For the 2025 edition of the Current Procedural Terminology (CPT) code set, several revisions in radiology codes have been proposed. These updates include the introduction of new codes for reporting various procedures such as MRI-monitored transurethral ultrasound ablation of the prostate (TULSA), transcranial Doppler studies, percutaneous radiofrequency (RF) ablation of the thyroid, fascial plane blocks, and magnetic resonance (MR) examination safety procedures. Additionally, the MRI-guided high-intensity focused ultrasound (MRgFUS) will transition from Category III to Category I.

A new subsection dedicated to Telemedicine Services will be introduced within the Evaluation and Management (E/M) section, encompassing 17 new codes and guidelines for reporting telemedicine E/M office visits.

The American College of Radiology (ACR) advises its members to review the proposed code changes carefully and assess their potential impact on their practices.

CATEGORY I

Effective January 1, 2025, the following Category I codes will be implemented:

MR Examination Safety Procedures

A new subsection will be established for MR safety services, introducing six new codes. These codes will cover procedures such as implant or foreign body evaluation, safety consultation, electronics preparation, and implant positioning or immobilization. The new codes and guidelines will be detailed in the Magnetic Resonance (MR) Safety Implant/Foreign Body Procedures section within the Radiology/Diagnostic Radiology (Diagnostic Imaging) category.

These codes will address the necessary assessment, consultation, and customization of medical physics examinations for patients with implants, devices, or foreign bodies prior to undergoing an MRI study.

MRI-Monitored Transurethral Ultrasound Ablation

MRI-monitored TULSA employs robotically driven directional thermal ultrasound combined with closed-loop temperature feedback control software to deliver precise, physician-prescribed ablation of prostate tissue for the treatment of prostate cancer.

MRI-Guided High-Intensity Focused Ultrasound (MRgFUS)
The existing Category III code 0398T for MRgFUS will be reclassified to Category I. This noninvasive procedure allows for tissue ablation within the skull without the need for open surgery. The previous code 0398T will be deleted, and three new codes will be introduced to cover the procedure, including treatment planning, insertion, and ablation.

Transcranial Doppler

Three new add-on codes will be available to report procedures performed with a complete transcranial Doppler study of intracranial arteries. These include codes for vasoreactivity studies, emboli detection without intravenous microbubble injection, and venous-arterial shunt detection with intravenous microbubble injection.

Code 93893 will be updated to describe venous-arterial shunt detection, while code 93890 will be deleted. Furthermore, the guidelines for Cerebrovascular Arterial Studies will be revised to clarify the reporting of existing transcranial Doppler study codes 93886, 93888, 93892, and 93893, as well as the new add-on codes.

Percutaneous Radiofrequency Ablation of the Thyroid

Currently, there are no CPT codes for reporting radiofrequency (RF) ablation of the thyroid under imaging guidance. Starting in 2025, a new CPT code will be introduced to cover percutaneous RF ablation of the thyroid, along with an add-on code for reporting the ablation of additional nodules.

Fascial Plane Blocks (FPB)

Six new CPT codes will be established for reporting specific fascial plane block infiltrations (injections or infusions) in the thoracic, lower extremity, and abdominal regions for post-operative pain management. Additionally, codes 64486-64489 will be editorially revised to include transverse abdominis plane blocks. The guidelines in the Introduction/Injection of Anesthetic Agent (Nerve Block) and Diagnostic or Therapeutic Somatic Nerves sections will also be updated to reflect these changes.

Telemedicine Office Visits

A new subsection within the Evaluation and Management (E/M) section of the CPT code set will introduce 17 new codes and guidelines for reporting telemedicine services. These codes will cover both audio-visual and audio-only telemedicine office visits and will be structured similarly to existing office and other outpatient E/M codes, with four levels based on medical decision-making or time, and separate codes for new and established patients.

Furthermore, a new virtual check-in code will be available to assess whether an in-person visit is necessary. This code will be analogous to the Healthcare Common Procedure Coding System (HCPCS) code G2012, Brief Communication Technology-Based Virtual Check-In. The existing codes 99441, 99442, and 99443 will be deleted.

Read also: Selective Catheterization Coding tips for CPT 36251 & 36252

Coding tips for CPT code 36902, 36903, 36904, 36905 and 36906

Coding Guide for Arthrodesis & Vertebral corpectomy CPT codes

Revision and Deletion of CPT Codes and Guidelines for 2025

Revised Guidelines

In 2025, the following revisions will be made to the CPT guidelines:

Vascular Procedures Guidelines

The guidelines within the Vascular Procedures subsection of the Radiology section will be updated to clarify that add-on code 75774, which covers “Angiography, selective, each additional vessel studied after basic examination, radiological supervision and interpretation (List separately in addition to code for primary procedure),” may be used to report additional vessels for both arteries and veins. The parenthetical cross-references currently directing users to codes 75600-75756 (angiography) and 36215-36248 (catheterization) will be removed.

Revised Codes

The following codes will be revised in 2025:

– 64486: Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) unilateral; by injection(s) (includes imaging guidance, when performed)
– 64487: Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) unilateral; by continuous infusion(s) (includes imaging guidance, when performed)
– 64488: Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) bilateral; by injection(s) (includes imaging guidance, when performed)
– 64489: Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) bilateral; by continuous infusion(s) (includes imaging guidance, when performed)
– 93893: Transcranial Doppler study of the intracranial arteries; emboli detection with intravenous microbubble injection

Deleted Codes

The following codes will be deleted in 2025:

– 0398T: Magnetic resonance image-guided high-intensity focused ultrasound (MRgFUS), stereotactic ablation lesion, intracranial for movement disorder, including stereotactic navigation and frame placement when performed
– 93890: Transcranial Doppler study of the intracranial arteries; vasoreactivity study
– 99441: Telephone evaluation and management service by a physician or other qualified healthcare professional for established patients, not originating from a related E/M service within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or earliest available appointment
– 99442: Telephone evaluation and management service by a physician or other qualified healthcare professional for established patients, not originating from a related E/M service within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or earliest available appointment; 11-20 minutes of medical discussion
– 99443: Telephone evaluation and management service by a physician or other qualified healthcare professional for established patients, not originating from a related E/M service within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or earliest available appointment; 21-30 minutes of medical discussion

Retained Codes

The following Category III codes, initially set to sunset in 2025, will be extended for an additional five years, now expiring in December 2030:

– 0071T: Focused ultrasound ablation of uterine leiomyomata, including MR guidance; for total leiomyomata volume less than 200 cc of tissue.
– 0072T: Focused ultrasound ablation of uterine leiomyomata, including MR guidance; for total leiomyomata volume of 200 cc or greater.
– 0075T: Transcatheter placement of extracranial vertebral artery stent(s), including radiologic supervision and interpretation, open or percutaneous; for the initial vessel.
– +0076T: Transcatheter placement of extracranial vertebral artery stent(s), including radiologic supervision and interpretation, open or percutaneous; for each additional vessel (List separately in addition to the code for the primary procedure).
– 0200T: Percutaneous sacral augmentation (sacroplasty), unilateral injections, including the use of a balloon or mechanical device when used, with one or more needles, including imaging guidance and bone biopsy, when performed.
– 0201T: Percutaneous sacral augmentation (sacroplasty), bilateral injections, including the use of a balloon or mechanical device when used, with two or more needles, including imaging guidance and bone biopsy, when performed.
– 0554T: Bone strength and fracture risk assessment using finite element analysis of functional data and bone mineral density from a computed tomography scan; including retrieval and transmission of scan data, assessment of bone strength and fracture risk, and bone mineral density, with interpretation and report.
– 0555T: Bone strength and fracture risk assessment using finite element analysis of functional data and bone mineral density from a computed tomography scan; including retrieval and transmission of scan data.
– 0556T: Bone strength and fracture risk assessment using finite element analysis of functional data and bone mineral density from a computed tomography scan; including assessment of bone strength and fracture risk and bone mineral density.
– 0557T: Bone strength and fracture risk assessment using finite element analysis of functional data and bone mineral density from a computed tomography scan; including interpretation and report.
– 0558T: Computed tomography scan conducted for biomechanical computed tomography analysis.
– 0559T: Anatomic model 3D-printed from image data set(s); first individually prepared and processed component of an anatomic structure.
– +0560T: Anatomic model 3D-printed from image data set(s); each additional individually prepared and processed component of an anatomic structure (List separately in addition to the code for the primary procedure).
– 0561T: Anatomic guide 3D-printed and designed from image data set(s); first anatomic guide.
– +0562T: Anatomic guide 3D-printed and designed from image data set(s); each additional anatomic guide (List separately in addition to the code for the primary procedure).