AMA Releases CPT® Editorial Panel SummaryOf Panel Actions

The American Medical Association (AMA) has made preliminary plans to update certain CPT® codes for 2024 and 2025, as detailed in its Summary of Panel Actions from the May 2023 CPT® Editorial Panel meeting.

The main objective of the CPT® Editorial Panel, also known as the Panel, is to make certain that CPT® codes accurately represent the most up-to-date medical care accessible to patients. Achieving this goal involves maintaining a process that is autonomous, transparent, and open.

The Panel organizes meetings three times a year to actively seek input from various stakeholders, including practicing physicians, medical device manufacturers, developers of advanced diagnostic tests, and advisors from over 100 specialty medical societies that represent physicians and other qualified healthcare professionals

Following each Panel meeting, a comprehensive document summarizing the actions taken by the Panel on each code application is made available on the American Medical Association (AMA) website This document serves as a valuable resource, providing a clear overview of the decisions and updates made by the Panel. It allows healthcare professionals, payers, and other interested parties to stay informed about the latest developments and changes in the CPT® codes.

The Summary advises of anticipated new CPT® codes and other changes that will be published in the CPT® 2024 manual at the end of 2023, and the CPT® 2025 Manual late next year This information is preliminary and is subject to change prior to publication

Anticipated CPT®code updates effective January 1, 2024 include (but are not limited to):

- Deletion of Category III code 0809T and instruction on how to report hybrid SI joint infusion

- Deletion of Category III code 0042T (cerebral perfusion analysis)

- New Category III add-on code for opto-acoustic imaging for breast masses

- New Category III codes for:

- Electrophysiological focused magnetic stimulation of brain

- Quantitative MRI analysis of the brain

- Near infrared spectroscopy (NIRS) for peripheral arterial disease (PAD)

- New Category III codes 0766T, 0767T (and deletion of previous codes 0768T, 0769T) for peripheral nerve transcutaneous magnetic stimulation

- New and revised Category III codes for wireless cardiac stimulation system for left ventricular pacing

- New Category III code for extracorporeal shockwave therapy (EWST) of the corpus cavernosum

- Retention and deletion (sundown) of various Category III codes

- Retention of code 34510 and deletion of 74710

Upcoming expected CPT®code changes for 2025 include:

- Development of Category I codes for Chimeric Antigen Receptor (CAR-T) services (and deletion of existing Category III codes)

- Addition of codes for excision or destruction of intra-abdominal peritoneal, mesenteric, and/or retroperitoneal primary or secondary tumors or cysts; deletion of codes 49203-49205

- Deletion of code 58957 (resection/debulking of intra-abdominal/retroperitoneal tumors) and revision of code 58958

- New codes for MRI-monitored transurethral USablation of the prostate

- Code addition and revisions relating to hand repair (suspension with interposition) (25447)

- Several new, revised and deleted codes for transcranial Dopper studies

- Updates to time recommendations for telemedicine E&M service codes

Ultrasound Documentation Requirements

Ultrasound Documentation Requirements: CompletevsLimited

Int roduct ion

Many facilities bill diagnostic ultrasound services from the referring physician?s order as an automated process, without any review by a coding professional This practice is discouraged because when charging for complete diagnostic ultrasounds, the CPT® Manual outlines very specific documentation requirements for these examinations.

The radiology report serves as the documentation for both the professional and technical portions of the examination The documentation within the medical record must support the exam that was performed--both for the professional fee (the radiologist?s interpretation) and the technical fee (the technologist?s work of performing the exam).

It is the reading radiologist?s responsibility to ensure the components of each diagnostic ultrasound exam performed are documented appropriately in the radiology report. The CPT® guidelines for diagnostic ultrasound state that all diagnostic ultrasound studies require the following:

- Permanently recorded images with measurements (when such measurements are clinically indicated)

- A final, written report to be issued for inclusion in the patient?s medical record

Per CPT® , ?Use of ultrasound, without thorough evaluation of organ(s) or anatomic region, image documentation, and final, written report, is not separately reportable.?

Com plet e vs Lim it ed Ult rasound

CPT® instructions pertaining to coding a complete vs. a limited ultrasound are as follows: ?For those anatomic regions that have ?complete?and ?limited?ultrasound codes, note the elements that comprise a ?complete?exam The report should contain a description of these elements or the reason that an element could not be visualized (eg, obscured by bowel gas, surgically absent).

If less than the required elements for a ?complete?exam are reported (eg, limited number of organs or limited portion of region evaluated), the ?limited?code for that anatomic region should be used once per patient exam session A ?limited?exam of an anatomic region should not be reported for the same exam session as a ?complete?exam of that same region ?