2022 Interventional Radiology Category III Codes Explained

As expected, new category III codes were officially effective on January 1, 2022. With these codes now active, interventional radiology providers and stakeholders should be aware of the scope of changes in place for the new year. By knowing the changes, staff and coders can prepare for a successful year while safeguarding compliance.

Lumbar Spine Allogeneic Injection

• 0627T  Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral injection, with fluoroscopic guidance, lumbar; first level
• 0628T  Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral injection, with fluoroscopic guidance, lumbar; each additional level (List separately in addition to code for primary procedure)
• 0629T  Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral injection, with CT guidance, lumbar; first level
• 0630T  Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral injection, with CT guidance, lumbar; each additional level (List separately in addition to code for primary procedure)

Understand that percutaneous allogeneic injection of the lumbar spine is a relatively new therapeutic procedure that involves the injection of the lumbar spine under fluoroscopic or CT guidance while using allogeneic cellular and/or tissue-based products to replace or supplement the disc tissue or cells to repair or reconstitute damaged intravertebral disc(s). Two codes (0627T-0628T) are reported for the first level and each additional level with fluoroscopic guidance; two codes (0629T – 0630T) are reported for the first level and each additional level with CT guidance technical calculation only.

Removal Intracardiac Vegetation

• 0644T  Transcatheter removal or debulking of intracardiac mass (eg, vegetations, thrombus) via suction (eg, vacuum, aspiration) device, percutaneous approach, with intraoperative reinfusion of aspirated blood, including imaging guidance, when performed

Under what circumstances is 0644T used? In terms of the parameters of this code, Category III code 0644T is reported for suction of intracardiac thrombus or vegetations (endocarditis). While this may be performed more often in a cardiology lab, many interventional radiology physicians are also performing this procedure. So, what does this code include? Code 0644T is a comprehensive code that includes access, sheath, and device introduction, manipulation and positioning of wires and catheters, dilation, embolic protection, and closure. Note that guidance is also included as is the introduction of cannula and initiation of an extracorporeal circuit. If prolonged extracorporeal membrane oxygenation (ECMO) or extracorporeal life support (ECLS) is required after the suction thrombectomy procedure is completed, that may be reported separately. When should this code not be reported? Do not report 0644T with 37187 or 37188.

These are not all the coding updates impacting interventional radiology. Explore more coding knowledge and additional pressing topics to master compliance and coding with our 2022 Radiology Coding Update on-demand webcast.