2022 Radiology Coding Changes

As expected, new and revised codes were officially effective on January 1, 2022. With the 2022 CPT® code files available, 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.

Diagnostic Radiology

For diagnostic radiology, note that 75573 has a revised description effective at the start of the year.

75573Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of left ventricular [LV] cardiac function, right ventricular [RV] structure and function and evaluation of vascular structures, if performed)

For 2022, four new codes for reporting trabecular bone score (TBS) procedures, which measure the structural condition of bone microarchitecture, were created. Understand that by utilizing DXA and other imaging data, TBS values can help predict osteoporotic fracture risk independently of BMD and other clinical factors in risk stratification. Technical services codes 77090 and 77091 should be reported with revenue code 0320 or 0329. Do not report global code 77089 in conjunction with codes 77090-77092.

77089 Trabecular bone score (TBS), structural condition of the bone microarchitecture; using dual X-ray absorptiometry (DXA) or other imaging data on gray-scale variogram, calculation, with interpretation and report on fracture-risk
77090 Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere
77091 Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical calculation only
77092 Trabecular bone score (TBS), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional

Understand that several new surgical codes will impact radiology starting in 2022 for a variety of procedures.

33370 Transcatheter placement and subsequent removal of cerebral embolic protection device(s), including arterial access, catheterization, imaging, and radiological supervision and interpretation, percutaneous (List separately in addition to code for primary procedure)
33894 Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches
33895 Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches
33897 Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta
64628 Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral
64629 Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (List separately in addition to code for primary procedure)

These are not all the coding updates impacting radiology. Explore more coding knowledge and additional pressing topics to master compliance and coding with our monthly Radiology Compliance Manager.

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