 FMR1 (fragile X messenger ribonucleoprotein 1) (e.g., fragile X
syndrome, X-linked intellectual disability [XLID]) gene analysis;
evaluation to detect abnormal (e.g., expanded) alleles
FMR1 (fragile X mental retardation 1) (e.g., fragile X mental
retardation) gene analysis; evaluation to detect abnormal (e.g.,
expanded) alleles
81244 FMR1 (fragile X messenger ribonucleoprotein 1) (e.g., fragile X
syndrome, X-linked intellectual disability [XLID]) gene analysis;
characterization of alleles (e.g., expanded size and promoter
methylation status)
FMR1 (fragile X mental retardation 1) (e.g., fragile X mental
retardation) gene analysis; characterization of alleles (e.g.,
expanded size and promoter methylation status)
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Revised Codes – Tier II Molecular Pathology
 CPT Codes 81403-81407 have been revised to replace “mental retardation” terminology
with “intellectual disability”
 CPT codes 81405 and 81406 have revised “methyltransferase homolog 1 [E. coli]” to “2’-
O-methyltransferase 1”
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Added Code – Chemistry
 82166 – Anti-mullerian hormone (AMH)
 New analyte-specific code added due to increased volume of testing
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Added Codes – Immunology
 86041 - Acetylcholine receptor (AChR); binding antibody
 86042 - Acetylcholine receptor (AChR); blocking antibody
 86043 - Acetylcholine receptor (AChR); modulating antibody
 86366 - Muscle-specific kinase (MuSK) antibody
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Added Codes – Microbiology
 87523 - Infectious agent detection by nucleic acid (DNA or RNA); hepatitis D (delta),
quantification, including reverse transcription, when performed
– Instructional notes added to direct coders to 86692 for hepatitis delta agent antibody testing or to
87523 for hepatitis D quantification
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Added Code – Multianalyte Assays with Algorithmic Analyses
 81517 - Liver disease, analysis of 3 biomarkers (hyaluronic acid [HA], procollagen III
amino terminal peptide [PIIINP], tissue inhibitor of metalloproteinase 1 [TIMP-1]),
using immunoassays, utilizing serum, prognostic algorithm reported as a risk score
and risk of liver fibrosis and liver-related clinical events within 5 years
– Same descriptor as 0014M, which has been deleted
– Enhanced Liver Fibrosis™ Test found to have clinical utility and therefore moved to a Category I
code
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Deleted Code – Multianalyte Assays with Algorithmic Analyses
Deleted Code Suggested Replacement Codes
0014M – Liver disease, analysis of 3 biomarkers (hyaluronic acid
[HA], procollagen III amino terminal peptide [PIIINP], tissue inhibitor
of metalloproteinase 1 [TIMP-1]), using immunoassays, utilizing
serum, prognostic algorithm reported as a risk score and risk of liver
fibrosis and liver-related clinical events within 5 years
81517
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New Guidelines for Unlisted Code Selections
 Chemistry – Analytes not specified by analyte-specific or method-specific code
may be reported using 84999
 Similar guidelines found in Hematology and Coagulation, Immunology,
Microbiology, Cytopathology, Urinalysis, Transfusion Medicine, Anatomic
Pathology, Cytogenetic Studies, In Vivo Laboratory, Reproductive Medicine, and
Other Procedures subsections
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New Guidelines for Surgical Pathology
 88300 through 88309 do not include the services designated by codes 88311
through 88388 and 88399, which may be coded in addition, when provided
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Changes to
Proprietary
Laboratory
Analyses (PLA)
Codes
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Added Codes – PLA
 0420U - Oncology (urothelial), mRNA expression profiling by real-time quantitative
PCR of MDK, HOXA13, CDC2, IGFBP5, and CXCR2 in combination with droplet digital
PCR (ddPCR) analysis of 6 single-nucleotide polymorphisms (SNPs) genes TERT and
FGFR3, urine, algorithm reported as a risk score for urothelial carcinoma
– Cxbladder Detect+ from Pacific Edge Diagnostics USA LTD
– Measures the gene expression levels of five biomarkers in urine that effectively rule out or detect
the presence of bladder cancer
 0421U - Oncology (colorectal) screening, quantitative real-time target and signal
amplification of 8 RNA markers (GAPDH, SMAD4, ACY1, AREG, CDH1, KRAS,
TNFRSF10B, EGLN2) and fecal hemoglobin, algorithm reported as a positive or
negative for colorectal cancer risk
– Colosense™ from Geneoscopy, Inc.
– Multi-target stool RNA (mt-sRNA) biomarker panel, designed to detect precancerous lesions and
cancer
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Added Codes – PLA
 0422U - Oncology (pan-solid tumor), analysis of DNA biomarker response to anti-
cancer therapy using cell-free circulating DNA, biomarker comparison to a previous
baseline pre-treatment cell-free circulating DNA analysis using next-generation
sequencing, algorithm reported as a quantitative change from baseline, including
specific alterations, if appropriate
– Guardant360 Response™ from Guardant Health, Inc
– Provides a view of molecular response from a simple blood draw to get an early indication of
patient response to immunotherapy or targeted therapy
 0423U - Psychiatry (eg, depression, anxiety), genomic analysis panel, including variant
analysis of 26 genes, buccal swab, report including metabolizer status and risk of drug
toxicity by condition
– Genomind® Pharmacogenetics Report – Full by Genomind®, Inc
– Testing for 26 genes to evaluate psychiatric patient’s genome and predict reaction to 130+
neuropsychiatric medications
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Added Codes – PLA
 0424U - Oncology (prostate), exosomebased analysis of 53 small noncoding RNAs
(sncRNAs) by quantitative reverse transcription polymerase chain reaction (RTqPCR),
urine, reported as no molecular evidence, low-, moderate- or elevated-risk of
prostate cancer
– miR Sentinel™ Prostate Cancer Test from miR Scientific®, LLC
– Urine test that detects, classifies and can monitor prostate cancer at the molecular level
 0425U - Genome (eg, unexplained constitutional or heritable disorder or syndrome),
rapid sequence analysis, each comparator genome (eg, parents, siblings)
– RCIGM Rapid Whole Genome Sequencing, Comparator Genome from Rady Children’s Institute for
Genomic Medicine
– Rapid whole genome sequencing to help physicians identify or rule out genetic diseases in one step
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Added Codes – PLA
 0426U - Genome (eg, unexplained constitutional or heritable disorder or syndrome),
ultra-rapid sequence analysis
– RCIGM Ultra-Rapid Whole Genome Sequencing from Rady Children’s Institute for Genomic
Medicine
– Ultra-rapid whole genome sequencing to help physicians identify or rule out genetic diseases in
one step
 0427U - Monocyte distribution width, whole blood (List separately in addition to
code for primary procedure)
– Early Sepsis Indicator from Beckman Coulter, Inc
– MDW, a novel parameter for early sepsis detection and intervention in adult ED patients that’s part
of a CBC-Diff
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Added Codes – PLA
 0428U - Oncology (breast), targeted hybrid-capture genomic sequence analysis panel,
circulating tumor DNA (ctDNA) analysis of 56 or more genes, interrogation for
sequence variants, gene copy number amplifications, gene rearrangements,
microsatellite instability, and tumor mutation burden
– Epic Sciences ctDNA Metastatic Breast Cancer Panel from Epic Sciences, Inc
– Blood-based test which provides comprehensive profiling of metastatic breast cancer when a tissue
biopsy result is not available
 0429U - Human papillomavirus (HPV), oropharyngeal swab, 14 high-risk types (i.e.,
16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68)
– Omnipathology Oropharyngeal HPV PCR Test from OmniPathology
– New test which can detect HPV using a throat swab
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Added Codes – PLA
 0430U - Gastroenterology, malabsorption evaluation of alpha-1-antitrypsin,
calprotectin, pancreatic elastase and reducing substances, feces, quantitative
– Malabsorption Evaluation Panel from Mayo Clinic
– Provides differentiation between causes of malabsorption, specifically inflammatory conditions,
pancreatic insufficiency, and osmotic diarrhea
 0431U - Glycine receptor alpha1 IgG, serum or cerebrospinal fluid (CSF), live cell-
binding assay (LCBA), qualitative
– Glycine Receptor Alpha1 IgG from Mayo Clinic
– Evaluates patients with suspected autoimmune stiff-person spectrum disorders (stiff-person
syndrome, stiff-limb, stiff trunk or progressive encephalomyelitis with rigidity and myoclonus
[PERM]) using serum specimens
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Added Codes – PLA
 0432U - Kelch-like protein 11 (KLHL11) antibody, serum or cerebrospinal fluid (CSF),
cell-binding assay, qualitative
– Kelch-Like Protein 11 Antibody from Mayo Clinic
– Evaluates patients with paraneoplastic or autoimmune encephalitis (brainstem encephalitis or
limbic encephalitis or cerebellar ataxia) using serum specimens
 0433U - Oncology (prostate), 5 DNA regulatory markers by quantitative PCR, whole
blood, algorithm, including prostate-specific antigen, reported as likelihood of cancer
– EpiSwitch® Prostate Screening Test (PSE) from Oxford BioDynamics, Inc
– A screening test that identifies an individual’s current risk of prostate cancer from blood to identify
individuals requiring biopsy
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Added Codes – PLA
 0434U - Drug metabolism (adverse drug reactions and drug response), genomic
analysis panel, variant analysis of 25 genes with reported phenotypes
– RightMed® Gene Test Exclude F2 and F5 from OneOme® LLC
– A pharmacogenomic test which covers 27 genes that may impact how a patient responds to certain
medications used to treat varied medical conditions.
 0435U - Oncology, chemotherapeutic drug cytotoxicity assay of cancer stem cells
(CSCs), from cultured CSCs and primary tumor cells, categorical drug response
reported based on cytotoxicity percentage observed, minimum of 14 drugs or drug
combinations
– ChemoID® from ChemoID® Lab
– A functional test that uses patient's live tumor cells to indicate which chemotherapy agent(s) will
kill not only the bulk tumor cells, but also the cancer stem cells that are known to cause cancer to
recur
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Added Codes – PLA
 0436U - Oncology (lung), plasma analysis of 388 proteins, using aptamerbased
proteomics technology, predictive algorithm reported as clinical benefit from
immune checkpoint inhibitor therapy
– PROphet® NSCLC Test from OncoHost, Inc
– Scans approximately 7,000 proteins in the blood to identify patterns to guide first-line
immunotherapy decision making
 0437U - Psychiatry (anxiety disorders), mRNA, gene expression profiling by RNA
sequencing of 15 biomarkers, whole blood, algorithm reported as predictive risk
score
– MindX One™ Blood Test – Anxiety from MindX Sciences
– A panel of mRNA biomarkers to help clinicians assess anxiety severity and risk and match patients
to appropriate medications
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Added Codes – PLA
 0438U - Drug metabolism (adverse drug reactions and drug response), buccal
specimen, gene-drug interactions, variant analysis of 33 genes, including
deletion/duplication analysis of CYP2D6, including reported phenotypes and
impacted gene drug interactions
– EffectiveRX™ Comprehensive Panel from RCA Laboratory Services
– Analysis of patient specific genes to assist in creation of a holistic treatment plan based on genetic
results
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Revised Codes – PLA
Code 2024 Long Description 2023 Long Description
0351U Infectious disease (bacterial or viral), biochemical assays, tumor necrosis
factor-related apoptosisinducing ligand (TRAIL), interferon gamma-
induced protein-10 (IP-10), and C-reactive protein, serum, or venous
whole blood, algorithm reported as likelihood of bacterial infection
Infectious disease (bacterial or viral), biochemical assays, tumor
necrosis factor-related apoptosisinducing ligand (TRAIL), interferon
gamma-induced protein-10 (IP-10), and C-reactive protein, serum,
algorithm reported as likelihood of bacterial infection
0356U Oncology (oropharyngeal or anal), evaluation of 17 DNA biomarkers
using droplet digital PCR (ddPCR), cell-free DNA, algorithm reported as a
prognostic risk score for cancer recurrence
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
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Changes to
Medicine Section
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Added Codes – Vaccines/Toxoids
 90589 - Chikungunya virus vaccine, live attenuated, for intramuscular use
– RSVpreF vaccine
– Indicated for patients 60 years and older and for patients in their 2nd or 3rd trimester of pregnancy
– Ixchiq® approved for patients 18+ years old who are at risk for exposure
 90623 - Meningococcal pentavalent vaccine, conjugated Men A, C, W, Y- tetanus
toxoid carrier, and Men B-FHbp, for intramuscular use
– Penbraya™ approved for 5 most common serogroups causing meningococcal disease in patients
aged 10-25
 90683 - Respiratory syncytial virus vaccine, mRNA lipid nanoparticles, for
intramuscular use
– mRNA-1345
– Used for patients aged 60+
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Added Codes – Special Otorhinolaryngologic Services
 92622 - Diagnostic analysis, programming, and verification of an auditory
osseointegrated sound processor, any type; first 60 minutes
 92623 - Diagnostic analysis, programming, and verification of an auditory
osseointegrated sound processor, any type; each additional 15 minutes (List
separately in addition to code for primary procedure)
– “Codes 92622, 92623 describe the analysis, programming, and verification of an auditory
osseointegrated sound processor, any type. These services include evaluating the attachment of
the processor, device feedback calibration, device programming, and verification of the processor
performance. These codes should be used for subsequent reprogramming, when performed.”
– Do not report with 92626 or 92627 – Candidacy testing or postoperative device testing
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Added Subsection – Cardiovascular
 New subsection and guidelines added – Phrenic Nerve Stimulation System
– Codes 93150-93153
 Codes are not to be reported on the same date of service as phrenic nerve
stimulation services
 May be performed to evaluate device function and/or to optimize performance
subsequent to implantation
 Replaces 0434T-0436T which have been “promoted” to Category I status
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Added Codes – Cardiovascular
 93150 - Therapy activation of implanted phrenic nerve stimulator system, including
all interrogation and programming
– Used once 30 days post surgery to allow for lead stabilization and includes evaluation and
programming
 93151 - Interrogation and programming (minimum one parameter) of implanted
phrenic nerve stimulator system
 93152 - Interrogation and programming of implanted phrenic nerve stimulator
system during polysomnography
– Reported only once regardless of number of programming changes made
 93153 - Interrogation without programming of implanted phrenic nerve stimulator
system
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Added Codes – Cardiovascular
 92972 - Percutaneous transluminal coronary lithotripsy (List separately in addition to
code for primary procedure)
– Replaces Category III code 0715T
– Used to treat coronary artery calcifications as an alternative to atherectomy
– Use in conjunction with 92920, 92924, 92928, 92933, 92937, 92941, 92943, 92975
• Not meant to be an all-inclusive listing of procedures – Note that HCPCS codes are omitted
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Added Guidelines – Cardiac Cath for Congenital Heart Defects
 Venography of anomalous or persistent SVC (93584), azygous/hemiazygous venous
system (93585), the coronary sinus (93586), or venovenous collaterals (93587/93588)
require catheter placement distinct from catheter placement required for RHC/LHC
 Codes include catheter placement, venography, imaging supervision, interpretation,
and report
 93584-93588 represent separate services that can be reported together, when
appropriate
 Venography of normal IVC is reported with 75825
 Venography of normal SVC is reported with 75827
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Venography for Congenital Heart Disease
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Added Codes – Cardiovascular
 93584 - Venography for congenital heart defect(s), including catheter placement, and
radiological supervision and interpretation; anomalous or persistent superior vena
cava when it exists as a second contralateral superior vena cava, with native drainage
to heart (List separately in addition to code for primary procedure)
 93585 - Venography for congenital heart defect(s), including catheter placement, and
radiological supervision and interpretation; azygos/hemiazygos venous system (List
separately in addition to code for primary procedure)
– Use in conjunction with 93593-93597
– Report once per session
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Added Codes – Cardiovascular
 93586 - Venography for congenital heart defect(s), including catheter placement, and
radiological supervision and interpretation; coronary sinus (List separately in addition
to code for primary procedure)
 93587 - Venography for congenital heart defect(s), including catheter placement, and
radiological supervision and interpretation; venovenous collaterals originating at or
above the heart (e.g., from innominate vein) (List separately in addition to code for
primary procedure)
• Use in conjunction with 93593-93597
• Report once per session
© Health Catalyst. Confidential and Proprietary.
Added Codes – Cardiovascular
 93588 - Venography for congenital heart defect(s), including catheter placement, and
radiological supervision and interpretation; venovenous collaterals originating below
the heart (eg, from the inferior vena cava) (List separately in addition to code for
primary procedure)
– Use in conjunction with 93593-93597
– Report once per session
© Health Catalyst. Confidential and Proprietary.
Added Codes – Chemotherapy
 96547 - Intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC)
procedure, including separate incision(s) and closure, when performed; first 60
minutes (List separately in addition to code for primary procedure)
 96548 - Intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC)
procedure, including separate incision(s) and closure, when performed; each
additional 30 minutes (List separately in addition to code for primary procedure)
– Also known as HIPEC
– Codes established to distinguish between 96446 and because of the varying time required to
perform HIPEC based on the chemotherapy drug chosen
– Count only time related to HIPEC; not total time patient is in OR
© Health Catalyst. Confidential and Proprietary.
New Guidelines - HIPEC
 HIPEC includes intraoperative perfusion of heated chemotherapy agent into the
abdominal cavity through catheters
 Includes incisions required for catheter insertion and probe placement, manual
agitation of chemotherapy in the abdominal cavity, irrigation post procedure, and
closure related to catheter and probe placement
 These are add-on codes, but it is important to capture all relevant and medically
necessary charges
© Health Catalyst. Confidential and Proprietary.
Revised Code – Chemotherapy
Code 2024 Long Description 2023 Long Description
96446 Chemotherapy administration into the peritoneal cavity
via implanted port or catheter
Chemotherapy administration into the peritoneal
cavity via indwelling port or catheter
Code revised to distinguish it from HIPEC procedure
© Health Catalyst. Confidential and Proprietary.
Revised Codes – Special Dermatological Procedures
Code 2024 Long Description 2023 Long Description
96920 Excimer laser treatment for psoriasis; total area less than
250 sq cm
Laser treatment for inflammatory skin disease (psoriasis);
total area less than 250 sq cm
96921 Excimer laser treatment for psoriasis; 250 sq cm to 500 sq
cm
Laser treatment for inflammatory skin disease (psoriasis);
250 sq cm to 500 sq cm
96922 Excimer laser treatment for psoriasis; over 500 sq cm Laser treatment for inflammatory skin disease (psoriasis);
over 500 sq cm
Excimer laser therapy uses UVB light to treat affected areas of skin; edits made for
clarification to help avoid coding errors
© Health Catalyst. Confidential and Proprietary.
Added Codes – Physical Medicine
 97037 - Application of a modality to 1 or more areas; low-level laser therapy (i.e.,
nonthermal and non-ablative) for post-operative pain reduction
– This is for laser therapy that has no heat (0552T is for thermal laser therapy)
– Infrared thermal energy is reported using 97026
– 97037 requires a specific indication (post-op pain reduction)
© Health Catalyst. Confidential and Proprietary.
Added Codes – Physical Medicine
New Codes 97550-97552:
 Skilled intervention to introduce strategies and techniques to caregivers
 Provide training in skills, knowledge, and awareness to assist patients with certain
conditions that result in functional deficits
 Allows caregivers to understand the treatment plan, engage in activities with the
patient in between treatment sessions, and gain knowledge of outside resources to
assist with patient care in ADLs, transfers, mobility, safety, problem solving, and
communication
 Training may consist of verbal instructions, video and live demos, and feedback from
the trainer
© Health Catalyst. Confidential and Proprietary.
Added Codes – Physical Medicine
 97550 - Caregiver training in strategies and techniques to facilitate the patient’s
functional performance in the home or community (eg, activities of daily living
[ADLs], instrumental ADLs [iADLs], transfers, mobility, communication, swallowing,
feeding, problem solving, safety practices) (without the patient present), face to face;
initial 30 minutes
 97551 - Caregiver training in strategies and techniques to facilitate the patient’s
functional performance in the home or community (eg, activities of daily living
[ADLs], instrumental ADLs [iADLs], transfers, mobility, communication, swallowing,
feeding, problem solving, safety practices) (without the patient present), face to face;
each additional 15 minutes (List separately in addition to code for primary service)
 97552 - Group caregiver training in strategies and techniques to facilitate the
patient's functional performance in the home or community (eg, activities of daily
living [ADLs], instrumental ADLs [iADLs], transfers, mobility, communication,
swallowing, feeding, problem solving, safety practices) (without the patient present),
face to face with multiple sets of caregivers
© Health Catalyst. Confidential and Proprietary.
Changes to
Category III Codes
© Health Catalyst. Confidential and Proprietary.
Added Codes - New & Emerging Technology
Code Long Description
0811T Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); set-up and patient
education on use of equipment
0812T Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); device supply with
automated report generation, up to 10 days
 Codes differ from remote physiologic monitoring (99453 and 99454) as they are for up to 10 days of data
collection versus 16+ days with RPM
 Reported once per episode of care
 Do not report for simple or complex uroflowmetry (51736 and 51741)
© Health Catalyst. Confidential and Proprietary.
Added Codes - New & Emerging Technology
Code Long Description
0815T Ultrasound-based radiofrequency echographic multi-spectrometry (REMS), bone-density study and
fracture-risk assessment, 1 or more sites, hips, pelvis, or spine
 Uses no radiation – Predicted to be method of choice to diagnosis altered bone status in children and
women of childbearing age
© Health Catalyst. Confidential and Proprietary.
Added Codes - New & Emerging Technology
Code Long Description Assoc Code
0827T Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings,
except cervical or vaginal; smears with interpretation (List separately in addition to code
for primary procedure)
88104
0828T Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings,
except cervical or vaginal; simple filter method with interpretation (List separately in
addition to code for primary procedure)
88106
0829T Digitization of glass microscope slides for cytopathology, concentration technique,
smears, and interpretation (e.g., Saccomanno technique) (List separately in addition to
code for primary procedure)
88108
 Slides are scanned with images used for digital examination for pathologic diagnosis distinct from direct
visualization through a microscope
 May not be used solely for education purposes, for developing a database for training or validation, or for
presentations
© Health Catalyst. Confidential and Proprietary.
Added Codes - New & Emerging Technology
Code Long Description Assoc Code
0830T Digitization of glass microscope slides for cytopathology, selective-cellular
enhancement technique with interpretation (eg, liquid-based slide preparation method),
except cervical or vaginal (List separately in addition to code for primary procedure)
88112
0831T Digitization of glass microscope slides for cytopathology, cervical or vaginal (any
reporting system), requiring interpretation by physician (List separately in addition to
code for primary procedure)
88141
0832T Digitization of glass microscope slides for cytopathology, smears, any other source;
screening and interpretation (List separately in addition to code for primary procedure)
88160
0833T Digitization of glass microscope slides for cytopathology, smears, any other source;
preparation, screening and interpretation (List separately in addition to code for
primary procedure)
88161
0834T Digitization of glass microscope slides for cytopathology, smears, any other source;
extended study involving over 5 slides and/or multiple stains (List separately in addition
to code for primary procedure)
88162
© Health Catalyst. Confidential and Proprietary.
Added Codes - New & Emerging Technology
Code Long Description Assoc Code
0835T Digitization of glass microscope slides for cytopathology, evaluation of fine needle
aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first
evaluation episode, each site (List separately in addition to code for primary procedure)
88172
0836T Digitization of glass microscope slides for cytopathology, evaluation of fine needle
aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each
separate additional evaluation episode, same site (List separately in addition to code for
primary procedure)
88177
0837T Digitization of glass microscope slides for cytopathology, evaluation of fine needle
aspirate; interpretation and report (List separately in addition to code for primary
procedure)
88173
0838T Digitization of glass microscope slides for consultation and report on referred slides
prepared elsewhere (List separately in addition to code for primary procedure)
88321
0839T Digitization of glass microscope slides for consultation and report on referred material
requiring preparation of slides (List separately in addition to code for primary procedure)
88323
© Health Catalyst. Confidential and Proprietary.
Added Codes - New & Emerging Technology
Code Long Description Assoc Code
0840T Digitization of glass microscope slides for consultation, comprehensive, with review of
records and specimens, with report on referred material (List separately in addition to
code for primary procedure)
88325
0841T Digitization of glass microscope slides for pathology consultation during surgery; first
tissue block, with frozen section(s), single specimen (List separately in addition to
code for primary procedure)
88331
0842T Digitization of glass microscope slides for pathology consultation during surgery; each
additional tissue block with frozen section(s) (List separately in addition to code for
primary procedure)
88332
0843T Digitization of glass microscope slides for pathology consultation during surgery;
cytologic examination (eg, touch preparation, squash preparation), initial site (List
separately in addition to code for primary procedure)
88333
0844T Digitization of glass microscope slides for pathology consultation during surgery;
cytologic examination (eg, touch preparation, squash preparation), each additional site
(List separately in addition to code for primary procedure)
88334
© Health Catalyst. Confidential and Proprietary.
Added Codes - New & Emerging Technology
Code Long Description Assoc Code
0845T Digitization of glass microscope slides for immunofluorescence, per specimen; initial
single antibody stain procedure (List separately in addition to code for primary
procedure)
88346
0846T Digitization of glass microscope slides for immunofluorescence, per specimen; each
additional single antibody stain procedure (List separately in addition to code for
primary procedure)
88350
0847T Digitization of glass microscope slides for examination and selection of retrieved
archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, KRAS
mutational analysis) (List separately in addition to code for primary procedure)
88363
0848T Digitization of glass microscope slides for in situ hybridization (eg, FISH), per specimen;
initial single probe stain procedure (List separately in addition to code for primary
procedure)
88365
0849T Digitization of glass microscope slides for in situ hybridization (eg, FISH), per specimen;
each additional single probe stain procedure (List separately in addition to code for
primary procedure)
88364
© Health Catalyst. Confidential and Proprietary.
Added Codes - New & Emerging Technology
Code Long Description Assoc Code
0850T Digitization of glass microscope slides for in situ hybridization (eg, FISH), per
specimen; each multiplex probe stain procedure (List separately in addition to code for
primary procedure)
88366
0851T Digitization of glass microscope slides for morphometric analysis, in situ hybridization
(quantitative or semiquantitative), manual, per specimen; initial single probe stain
procedure (List separately in addition to code for primary procedure)
88368
0852T Digitization of glass microscope slides for morphometric analysis, in situ hybridization
(quantitative or semiquantitative), manual, per specimen; each additional single probe
stain procedure (List separately in addition to code for primary procedure)
88369
0853T Digitization of glass microscope slides for morphometric analysis, in situ hybridization
(quantitative or semiquantitative), manual, per specimen; each multiplex probe stain
procedure (List separately in addition to code for primary procedure)
88377
© Health Catalyst. Confidential and Proprietary.
Added Codes - New & Emerging Technology
Code Long Description Assoc Code
0854T Digitization of glass microscope slides for blood smear, peripheral, interpretation by
physician with written report (List separately in addition to code for primary procedure)
85060
0855T Digitization of glass microscope slides for bone marrow, smear interpretation (List
separately in addition to code for primary procedure)
85097
0856T Digitization of glass microscope slides for electron microscopy, diagnostic (List
separately in addition to code for primary procedure)
88348
© Health Catalyst. Confidential and Proprietary.
Added Codes - New & Emerging Technology
Code Long Description
0857T Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image
documentation, augmentative analysis and report (List separately in addition to code for primary
procedure)
0858T Externally applied transcranial magnetic stimulation with concomitant measurement of evoked
cortical potentials with automated report
 0857T is an add-on code that may be reported with 76641 or 76642
 0858T is transcranial magnetic stimulation with measurement of TMS evoked potentials in 2 or more
cortical areas at the same time, which is used to assess brain function in patients with existing brain disease
© Health Catalyst. Confidential and Proprietary.
Added Codes - New & Emerging Technology
Code Long Description
0859T Noncontact near-infrared spectroscopy (e.g., for measurement of deoxyhemoglobin, oxyhemoglobin,
and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image
acquisition, interpretation, and report; each additional anatomic site (List separately in addition to
code for primary procedure)
0860T Noncontact near-infrared spectroscopy (e.g., for measurement of deoxyhemoglobin, oxyhemoglobin,
and ratio of tissue oxygenation), for screening for peripheral arterial disease, including provocative
maneuvers, image acquisition, interpretation, and report, one or both lower extremities
 0859T is add-on code to 0640T to allow for reporting of multiple sites during the same encounter; each
code may be reported only once per anatomic site
 0860T is specifically for screening for peripheral arterial disease; although device is non-contact, code
includes provocative maneuvers by the technician
© Health Catalyst. Confidential and Proprietary.
Added Codes - New & Emerging Technology
Code Long Description
0865T Quantitative magnetic resonance image (MRI) analysis of the brain with comparison to prior
magnetic resonance (MR) study(ies), including lesion identification, characterization, and
quantification, with brain volume(s) quantification and/or severity score, when performed, data
preparation and transmission, interpretation and report, obtained without diagnostic MRI examination
of the brain during the same session
0866T Quantitative magnetic resonance image (MRI) analysis of the brain with comparison to prior
magnetic resonance (MR) study(ies), including lesion detection, characterization, and quantification,
with brain volume(s) quantification and/or severity score, when performed, data preparation and
transmission, interpretation and report, obtained with diagnostic MRI examination of the brain (List
separately in addition to code for primary procedure)
 0865T and 0866T represent use of software to analyze differences between MRIs
 0866T is add-on code that is used in conjunction with 70551-70553
 Quantitative MR analysis of tissue composition is reported using 0648T, 0649T, 0697T, 0698T
 Quantitative CT analysis of tissue composition is reported using 0721T or 0722T
 Quantitative MR analysis of brain without comparison to prior study is reported using modifier 52
© Health Catalyst. Confidential and Proprietary.
Deleted Codes - New & Emerging Technology
Deleted Code Suggested Replacement Codes
0501T – Noninvasive estimated coronary fractional flow reserve
(FFR) derived from coronary computed tomography angiography
data using computation fluid dynamics physiologic simulation
software analysis of functional data to assess the severity of
coronary artery disease; data preparation and transmission,
analysis of fluid dynamics and simulated maximal coronary
hyperemia, generation of estimated FFR model, with anatomical
data review in comparison with estimated FFR model to reconcile
discordant data, interpretation and report
75580
0502T - Noninvasive estimated coronary fractional flow reserve
(FFR) derived from coronary computed tomography angiography
data using computation fluid dynamics physiologic simulation
software analysis of functional data to assess the severity of
coronary artery disease; data preparation and transmission
75580
© Health Catalyst. Confidential and Proprietary.
Deleted Codes - New & Emerging Technology
Deleted Code Suggested Replacement Codes
0503T – Noninvasive estimated coronary fractional flow reserve
(FFR) derived from coronary computed tomography angiography
data using computation fluid dynamics physiologic simulation
software analysis of functional data to assess the severity of
coronary artery disease; analysis of fluid dynamics and simulated
maximal coronary hyperemia, and generation of estimated FFR
model
75580
0504T - Noninvasive estimated coronary fractional flow reserve
(FFR) derived from coronary computed tomography angiography
data using computation fluid dynamics physiologic simulation
software analysis of functional data to assess the severity of
coronary artery disease; anatomical data review in comparison with
estimated FFR model to reconcile discordant data, interpretation
and report
75580
© Health Catalyst. Confidential and Proprietary.
Deleted Codes - New & Emerging Technology
Deleted Code Suggested Replacement Codes
0508T - Pulse-echo ultrasound bone density measurement resulting
in indicator of axial bone mineral density, tibia
76999
© Health Catalyst. Confidential and Proprietary.
Deleted Codes - New & Emerging Technology
Deleted Code Suggested Replacement Codes
0533T – Continuous recording of movement disorder symptoms,
including bradykinesia, dyskinesia, and tremor for 6 days up to 10
days; includes set-up, patient training, configuration of monitor, data
upload, analysis and initial report configuration, download review,
interpretation and report
95999
0534T - Continuous recording of movement disorder symptoms,
including bradykinesia, dyskinesia, and tremor for 6 days up to 10
days; set-up, patient training, configuration of monitor
95999
0535T - Continuous recording of movement disorder symptoms,
including bradykinesia, dyskinesia, and tremor for 6 days up to 10
days; data upload, analysis and initial report configuration
95999
0536T - Continuous recording of movement disorder symptoms,
including bradykinesia, dyskinesia, and tremor for 6 days up to 10
days; download review, interpretation and report
95999
© Health Catalyst. Confidential and Proprietary.
Deleted Codes - New & Emerging Technology
Deleted Code Suggested Replacement Codes
0641T - Noncontact near-infrared spectroscopy studies of flap or
wound (eg, for measurement of deoxyhemoglobin, oxyhemoglobin,
and ratio of tissue oxygenation [StO2]); image acquisition only, each
flap or wound
0859T
0860T
0642T - Noncontact near-infrared spectroscopy studies of flap or
wound (eg, for measurement of deoxyhemoglobin, oxyhemoglobin,
and ratio of tissue oxygenation [StO2]); interpretation and report
only, each flap or wound
0859T
0860T
© Health Catalyst. Confidential and Proprietary.
Revised Codes – New & Emerging Technology
Code 2024 Long Description 2023 Long Description
0640T Noncontact near-infrared spectroscopy (e.g., for
measurement of deoxyhemoglobin,
oxyhemoglobin, and ratio of tissue oxygenation),
other than for screening for peripheral arterial
disease, image acquisition, interpretation, and
report; first anatomic site
Noncontact near-infrared spectroscopy studies
of flap or wound (e.g., for measurement of
deoxyhemoglobin, oxyhemoglobin, and ratio of
tissue oxygenation [StO2]); image acquisition,
interpretation and report, each flap or wound
© Health Catalyst. Confidential and Proprietary.
Deleted Codes - New & Emerging Technology
Deleted Code Suggested Replacement Codes
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
0766T
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)
0767T
 Prior to 2024 procedure is divided into initial and subsequent treatments
 Codes describe transcutaneous magnetic stimulation to treat chronic nerve pain
 Nerve conduction may be used as guidance but is not separately reported; a separate diagnostic nerve
conduction study prior to treatment may be separately reported
© Health Catalyst. Confidential and Proprietary.
Revised Codes – New & Emerging Technology
Code 2024 Long Description 2023 Long Description
0766T Transcutaneous magnetic stimulation by focused low-frequency
electromagnetic pulse, peripheral nerve, with identification and
marking of the treatment location, including noninvasive
electroneurographic localization (nerve conduction localization),
when performed; first nerve
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, 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)
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)
© Health Catalyst. Confidential and Proprietary.
Revised Codes – New & Emerging Technology
Code 2024 Long Description 2023 Long Description
0589T Electronic analysis with simple programming of implanted
integrated neurostimulation system for bladder dysfunction (eg,
electrode array and receiver), including contact group(s),
amplitude, pulse width, frequency (Hz), on/off cycling, burst, dose
lockout, patient-selectable parameters, responsive
neurostimulation, detection algorithms, closed-loop parameters,
and passive parameters, when performed by physician or other
qualified health care professional, posterior tibial nerve, 1-3
parameters
Electronic analysis with simple programming of implanted
integrated neurostimulation system (eg, electrode array and
receiver), including contact group(s), amplitude, pulse width,
frequency (Hz), on/off cycling, burst, dose lockout, patient-
selectable parameters, responsive neurostimulation, detection
algorithms, closed-loop parameters, and passive parameters,
when performed by physician or other qualified health care
professional, posterior tibial nerve, 1-3 parameters
0590T Electronic analysis with complex programming of implanted
integrated neurostimulation system for bladder dysfunction (eg,
electrode array and receiver), including contact group(s),
amplitude, pulse width, frequency (Hz), on/off cycling, burst, dose
lockout, patient-selectable parameters, responsive
neurostimulation, detection algorithms, closed-loop parameters,
and passive parameters, when performed by physician or other
qualified health care professional, posterior tibial nerve, 4 or more
parameters
Electronic analysis with complex programming of implanted
integrated neurostimulation system (eg, electrode array and
receiver), including contact group(s), amplitude, pulse width,
frequency (Hz), on/off cycling, burst, dose lockout, patient-
selectable parameters, responsive neurostimulation, detection
algorithms, closed-loop parameters, and passive parameters,
when performed by physician or other qualified health care
professional, posterior tibial nerve, 4 or more parameters
Questions?
© Health Catalyst. Confidential and Proprietary.
Jennifer Bishop
hcwebinars@healthcatalyst.com
© Health Catalyst. Confidential and Proprietary.
Thank you!

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2024 CPT® Code Updates (CDM Focused) - Part 1

  • 1. © Health Catalyst. Confidential and Proprietary. 2024 CPT® Code Updates (CDM Focused) Jennifer Bishop, RHIT, CCS, CCS-P, CHRI
  • 2. © Health Catalyst. Confidential and Proprietary. Disclaimer Statement This webinar/presentation was current at the time it was published or provided via the web and is designed to provide accurate and authoritative information regarding the subject matter covered. The information provided is only intended to be a general overview with the understanding that neither the presenter nor the event sponsor is engaged in rendering specific coding advice. It is not intended to take the place of either the written policies or regulations. We encourage participants to review the specific regulations and other interpretive materials, as necessary.
  • 3. © Health Catalyst. Confidential and Proprietary. Overview of 2024 Changes CPT® Section Additions Deletions Revisions Evaluation & Management 1 0 10 Anesthesia 0 0 0 Surgery 23 0 10 Radiology 5 1 0 Pathology & Laboratory 13 0 16 PLA & MAAA 19 1 2 Medicine 21 0 4 Category II 0 0 0 Category III 63 32 13 Totals 145 34 55 • Totals do not include codes added, deleted, or revised in CY 2023 but appearing for the first time in the CY 2024 book • Revised totals do not include codes with changes to short or medium descriptions only
  • 4. © Health Catalyst. Confidential and Proprietary. Changes to Radiology Section
  • 5. © Health Catalyst. Confidential and Proprietary. Added Codes - Radiology Section  75580 - Noninvasive estimate of coronary fractional flow reserve (FFR) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified health care professional – Code falls into augmentative category of artificial intelligence (AI) – Replacement code for Category III code 0501T-0504T – Report in conjunction with 75574 is CCTA is performed on the same date of service – Report only once per CCTA analysis
  • 6. © Health Catalyst. Confidential and Proprietary. New Guidelines for AI (Appendix S) Service Components Assistive Augmentative Autonomous Primary Objective Detects Data Analyzes or Quantifies Data to Yield Output Interprets Data and Generates Conclusions Provides Independent Diagnosis and/or Management No No Yes Analyzes Data No Yes Yes Requires Physician Interpretation Yes Yes No Examples 0764T, 0765T 75580 92229
  • 7. © Health Catalyst. Confidential and Proprietary. Added Codes - Radiology Section  76984 - Ultrasound, intraoperative thoracic aorta (e.g., epiaortic), diagnostic  76987 - Intraoperative epicardial cardiac ultrasound (i.e., echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report  76988 - Intraoperative epicardial cardiac ultrasound (i.e., echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only  76989 - Intraoperative epicardial cardiac ultrasound (i.e., echocardiography) for congenital heart disease, diagnostic; interpretation and report only – Codes broken out upon review of CPT code 76998 (Intraoperative US guidance) which was used by multiple different specialty groups for multiple different purposes
  • 8. © Health Catalyst. Confidential and Proprietary. Added Codes - Radiology Section  76984 - Ultrasound, intraoperative thoracic aorta (e.g., epiaortic), diagnostic – Limits exposure to radiation and iodinated contrast – Allows physician to “see” and avoid aortic disease – Also used to assess for leaks following EVAR
  • 9. © Health Catalyst. Confidential and Proprietary. Added Codes - Radiology Section  76987 – Complete procedure when done intraoperatively to assess congenital heart disease  76988 – Placement and manipulation of device with image acquisition  76989 – Physician review and interpretation of images
  • 10. © Health Catalyst. Confidential and Proprietary. Deleted Code – Radiology Section Deleted Code Suggested Replacement Codes 74710 – Pelvimetry, with or without placental localization 76499 Code is obsolete and therefore no longer needed
  • 11. © Health Catalyst. Confidential and Proprietary. Changes to Laboratory & Pathology Section
  • 12. © Health Catalyst. Confidential and Proprietary. Guidelines for Genomic Sequencing Procedures  GSPs are DNA/RNA sequence analysis methods that simultaneously assay multiple genes or regions from germline or neoplastic sample  MPS/NGS technology is typically used, but other technologies may be used – Code selection should be based on components  If all components are not performed, see Tier I or Tier II codes  When GSP assay includes a gene listed in more than one code descriptor, choose code based on primary disorder  Testing for somatic alterations in neoplasms is reported differently based on methods and analytes (DNA and/or RNA)  See Table on page 661 of code book for more details
  • 13. © Health Catalyst. Confidential and Proprietary. Definitions for Genomic Sequencing Procedures  Cell-free nucleic acid – DNA or RNA released into the blood and other body fluids. Sometimes referred to as “liquid biopsy”  Copy number variants – Structural changes in the genome which are composed of large deletions or duplications  Duplication/Deletion – Used in molecular testing to assess the dosage of a particular genomic regions; 0-1 copy represents a deletion, while 3+ copies represent a duplication  Massively parallel sequencing (MPS) – Method used to determine a portion of the nucleotide sequences in an individual patient’s genome utilizing advanced sequencing technologies that can process multiple DNA/RNA sequences in parallel; NGS is a common technique to achieve MPS
  • 14. © Health Catalyst. Confidential and Proprietary. Definitions for Genomic Sequencing Procedures  Microsatellite instability (MSI) – A type of DNA hypermutation or predisposition to mutation in which replication errors are not corrected due to defective DNA mismatch repair  Rearrangements– Structural chromosomal variations such as deletions, insertion, inversions, or translocations that bring together genetic material that is not normally adjacent  Tumor mutational burden – The number of somatic mutations detected per million bases of genomic sequence investigated from a neoplasm specimen
  • 15. © Health Catalyst. Confidential and Proprietary. Added Codes – Genomic Sequencing Procedures (GSPs)  81457 – Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis, microsatellite instability  81458 - Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis, copy number variants and microsatellite instability  81459 - Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements
  • 16. © Health Catalyst. Confidential and Proprietary. Added Codes – Genomic Sequencing Procedures (GSPs)  81462 - Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants and rearrangements  81463 - Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis, copy number variants, and microsatellite instability  81464 - Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements
  • 17. © Health Catalyst. Confidential and Proprietary. Revised Codes – Genomic Sequencing Panels Code 2024 Long Description 2023 Long Description 81445 Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; DNA analysis or combined DNA and RNA analysis 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 81449 Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; RNA analysis 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
  • 18. © Health Catalyst. Confidential and Proprietary. Revised Codes – Genomic Sequencing Panels Code 2024 Long Description 2023 Long Description 81450 Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, 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 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 81451 Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mRNA expression levels, if performed; RNA analysis 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
  • 19. © Health Catalyst. Confidential and Proprietary. Revised Codes – Genomic Sequencing Panels Code 2024 Long Description 2023 Long Description 81455 Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, 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 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 81456 Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform expression or mRNA expression levels, if performed; RNA analysis 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
  • 20. © Health Catalyst. Confidential and Proprietary. Revised Codes – Tier I Molecular Pathology Code 2024 Long Description 2023 Long Description 81171 AFF2 (ALF transcription elongation factor 2 [FMR2]) (e.g., fragile X intellectual disability 2 [FRAXE]) gene analysis; evaluation to detect abnormal (e.g., expanded) alleles AFF2 (AF4/FMR2 family, member 2 [FMR2]) (e.g., fragile X mental retardation 2 [FRAXE]) gene analysis; evaluation to detect abnormal (e.g., expanded) alleles 81172 AFF2 (ALF transcription elongation factor 2 [FMR2]) (e.g., fragile X intellectual disability 2 [FRAXE]) gene analysis; characterization of alleles (e.g., expanded size and methylation status) AFF2 (AF4/FMR2 family, member 2 [FMR2]) (e.g., fragile X mental retardation 2 [FRAXE]) gene analysis; characterization of alleles (e.g., expanded size and methylation status)
  • 21. © Health Catalyst. Confidential and Proprietary. Revised Codes – Tier I Molecular Pathology Code 2024 Long Description 2023 Long Description 81243 FMR1 (fragile X messenger ribonucleoprotein 1) (e.g., fragile X syndrome, X-linked intellectual disability [XLID]) gene analysis; evaluation to detect abnormal (e.g., expanded) alleles FMR1 (fragile X mental retardation 1) (e.g., fragile X mental retardation) gene analysis; evaluation to detect abnormal (e.g., expanded) alleles 81244 FMR1 (fragile X messenger ribonucleoprotein 1) (e.g., fragile X syndrome, X-linked intellectual disability [XLID]) gene analysis; characterization of alleles (e.g., expanded size and promoter methylation status) FMR1 (fragile X mental retardation 1) (e.g., fragile X mental retardation) gene analysis; characterization of alleles (e.g., expanded size and promoter methylation status)
  • 22. © Health Catalyst. Confidential and Proprietary. Revised Codes – Tier II Molecular Pathology  CPT Codes 81403-81407 have been revised to replace “mental retardation” terminology with “intellectual disability”  CPT codes 81405 and 81406 have revised “methyltransferase homolog 1 [E. coli]” to “2’- O-methyltransferase 1”
  • 23. © Health Catalyst. Confidential and Proprietary. Added Code – Chemistry  82166 – Anti-mullerian hormone (AMH)  New analyte-specific code added due to increased volume of testing
  • 24. © Health Catalyst. Confidential and Proprietary. Added Codes – Immunology  86041 - Acetylcholine receptor (AChR); binding antibody  86042 - Acetylcholine receptor (AChR); blocking antibody  86043 - Acetylcholine receptor (AChR); modulating antibody  86366 - Muscle-specific kinase (MuSK) antibody
  • 25. © Health Catalyst. Confidential and Proprietary. Added Codes – Microbiology  87523 - Infectious agent detection by nucleic acid (DNA or RNA); hepatitis D (delta), quantification, including reverse transcription, when performed – Instructional notes added to direct coders to 86692 for hepatitis delta agent antibody testing or to 87523 for hepatitis D quantification
  • 26. © Health Catalyst. Confidential and Proprietary. Added Code – Multianalyte Assays with Algorithmic Analyses  81517 - Liver disease, analysis of 3 biomarkers (hyaluronic acid [HA], procollagen III amino terminal peptide [PIIINP], tissue inhibitor of metalloproteinase 1 [TIMP-1]), using immunoassays, utilizing serum, prognostic algorithm reported as a risk score and risk of liver fibrosis and liver-related clinical events within 5 years – Same descriptor as 0014M, which has been deleted – Enhanced Liver Fibrosis™ Test found to have clinical utility and therefore moved to a Category I code
  • 27. © Health Catalyst. Confidential and Proprietary. Deleted Code – Multianalyte Assays with Algorithmic Analyses Deleted Code Suggested Replacement Codes 0014M – Liver disease, analysis of 3 biomarkers (hyaluronic acid [HA], procollagen III amino terminal peptide [PIIINP], tissue inhibitor of metalloproteinase 1 [TIMP-1]), using immunoassays, utilizing serum, prognostic algorithm reported as a risk score and risk of liver fibrosis and liver-related clinical events within 5 years 81517
  • 28. © Health Catalyst. Confidential and Proprietary. New Guidelines for Unlisted Code Selections  Chemistry – Analytes not specified by analyte-specific or method-specific code may be reported using 84999  Similar guidelines found in Hematology and Coagulation, Immunology, Microbiology, Cytopathology, Urinalysis, Transfusion Medicine, Anatomic Pathology, Cytogenetic Studies, In Vivo Laboratory, Reproductive Medicine, and Other Procedures subsections
  • 29. © Health Catalyst. Confidential and Proprietary. New Guidelines for Surgical Pathology  88300 through 88309 do not include the services designated by codes 88311 through 88388 and 88399, which may be coded in addition, when provided
  • 30. © Health Catalyst. Confidential and Proprietary. Changes to Proprietary Laboratory Analyses (PLA) Codes
  • 31. © Health Catalyst. Confidential and Proprietary. Added Codes – PLA  0420U - Oncology (urothelial), mRNA expression profiling by real-time quantitative PCR of MDK, HOXA13, CDC2, IGFBP5, and CXCR2 in combination with droplet digital PCR (ddPCR) analysis of 6 single-nucleotide polymorphisms (SNPs) genes TERT and FGFR3, urine, algorithm reported as a risk score for urothelial carcinoma – Cxbladder Detect+ from Pacific Edge Diagnostics USA LTD – Measures the gene expression levels of five biomarkers in urine that effectively rule out or detect the presence of bladder cancer  0421U - Oncology (colorectal) screening, quantitative real-time target and signal amplification of 8 RNA markers (GAPDH, SMAD4, ACY1, AREG, CDH1, KRAS, TNFRSF10B, EGLN2) and fecal hemoglobin, algorithm reported as a positive or negative for colorectal cancer risk – Colosense™ from Geneoscopy, Inc. – Multi-target stool RNA (mt-sRNA) biomarker panel, designed to detect precancerous lesions and cancer
  • 32. © Health Catalyst. Confidential and Proprietary. Added Codes – PLA  0422U - Oncology (pan-solid tumor), analysis of DNA biomarker response to anti- cancer therapy using cell-free circulating DNA, biomarker comparison to a previous baseline pre-treatment cell-free circulating DNA analysis using next-generation sequencing, algorithm reported as a quantitative change from baseline, including specific alterations, if appropriate – Guardant360 Response™ from Guardant Health, Inc – Provides a view of molecular response from a simple blood draw to get an early indication of patient response to immunotherapy or targeted therapy  0423U - Psychiatry (eg, depression, anxiety), genomic analysis panel, including variant analysis of 26 genes, buccal swab, report including metabolizer status and risk of drug toxicity by condition – Genomind® Pharmacogenetics Report – Full by Genomind®, Inc – Testing for 26 genes to evaluate psychiatric patient’s genome and predict reaction to 130+ neuropsychiatric medications
  • 33. © Health Catalyst. Confidential and Proprietary. Added Codes – PLA  0424U - Oncology (prostate), exosomebased analysis of 53 small noncoding RNAs (sncRNAs) by quantitative reverse transcription polymerase chain reaction (RTqPCR), urine, reported as no molecular evidence, low-, moderate- or elevated-risk of prostate cancer – miR Sentinel™ Prostate Cancer Test from miR Scientific®, LLC – Urine test that detects, classifies and can monitor prostate cancer at the molecular level  0425U - Genome (eg, unexplained constitutional or heritable disorder or syndrome), rapid sequence analysis, each comparator genome (eg, parents, siblings) – RCIGM Rapid Whole Genome Sequencing, Comparator Genome from Rady Children’s Institute for Genomic Medicine – Rapid whole genome sequencing to help physicians identify or rule out genetic diseases in one step
  • 34. © Health Catalyst. Confidential and Proprietary. Added Codes – PLA  0426U - Genome (eg, unexplained constitutional or heritable disorder or syndrome), ultra-rapid sequence analysis – RCIGM Ultra-Rapid Whole Genome Sequencing from Rady Children’s Institute for Genomic Medicine – Ultra-rapid whole genome sequencing to help physicians identify or rule out genetic diseases in one step  0427U - Monocyte distribution width, whole blood (List separately in addition to code for primary procedure) – Early Sepsis Indicator from Beckman Coulter, Inc – MDW, a novel parameter for early sepsis detection and intervention in adult ED patients that’s part of a CBC-Diff
  • 35. © Health Catalyst. Confidential and Proprietary. Added Codes – PLA  0428U - Oncology (breast), targeted hybrid-capture genomic sequence analysis panel, circulating tumor DNA (ctDNA) analysis of 56 or more genes, interrogation for sequence variants, gene copy number amplifications, gene rearrangements, microsatellite instability, and tumor mutation burden – Epic Sciences ctDNA Metastatic Breast Cancer Panel from Epic Sciences, Inc – Blood-based test which provides comprehensive profiling of metastatic breast cancer when a tissue biopsy result is not available  0429U - Human papillomavirus (HPV), oropharyngeal swab, 14 high-risk types (i.e., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68) – Omnipathology Oropharyngeal HPV PCR Test from OmniPathology – New test which can detect HPV using a throat swab
  • 36. © Health Catalyst. Confidential and Proprietary. Added Codes – PLA  0430U - Gastroenterology, malabsorption evaluation of alpha-1-antitrypsin, calprotectin, pancreatic elastase and reducing substances, feces, quantitative – Malabsorption Evaluation Panel from Mayo Clinic – Provides differentiation between causes of malabsorption, specifically inflammatory conditions, pancreatic insufficiency, and osmotic diarrhea  0431U - Glycine receptor alpha1 IgG, serum or cerebrospinal fluid (CSF), live cell- binding assay (LCBA), qualitative – Glycine Receptor Alpha1 IgG from Mayo Clinic – Evaluates patients with suspected autoimmune stiff-person spectrum disorders (stiff-person syndrome, stiff-limb, stiff trunk or progressive encephalomyelitis with rigidity and myoclonus [PERM]) using serum specimens
  • 37. © Health Catalyst. Confidential and Proprietary. Added Codes – PLA  0432U - Kelch-like protein 11 (KLHL11) antibody, serum or cerebrospinal fluid (CSF), cell-binding assay, qualitative – Kelch-Like Protein 11 Antibody from Mayo Clinic – Evaluates patients with paraneoplastic or autoimmune encephalitis (brainstem encephalitis or limbic encephalitis or cerebellar ataxia) using serum specimens  0433U - Oncology (prostate), 5 DNA regulatory markers by quantitative PCR, whole blood, algorithm, including prostate-specific antigen, reported as likelihood of cancer – EpiSwitch® Prostate Screening Test (PSE) from Oxford BioDynamics, Inc – A screening test that identifies an individual’s current risk of prostate cancer from blood to identify individuals requiring biopsy
  • 38. © Health Catalyst. Confidential and Proprietary. Added Codes – PLA  0434U - Drug metabolism (adverse drug reactions and drug response), genomic analysis panel, variant analysis of 25 genes with reported phenotypes – RightMed® Gene Test Exclude F2 and F5 from OneOme® LLC – A pharmacogenomic test which covers 27 genes that may impact how a patient responds to certain medications used to treat varied medical conditions.  0435U - Oncology, chemotherapeutic drug cytotoxicity assay of cancer stem cells (CSCs), from cultured CSCs and primary tumor cells, categorical drug response reported based on cytotoxicity percentage observed, minimum of 14 drugs or drug combinations – ChemoID® from ChemoID® Lab – A functional test that uses patient's live tumor cells to indicate which chemotherapy agent(s) will kill not only the bulk tumor cells, but also the cancer stem cells that are known to cause cancer to recur
  • 39. © Health Catalyst. Confidential and Proprietary. Added Codes – PLA  0436U - Oncology (lung), plasma analysis of 388 proteins, using aptamerbased proteomics technology, predictive algorithm reported as clinical benefit from immune checkpoint inhibitor therapy – PROphet® NSCLC Test from OncoHost, Inc – Scans approximately 7,000 proteins in the blood to identify patterns to guide first-line immunotherapy decision making  0437U - Psychiatry (anxiety disorders), mRNA, gene expression profiling by RNA sequencing of 15 biomarkers, whole blood, algorithm reported as predictive risk score – MindX One™ Blood Test – Anxiety from MindX Sciences – A panel of mRNA biomarkers to help clinicians assess anxiety severity and risk and match patients to appropriate medications
  • 40. © Health Catalyst. Confidential and Proprietary. Added Codes – PLA  0438U - Drug metabolism (adverse drug reactions and drug response), buccal specimen, gene-drug interactions, variant analysis of 33 genes, including deletion/duplication analysis of CYP2D6, including reported phenotypes and impacted gene drug interactions – EffectiveRX™ Comprehensive Panel from RCA Laboratory Services – Analysis of patient specific genes to assist in creation of a holistic treatment plan based on genetic results
  • 41. © Health Catalyst. Confidential and Proprietary. Revised Codes – PLA Code 2024 Long Description 2023 Long Description 0351U Infectious disease (bacterial or viral), biochemical assays, tumor necrosis factor-related apoptosisinducing ligand (TRAIL), interferon gamma- induced protein-10 (IP-10), and C-reactive protein, serum, or venous whole blood, algorithm reported as likelihood of bacterial infection Infectious disease (bacterial or viral), biochemical assays, tumor necrosis factor-related apoptosisinducing ligand (TRAIL), interferon gamma-induced protein-10 (IP-10), and C-reactive protein, serum, algorithm reported as likelihood of bacterial infection 0356U Oncology (oropharyngeal or anal), evaluation of 17 DNA biomarkers using droplet digital PCR (ddPCR), cell-free DNA, algorithm reported as a prognostic risk score for cancer recurrence 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
  • 42. © Health Catalyst. Confidential and Proprietary. Changes to Medicine Section
  • 43. © Health Catalyst. Confidential and Proprietary. Added Codes – Vaccines/Toxoids  90589 - Chikungunya virus vaccine, live attenuated, for intramuscular use – RSVpreF vaccine – Indicated for patients 60 years and older and for patients in their 2nd or 3rd trimester of pregnancy – Ixchiq® approved for patients 18+ years old who are at risk for exposure  90623 - Meningococcal pentavalent vaccine, conjugated Men A, C, W, Y- tetanus toxoid carrier, and Men B-FHbp, for intramuscular use – Penbraya™ approved for 5 most common serogroups causing meningococcal disease in patients aged 10-25  90683 - Respiratory syncytial virus vaccine, mRNA lipid nanoparticles, for intramuscular use – mRNA-1345 – Used for patients aged 60+
  • 44. © Health Catalyst. Confidential and Proprietary. Added Codes – Special Otorhinolaryngologic Services  92622 - Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes  92623 - Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (List separately in addition to code for primary procedure) – “Codes 92622, 92623 describe the analysis, programming, and verification of an auditory osseointegrated sound processor, any type. These services include evaluating the attachment of the processor, device feedback calibration, device programming, and verification of the processor performance. These codes should be used for subsequent reprogramming, when performed.” – Do not report with 92626 or 92627 – Candidacy testing or postoperative device testing
  • 45. © Health Catalyst. Confidential and Proprietary. Added Subsection – Cardiovascular  New subsection and guidelines added – Phrenic Nerve Stimulation System – Codes 93150-93153  Codes are not to be reported on the same date of service as phrenic nerve stimulation services  May be performed to evaluate device function and/or to optimize performance subsequent to implantation  Replaces 0434T-0436T which have been “promoted” to Category I status
  • 46. © Health Catalyst. Confidential and Proprietary. Added Codes – Cardiovascular  93150 - Therapy activation of implanted phrenic nerve stimulator system, including all interrogation and programming – Used once 30 days post surgery to allow for lead stabilization and includes evaluation and programming  93151 - Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system  93152 - Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography – Reported only once regardless of number of programming changes made  93153 - Interrogation without programming of implanted phrenic nerve stimulator system
  • 47. © Health Catalyst. Confidential and Proprietary. Added Codes – Cardiovascular  92972 - Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure) – Replaces Category III code 0715T – Used to treat coronary artery calcifications as an alternative to atherectomy – Use in conjunction with 92920, 92924, 92928, 92933, 92937, 92941, 92943, 92975 • Not meant to be an all-inclusive listing of procedures – Note that HCPCS codes are omitted
  • 48. © Health Catalyst. Confidential and Proprietary. Added Guidelines – Cardiac Cath for Congenital Heart Defects  Venography of anomalous or persistent SVC (93584), azygous/hemiazygous venous system (93585), the coronary sinus (93586), or venovenous collaterals (93587/93588) require catheter placement distinct from catheter placement required for RHC/LHC  Codes include catheter placement, venography, imaging supervision, interpretation, and report  93584-93588 represent separate services that can be reported together, when appropriate  Venography of normal IVC is reported with 75825  Venography of normal SVC is reported with 75827
  • 49. © Health Catalyst. Confidential and Proprietary. Venography for Congenital Heart Disease
  • 50. © Health Catalyst. Confidential and Proprietary. Added Codes – Cardiovascular  93584 - Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart (List separately in addition to code for primary procedure)  93585 - Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (List separately in addition to code for primary procedure) – Use in conjunction with 93593-93597 – Report once per session
  • 51. © Health Catalyst. Confidential and Proprietary. Added Codes – Cardiovascular  93586 - Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (List separately in addition to code for primary procedure)  93587 - Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (e.g., from innominate vein) (List separately in addition to code for primary procedure) • Use in conjunction with 93593-93597 • Report once per session
  • 52. © Health Catalyst. Confidential and Proprietary. Added Codes – Cardiovascular  93588 - Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena cava) (List separately in addition to code for primary procedure) – Use in conjunction with 93593-93597 – Report once per session
  • 53. © Health Catalyst. Confidential and Proprietary. Added Codes – Chemotherapy  96547 - Intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) procedure, including separate incision(s) and closure, when performed; first 60 minutes (List separately in addition to code for primary procedure)  96548 - Intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) procedure, including separate incision(s) and closure, when performed; each additional 30 minutes (List separately in addition to code for primary procedure) – Also known as HIPEC – Codes established to distinguish between 96446 and because of the varying time required to perform HIPEC based on the chemotherapy drug chosen – Count only time related to HIPEC; not total time patient is in OR
  • 54. © Health Catalyst. Confidential and Proprietary. New Guidelines - HIPEC  HIPEC includes intraoperative perfusion of heated chemotherapy agent into the abdominal cavity through catheters  Includes incisions required for catheter insertion and probe placement, manual agitation of chemotherapy in the abdominal cavity, irrigation post procedure, and closure related to catheter and probe placement  These are add-on codes, but it is important to capture all relevant and medically necessary charges
  • 55. © Health Catalyst. Confidential and Proprietary. Revised Code – Chemotherapy Code 2024 Long Description 2023 Long Description 96446 Chemotherapy administration into the peritoneal cavity via implanted port or catheter Chemotherapy administration into the peritoneal cavity via indwelling port or catheter Code revised to distinguish it from HIPEC procedure
  • 56. © Health Catalyst. Confidential and Proprietary. Revised Codes – Special Dermatological Procedures Code 2024 Long Description 2023 Long Description 96920 Excimer laser treatment for psoriasis; total area less than 250 sq cm Laser treatment for inflammatory skin disease (psoriasis); total area less than 250 sq cm 96921 Excimer laser treatment for psoriasis; 250 sq cm to 500 sq cm Laser treatment for inflammatory skin disease (psoriasis); 250 sq cm to 500 sq cm 96922 Excimer laser treatment for psoriasis; over 500 sq cm Laser treatment for inflammatory skin disease (psoriasis); over 500 sq cm Excimer laser therapy uses UVB light to treat affected areas of skin; edits made for clarification to help avoid coding errors
  • 57. © Health Catalyst. Confidential and Proprietary. Added Codes – Physical Medicine  97037 - Application of a modality to 1 or more areas; low-level laser therapy (i.e., nonthermal and non-ablative) for post-operative pain reduction – This is for laser therapy that has no heat (0552T is for thermal laser therapy) – Infrared thermal energy is reported using 97026 – 97037 requires a specific indication (post-op pain reduction)
  • 58. © Health Catalyst. Confidential and Proprietary. Added Codes – Physical Medicine New Codes 97550-97552:  Skilled intervention to introduce strategies and techniques to caregivers  Provide training in skills, knowledge, and awareness to assist patients with certain conditions that result in functional deficits  Allows caregivers to understand the treatment plan, engage in activities with the patient in between treatment sessions, and gain knowledge of outside resources to assist with patient care in ADLs, transfers, mobility, safety, problem solving, and communication  Training may consist of verbal instructions, video and live demos, and feedback from the trainer
  • 59. © Health Catalyst. Confidential and Proprietary. Added Codes – Physical Medicine  97550 - Caregiver training in strategies and techniques to facilitate the patient’s functional performance in the home or community (eg, activities of daily living [ADLs], instrumental ADLs [iADLs], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patient present), face to face; initial 30 minutes  97551 - Caregiver training in strategies and techniques to facilitate the patient’s functional performance in the home or community (eg, activities of daily living [ADLs], instrumental ADLs [iADLs], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patient present), face to face; each additional 15 minutes (List separately in addition to code for primary service)  97552 - Group caregiver training in strategies and techniques to facilitate the patient's functional performance in the home or community (eg, activities of daily living [ADLs], instrumental ADLs [iADLs], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patient present), face to face with multiple sets of caregivers
  • 60. © Health Catalyst. Confidential and Proprietary. Changes to Category III Codes
  • 61. © Health Catalyst. Confidential and Proprietary. Added Codes - New & Emerging Technology Code Long Description 0811T Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); set-up and patient education on use of equipment 0812T Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); device supply with automated report generation, up to 10 days  Codes differ from remote physiologic monitoring (99453 and 99454) as they are for up to 10 days of data collection versus 16+ days with RPM  Reported once per episode of care  Do not report for simple or complex uroflowmetry (51736 and 51741)
  • 62. © Health Catalyst. Confidential and Proprietary. Added Codes - New & Emerging Technology Code Long Description 0815T Ultrasound-based radiofrequency echographic multi-spectrometry (REMS), bone-density study and fracture-risk assessment, 1 or more sites, hips, pelvis, or spine  Uses no radiation – Predicted to be method of choice to diagnosis altered bone status in children and women of childbearing age
  • 63. © Health Catalyst. Confidential and Proprietary. Added Codes - New & Emerging Technology Code Long Description Assoc Code 0827T Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation (List separately in addition to code for primary procedure) 88104 0828T Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; simple filter method with interpretation (List separately in addition to code for primary procedure) 88106 0829T Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (e.g., Saccomanno technique) (List separately in addition to code for primary procedure) 88108  Slides are scanned with images used for digital examination for pathologic diagnosis distinct from direct visualization through a microscope  May not be used solely for education purposes, for developing a database for training or validation, or for presentations
  • 64. © Health Catalyst. Confidential and Proprietary. Added Codes - New & Emerging Technology Code Long Description Assoc Code 0830T Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (List separately in addition to code for primary procedure) 88112 0831T Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (List separately in addition to code for primary procedure) 88141 0832T Digitization of glass microscope slides for cytopathology, smears, any other source; screening and interpretation (List separately in addition to code for primary procedure) 88160 0833T Digitization of glass microscope slides for cytopathology, smears, any other source; preparation, screening and interpretation (List separately in addition to code for primary procedure) 88161 0834T Digitization of glass microscope slides for cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains (List separately in addition to code for primary procedure) 88162
  • 65. © Health Catalyst. Confidential and Proprietary. Added Codes - New & Emerging Technology Code Long Description Assoc Code 0835T Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site (List separately in addition to code for primary procedure) 88172 0836T Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (List separately in addition to code for primary procedure) 88177 0837T Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; interpretation and report (List separately in addition to code for primary procedure) 88173 0838T Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (List separately in addition to code for primary procedure) 88321 0839T Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (List separately in addition to code for primary procedure) 88323
  • 66. © Health Catalyst. Confidential and Proprietary. Added Codes - New & Emerging Technology Code Long Description Assoc Code 0840T Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (List separately in addition to code for primary procedure) 88325 0841T Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (List separately in addition to code for primary procedure) 88331 0842T Digitization of glass microscope slides for pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for primary procedure) 88332 0843T Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), initial site (List separately in addition to code for primary procedure) 88333 0844T Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), each additional site (List separately in addition to code for primary procedure) 88334
  • 67. © Health Catalyst. Confidential and Proprietary. Added Codes - New & Emerging Technology Code Long Description Assoc Code 0845T Digitization of glass microscope slides for immunofluorescence, per specimen; initial single antibody stain procedure (List separately in addition to code for primary procedure) 88346 0846T Digitization of glass microscope slides for immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) 88350 0847T Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, KRAS mutational analysis) (List separately in addition to code for primary procedure) 88363 0848T Digitization of glass microscope slides for in situ hybridization (eg, FISH), per specimen; initial single probe stain procedure (List separately in addition to code for primary procedure) 88365 0849T Digitization of glass microscope slides for in situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure) 88364
  • 68. © Health Catalyst. Confidential and Proprietary. Added Codes - New & Emerging Technology Code Long Description Assoc Code 0850T Digitization of glass microscope slides for in situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure (List separately in addition to code for primary procedure) 88366 0851T Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial single probe stain procedure (List separately in addition to code for primary procedure) 88368 0852T Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure) 88369 0853T Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex probe stain procedure (List separately in addition to code for primary procedure) 88377
  • 69. © Health Catalyst. Confidential and Proprietary. Added Codes - New & Emerging Technology Code Long Description Assoc Code 0854T Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (List separately in addition to code for primary procedure) 85060 0855T Digitization of glass microscope slides for bone marrow, smear interpretation (List separately in addition to code for primary procedure) 85097 0856T Digitization of glass microscope slides for electron microscopy, diagnostic (List separately in addition to code for primary procedure) 88348
  • 70. © Health Catalyst. Confidential and Proprietary. Added Codes - New & Emerging Technology Code Long Description 0857T Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation, augmentative analysis and report (List separately in addition to code for primary procedure) 0858T Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report  0857T is an add-on code that may be reported with 76641 or 76642  0858T is transcranial magnetic stimulation with measurement of TMS evoked potentials in 2 or more cortical areas at the same time, which is used to assess brain function in patients with existing brain disease
  • 71. © Health Catalyst. Confidential and Proprietary. Added Codes - New & Emerging Technology Code Long Description 0859T Noncontact near-infrared spectroscopy (e.g., for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; each additional anatomic site (List separately in addition to code for primary procedure) 0860T Noncontact near-infrared spectroscopy (e.g., for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), for screening for peripheral arterial disease, including provocative maneuvers, image acquisition, interpretation, and report, one or both lower extremities  0859T is add-on code to 0640T to allow for reporting of multiple sites during the same encounter; each code may be reported only once per anatomic site  0860T is specifically for screening for peripheral arterial disease; although device is non-contact, code includes provocative maneuvers by the technician
  • 72. © Health Catalyst. Confidential and Proprietary. Added Codes - New & Emerging Technology Code Long Description 0865T Quantitative magnetic resonance image (MRI) analysis of the brain with comparison to prior magnetic resonance (MR) study(ies), including lesion identification, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transmission, interpretation and report, obtained without diagnostic MRI examination of the brain during the same session 0866T Quantitative magnetic resonance image (MRI) analysis of the brain with comparison to prior magnetic resonance (MR) study(ies), including lesion detection, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transmission, interpretation and report, obtained with diagnostic MRI examination of the brain (List separately in addition to code for primary procedure)  0865T and 0866T represent use of software to analyze differences between MRIs  0866T is add-on code that is used in conjunction with 70551-70553  Quantitative MR analysis of tissue composition is reported using 0648T, 0649T, 0697T, 0698T  Quantitative CT analysis of tissue composition is reported using 0721T or 0722T  Quantitative MR analysis of brain without comparison to prior study is reported using modifier 52
  • 73. © Health Catalyst. Confidential and Proprietary. Deleted Codes - New & Emerging Technology Deleted Code Suggested Replacement Codes 0501T – Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation software analysis of functional data to assess the severity of coronary artery disease; data preparation and transmission, analysis of fluid dynamics and simulated maximal coronary hyperemia, generation of estimated FFR model, with anatomical data review in comparison with estimated FFR model to reconcile discordant data, interpretation and report 75580 0502T - Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation software analysis of functional data to assess the severity of coronary artery disease; data preparation and transmission 75580
  • 74. © Health Catalyst. Confidential and Proprietary. Deleted Codes - New & Emerging Technology Deleted Code Suggested Replacement Codes 0503T – Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation software analysis of functional data to assess the severity of coronary artery disease; analysis of fluid dynamics and simulated maximal coronary hyperemia, and generation of estimated FFR model 75580 0504T - Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation software analysis of functional data to assess the severity of coronary artery disease; anatomical data review in comparison with estimated FFR model to reconcile discordant data, interpretation and report 75580
  • 75. © Health Catalyst. Confidential and Proprietary. Deleted Codes - New & Emerging Technology Deleted Code Suggested Replacement Codes 0508T - Pulse-echo ultrasound bone density measurement resulting in indicator of axial bone mineral density, tibia 76999
  • 76. © Health Catalyst. Confidential and Proprietary. Deleted Codes - New & Emerging Technology Deleted Code Suggested Replacement Codes 0533T – Continuous recording of movement disorder symptoms, including bradykinesia, dyskinesia, and tremor for 6 days up to 10 days; includes set-up, patient training, configuration of monitor, data upload, analysis and initial report configuration, download review, interpretation and report 95999 0534T - Continuous recording of movement disorder symptoms, including bradykinesia, dyskinesia, and tremor for 6 days up to 10 days; set-up, patient training, configuration of monitor 95999 0535T - Continuous recording of movement disorder symptoms, including bradykinesia, dyskinesia, and tremor for 6 days up to 10 days; data upload, analysis and initial report configuration 95999 0536T - Continuous recording of movement disorder symptoms, including bradykinesia, dyskinesia, and tremor for 6 days up to 10 days; download review, interpretation and report 95999
  • 77. © Health Catalyst. Confidential and Proprietary. Deleted Codes - New & Emerging Technology Deleted Code Suggested Replacement Codes 0641T - Noncontact near-infrared spectroscopy studies of flap or wound (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation [StO2]); image acquisition only, each flap or wound 0859T 0860T 0642T - Noncontact near-infrared spectroscopy studies of flap or wound (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation [StO2]); interpretation and report only, each flap or wound 0859T 0860T
  • 78. © Health Catalyst. Confidential and Proprietary. Revised Codes – New & Emerging Technology Code 2024 Long Description 2023 Long Description 0640T Noncontact near-infrared spectroscopy (e.g., for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; first anatomic site Noncontact near-infrared spectroscopy studies of flap or wound (e.g., for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation [StO2]); image acquisition, interpretation and report, each flap or wound
  • 79. © Health Catalyst. Confidential and Proprietary. Deleted Codes - New & Emerging Technology Deleted Code Suggested Replacement Codes 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 0766T 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) 0767T  Prior to 2024 procedure is divided into initial and subsequent treatments  Codes describe transcutaneous magnetic stimulation to treat chronic nerve pain  Nerve conduction may be used as guidance but is not separately reported; a separate diagnostic nerve conduction study prior to treatment may be separately reported
  • 80. © Health Catalyst. Confidential and Proprietary. Revised Codes – New & Emerging Technology Code 2024 Long Description 2023 Long Description 0766T Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and marking of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve 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, 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) 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)
  • 81. © Health Catalyst. Confidential and Proprietary. Revised Codes – New & Emerging Technology Code 2024 Long Description 2023 Long Description 0589T Electronic analysis with simple programming of implanted integrated neurostimulation system for bladder dysfunction (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (Hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detection algorithms, closed-loop parameters, and passive parameters, when performed by physician or other qualified health care professional, posterior tibial nerve, 1-3 parameters Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (Hz), on/off cycling, burst, dose lockout, patient- selectable parameters, responsive neurostimulation, detection algorithms, closed-loop parameters, and passive parameters, when performed by physician or other qualified health care professional, posterior tibial nerve, 1-3 parameters 0590T Electronic analysis with complex programming of implanted integrated neurostimulation system for bladder dysfunction (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (Hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detection algorithms, closed-loop parameters, and passive parameters, when performed by physician or other qualified health care professional, posterior tibial nerve, 4 or more parameters Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (Hz), on/off cycling, burst, dose lockout, patient- selectable parameters, responsive neurostimulation, detection algorithms, closed-loop parameters, and passive parameters, when performed by physician or other qualified health care professional, posterior tibial nerve, 4 or more parameters
  • 82. Questions? © Health Catalyst. Confidential and Proprietary. Jennifer Bishop hcwebinars@healthcatalyst.com
  • 83. © Health Catalyst. Confidential and Proprietary. Thank you!

Editor's Notes

  1. These are used for cell-free nucleic acid – liquid biopsy
  2. Removed the word targeted; changed order to be consistent with current conventions; removed specific genes
  3. Since AMH is expressed by growing follicles prior to FSH-dependent selection and has been shown to be detectable in circulation, serum AMH has taken momentum as a marker for ovarian function, in particular in the assessment of the quantitative aspect of the ovarian reserve
  4. 86041 - 86043 – Myasthenia gravis diagnosis/confirmation 86366 - MuSK-MG differs from AChR-MG, in exhibiting more focal muscle involvement, including neck, shoulder, facial and bulbar-innervated muscles, as well as wasting of the involved muscles
  5. Remember Appendix O lists the laboratory or manufacturer that applied for the code. Others offering similar tests require their own PLA code or must use existing analyte, method, or unlisted codes in the Category I codes. PLA code must be assigned if such a code exists for the specific lab/manufacturer and test being performed
  6. Mood – Bipolar/depression Stress - PTSD
  7. Mood – Bipolar/depression Stress - PTSD
  8. Mood – Bipolar/depression Stress - PTSD
  9. Mood – Bipolar/depression Stress - PTSD
  10. Mood – Bipolar/depression Stress - PTSD
  11. Mood – Bipolar/depression Stress - PTSD
  12. Aural rehab – See 92630 or 92633 Analysis of cochlear implant – See 92601-92604
  13. Lots of notes through Category I section – 0827T used with 88104; 0828T used with 88106; 0829T used with 88108
  14. 0830T – 88112 0831T – 88141 0832T – 88160 0833T – 88161 0834T - 88162
  15. 0835T – 88172 0836T – 88177 0837T – 88173 0838T – 88321 0839T - 88323
  16. 0840T – 88325 0841T – 88331 0842T – 88332 0843T – 88333 0844T - 88334
  17. 0845T – 88346 0846T – 88350 0847T – 88363 0848T – 88365 0849T - 88364
  18. 0850T – 88366 0851T – 88368 0852T – 88369 0853T - 88377
  19. 0854T – 85060 0855T – 85097 0856T - 88348
  20. Code 0858T represents measurement of evoked cortical potentials associated with transcranial magnetic stimulation of two or more cortical areas using multiple, externally applied scalp electrode channels. Upon stimulation, the device performs automated signal processing indicating brain physiological features of connectivity, excitability, and plasticity, which may be impaired with structural and functional brain deficits. Because these physiological features may be altered in certain types of brain disease, the device's automated report of analyzed data is intended to provide clinical insight of brain function within the contextofcertain brain disease states.
  21. NoncontactNnear-infrared spectroscopy is used to measure cutaneous vascular perfusion. Codes 0640T, 0641T, 0642T0859Tdescribe noncontact near-infrared spectroscopy of skin flaps or woundsfor measurement of cutaneous vascular perfusion (other than for screening for peripheral arterial disease)that does not require direct contact of the spectrometer sensors with the patient’s skin. Codes 0640T, 0859T may only be reported once, when performing noncontact near-infrared spectroscopy of multiple wounds in one anatomic site (eg, multiple diabetic ulcers involving the plantar surface of the foot). For noncontact near-infrared spectroscopy studies for screening for peripheral arterial disease, use 0860T.
  22. Codes are now divided based on indication and number of anatomical sites
  23. Notes added to clarify that analysis is included in implantation and therefore shouldn’t be reported on the same date as insertion, replacement, or revision.