Healthcare technology continues to evolve, often significantly impacting the delivery of care and therefore reporting and coverage for providers. In response, the American Medical Association (AMA) has developed CPT Category III codes to report emerging technology, services, procedures, and service paradigms. New Category III codes for 2022 take effect on July 1. While these codes don’t guarantee coverage for a particular procedure, providers must assign them as appropriate for accurate data collection. The AMA will publish the new codes in the 2023 CPT codebook, but healthcare leaders can access them now within Vitalware® by Health Catalyst products.
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The American Medical Association (AMA) has published changes to the CPT Category III codes, which take effect on July 1, 2022. The Category III codes represent emerging technologies and procedures. The AMA updates CPT codes semi-annually, allowing for faster creation of new codes.
Healthcare organizations should remember that the creation of new CPT coding does not guarantee coverage for the service. These codes will be published in the 2023 CPT codebook but are available for review now within Vitalware® by Health Catalyst products.
Let’s take a look at these new codes and the procedures they describe:
A new code describes the transperineal laser ablation of benign prostatic hyperplasia (BPH) (0714T). This procedure is less invasive than the standard BPH treatment of transurethral resection or laser vaporization and uses a SoracteLite™ EchoLaser device.
Another new code is for percutaneous transluminal coronary lithotripsy (0715T). This is an add-on code and should be listed separately in addition to the code for the primary procedure.
A computer uses acoustic signal processing algorithms to analyze the recording and identify specific heart sounds (S1, S2, and murmurs) that could indicate coronary disease. A new CPT code describing the cardiac acoustic waveform recording, automated analysis, and generation of a coronary artery disease risk score (0716T) has been created to capture this.
Two new codes were created for autologous adipose-derived regenerative cell (ADRC) therapy for a partial-thickness rotator cuff tear:
The AMA has also approved a new code to capture the posterior replacement of a vertebral joint, which includes bilateral facetectomy, laminectomy, and radical discectomy for a single segment of the spine (0719T).
Another new code covers the percutaneous electrical nerve field stimulation of the cranial nerves (0720T). This code does not include the implantation of any type of device.
Quantitative tissue characterization using radiologic means has become a critical component for the integration of image-derived information into personalized treatment. Two new codes relate to this:
Magnetic resonance cholangiopancreatography (MRCP) allows the non-invasive visualization of the biliary tree, gallbladder, and pancreatic ducts. There are two new codes to address this technology:
The AMA has also approved new codes regarding implanted vestibular devices:
July 2022 will also see the introduction of a new code for a trabeculotomy procedure using a laser (0730T)—a technique used for the treatment of glaucoma to relieve intraocular pressure. This new code includes guidance using optical coherence tomography (OCT). OCT is an imaging method used to generate a picture of the back of the eye, called the retina.
Many diseases display distinctive facial manifestations. Clinicians are now using artificial intelligence (AI) technology to aid in the diagnosis of disease using facial characteristics. A new code has been created to capture the analysis and reporting of this technology (0731T).
A new code for immunotherapy administration with electroporation (0732T) has also been created. Electroporation is the use of high-voltage electric shocks to introduce DNA into cells. Since this method of immunotherapy administration requires few steps, it can be easier than alternative techniques.
Treating conditions remotely has become common in the COVID-19 era. The AMA has approved two new codes for remote body and limb kinematic measurement-based therapy:
The AMA has also approved a code for preparation of the tumor cavity, with a placement of a radiation therapy applicator for intraoperative radiation therapy (IORT) during a craniotomy procedure (0735T).This code should be used in conjunction with the code for the craniotomy procedure.
Colonic lavage is a procedure that uses water to cleanse the colon or large intestine. A new code (0736T) has been created to describe this procedure. This code includes the insertion of a rectal catheter.
Finally, July 2022 will introduce a new code for xenograft implantation into the articular surface (0737T). This procedure involves removing articular cartilage from a non-human animal, washing, treating, and preparing the cartilage, and implanting it into the articular surface of the patient.
The AMA recognizes that healthcare technology evolves rapidly and has developed the Category III codes to report emerging technology, services, procedures, and service paradigms in an expedient fashion. Although the existence of a CPT code does not guarantee coverage for a particular procedure, Category III codes must be assigned when appropriate to allow for accurate data collection.
Category III codes are temporary codes that are designed to be archived five years after creation, though they may be archived sooner if sufficient data is available. Rest assured that Vitalware will keep you apprised of future coding and reimbursement changes.
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