Radiology CPT Code Changes in 2021
Radiology CPT coding changes for 2021 have been released. There are changes in radiology coding that the American Medical Association is prepared to make, as they do every year. Some codes are removed and some are added or revised to reflect current practices, technologies, and services.
In 2021, there are very few changes to radiology coding. The new radiology codes assigned are also limited. The most significant change in CPT 2021 that affects radiology falls under the changes to the Evaluation and Management guidelines. Other changes affecting the practice of radiology are minimal.
It is crucial to understand the new codes in to get efficient reporting and proper reimbursements. For this reason, most radiology practices prefer to outsource their medical billing and coding to an experienced and skilled medical service provider.
In this blog, we’ve covered the major changes that most often affect the practice of radiology. Let’s have a look!
Evaluation & Management
There are significant changes that occurred to the Evaluation and Management codes for and other outpatient visits.
These revisions are the result of burdensome documentation and administrative complexities with previous CPT coding guidelines and code descriptions.
These revised codes and coding guidelines should reduce unnecessary documentation requirements and allow for resource management in reporting these visits.
Both the and exam portions of the visit should be documented as “medically appropriate” while not involved in the calculation of code selection. As a result, we see a consistency between the documented level of care and the patient’s documented .
Moreover, it is important to know that CPT 99201, the lowest level new patient visit option has been deleted for 2021. All the new patients should be stated under 99202-99205 and the patient who is established would be reported with 99211-99215.
Revised
99202 – For Evaluation and management of a new patient ( or another outpatient visit), which requires a medically appropriate and examination or straightforward medical decision making. Especially using time for code selection, 15-29 minutes of the total time is spent on the date of the encounter.
99203 – Not so much change in it. Same as code 99202. However, there’s been an addition of 30-44 minutes of total time spent on the date of the encounter.
99204 – Again no significant change in it. An addition of 45-59 minutes of the total time is spent on the date of the encounter.
99205 – Once again not so much change, Just an addition of 60-74 minutes total time is spent on the date of the encounter.
Moreover, the 99211 code is used for the evaluation and management of an established patient ( or another outpatient visit). This is for those who may not need the presence of a physician or any other qualified healthcare professional. Mostly, their presenting problems are minimal
On contrary to those established patients who require a medically appropriate or examination and straightforward medical decision making. When using time for code selection for an established patient;
99212, for 10-19 minutes of time spent on the date of the encounter.
99213, for 20-29 minutes of time spent on the date of the encounter.
99214, for 30-39 minutes of total time spent on the date of the encounter.
99215, for 40-54 minutes of the total time is spent on the date of the encounter.
New
A new code has been developed to state the additional time spent. It is important to note that this code would not be commonly reported for radiology groups
99417, this code would be reported for a prolonged or other outpatient evaluation and management services that are used beyond the minimum required time of the primary procedure.
Diagnostic Radiology Coding Changes
For Screening CT of the Thorax
The diagnostic codes used are 71250, 71260, and 71270. Also, a new CT of the thorax code is available for describing low-dose lung cancer screening.
G0297 is the current HCPCS code identified by the CMS (Centers for Medicare and Medicaid Services) used to report as a high-value growth screen.
This has later been submitted to the editorial board to create a Category CT code to report low-dose CT for lung cancer screening.
Urography
Diagnostic Radiology Procedures of the Urinary Tract code 74425 will be revised and reciprocal parenthetical will be added. It can be reported with codes 50390, 50396, 50684, and 50690.
Fluoroscopic Guidance
Radiology Codes 64400-64450 and 64455 is added in the inclusionary parenthetical notes by following codes 77002 and 77003
Ultrasound Follow-Up Study
Other diagnostic Ultrasound Procedure code 76970 has been referred to the CPT Editorial Panel for deletion due to low volume.
Interventional Radiology Coding Changes
Percutaneous Core Needle Lung Biopsy
For this procedure, code 32405 under excision procedures of the lungs and pleura is deleted and replaced with a new code that bundles percutaneous core needle lung biopsy.
The codes 32405 and 77012 were specifically mentioned by the editorial panel as code pairs that usually perform 75% of the time. Moreover, they were identified as bundled.
Medical
Medical dose Evaluation
The new category I radiology code includes Diagnostic Radiology, Diagnostic Imaging, and other procedures subsection of the CPT to report the assessment and calculation of radiation dose.
Also, the potential adverse iatrogenic effects received by the patients may require a follow-up observation or treatment. It is considered as the most technical component since a medical physicist performs this actual service.
We have provided a brief overview of the many changes in radiology coding that will take effect in 2021. Practices in radiology should carefully consider those codes that will impact their practice and make adjustments to their templates and EHR systems accordingly.
This year’s reporting guidelines have not changed significantly, but nevertheless should be reviewed to determine where practice documentation may need to be changed.
