ACR Releases Early New Analysis of 2023 Coding

Anticipation is already building for end of the year annual coding changes. The American College of Radiology (ACR) released a preview analysis of some of the coding changes that may impact radiology providers and stakeholders come 2023 and even earlier. Among the changes include new Category 1 codes for percutaneous arteriovenous fistula creation and neuromuscular ultrasound, which have already been created. Expect early-release Category III codes to be available on July 1, 2022. These will account for new technology like quantitative CT tissue characterization and quantitative magnetic resonance cholangiopancreatography (MRCP). According to the ACR, “Revisions will also be made within several subsections of the evaluation and management (E/M) section to standardize the rest of the E/M sections of the CPT code set to follow the CPT Editorial Panel’s (the Panel’s) revisions to the office or other outpatient E/M codes (99202–99215) for the CPT 2021 code set.” Note that a new artificial intelligence (AI) taxonomy appendix will arrive to add clarity for the specific terms that detail AI services as well as “how they can be differentiated within the CPT code set.”

The Evolution of E/M Codes

More revisions are expected for E/M codes in 2023. According to the ACR, “Additional revisions will be made to the E/M codes in 2023. The revisions are a result of the E/M workgroup’s agreement to standardize the rest of the E/M sections in the CPT code set following the Panel’s acceptance of the revisions to the E/M office or other outpatient E/M codes (99202-99215) for the CPT 2021 code set.” The panel review revealed that two sets of guidelines were made available in the 2021 and 2022 set. One of the sets comprised office or other outpatient E/M codes and the other represented any codes remaining. The end result was an increased administrative burden for physicians, QHPs, and coders, “who have to divide E/M reporting across separate code families.” The revisions will leave the codes more in sync with the rest of the E/M sections in CPT code set.

Early Bird 2022 Category III Codes

As you may know, four new Category III codes were available early, posted on the American Medical Association’s (AMA’s) website on January 1, 2022. These codes have an effective date of July 1, 2022.

Two new codes comprise quantitative CT tissue characterization, with the ACR noting “The new codes were structured similarly to existing quantitative ultrasound tissue characterization codes 0689T and 0690T.”

Understand that quantitative CT tissue characterization is a new technology capable of boosting population health strategies and ultimately achieve improved patient outcomes. The technology works by harnessing computer algorithms to “quantitatively characterize tissues on CT images that could only be subjectively evaluated in the past.”

In addition, two new codes will represent quantitative MRCP, “which will allow the reporting of quantitative evaluation of pancreato-biliary structure anatomy from MR images that produce quantitative data of the biliary tree and pancreatic ducts.”

The data is used to drive radiologists’ evaluation and interpretation and lend in physician decision making with the possibility of lowering the time for the initiation of specific treatments and interventions in diseases. These diseases include conditions like cholestatic liver disease, chronic pancreatitis, or gallstones.

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