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CPT code changes to be implemented in 2023 – What should Medical Practices, Medical Billers and Medical Coders know?

AMA released 2023 CPT updates: 393 edits, 225 new, 75 deleted, 93 revised codes. The new CPT code set will go into effect on January 1, 2023.

Surgery: Cardiovascular CPT

CPT 2023 adds 5 new codes for pulmonary artery stent placement. Introductory guidelines and parentheticals are also added:

  • Code 33900 is for an initial procedure performed unilaterally in normal native connections.
  • Code 33901 is for an initial procedure performed bilaterally in normal native connections.
  • Code 33902 is for an initial procedure performed unilaterally in abnormal connections.
  • Code 33903 is for an initial procedure performed bilaterally in abnormal connections.
  • Code +33904 reports each additional vessel or separate lesion in normal or abnormal connections. This add-on code can be reported with 33900, 33901, 33902, or 33903.

Two new codes are added for percutaneous arteriovenous fistula creation:

  • 36836: Stent placement across major side branches.
  • 36837: Separate access for artery and vein with fistula maturation. Both procedures include vascular access, imaging guidance, and radiologic supervision and interpretation.

Surgery: Nervous System CPT

Nerve injection codes were revised to include imaging guidance:

  • Imaging guidance may be reported separately for nerve injection codes 64400-64450.
  • Imaging and contrast are included in brachial plexus & sciatic nerve injection codes 64415-64454.
  • Imaging and contrast are included in codes 64461-64489, not separately reported.

Nerve Ultrasound:

  • 76882 - Limited ultrasound of extremity structures, real-time, with documentation
  • 76883 - Comprehensive ultrasound of nerves in one extremity, including real-time imaging

Radiology Coding Changes & Updates 2023

The descriptor for limited ultrasound code:

  • 76882 was revised to include "focal evaluation," and SPECT codes were updated to include "or acquisition."
  • New code 76883: ultrasound of nerves in one extremity.

Pathology & Laboratory Coding Changes & Updates 2023

There are 11 New codes & three revision in the pathology & lab:

  • Three new codes ( 81449, 81451, & 81456) describe targeted genomic sequence analyses.
  • New codes 87468, 87469, 87479, and 87484 detect infection agents with DNA or RNA.
  • One new code ( 81418) has been added for drug metabolism analysis using a genomic sequence.
  • New code 81441 detects inherited bone marrow failure syndromes (IBMFS).
  • Code 84433 describes the detection of an enzyme called thiopurine S- methyltransferase ( TPMT).
  • Code (87467) describes the detection of the hepatitis B surface antigen.

Three Codes are revised in this section:

  • 81445, 81450, and 81455 update descriptor placement without changing meaning.

Proprietary Laboratory Analyses:

For diagnostic laboratory tests (CLFS),

  • Professional components for human specimen use are not commercially available in the US.
  • Code review is on a quarterly cycle, available the second quarter following review
  • 70 new codes
  • 7 revised codes
  • 7 deleted codes

Codes describe PLAs from single or multiple labs, including MA and GSP.

Category III CPT Codes Changes & Updates 2023

There are many new Category III codes created for new and emerging technology:

  • 0751T-0763T for digital pathology digitization procedures.
  • 0764T-0765T for assistive algorithmic EKG risk-based assessment.
  • 0766T-0769T for transcutaneous magnetic stimulation of nerves for chronic nerve pain.
  • 0771T-0774T for virtual reality patient procedural dissociation.

Category III – Digital Pathology:

Glass slides scanned for digital pathologic diagnosis.

Do not report:

  • solely for archival purposes
  • solely for educational purposes
  • solely for developing a database for training or validation of AI algorithms
  • solely for clinical conference presentation

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