The 2025 update to the Current Procedural Terminology[i] (CPT) has 270 new codes, 38 revised codes, and 112 deleted codes. In addition, the ICD-10-CM[ii] update has over 300 revisions, additions and deletions. Although relatively few of these changes will impact radiology practices, it’s essential to know what they are and adjust your practice systems accordingly.
Diagnostic radiology
MRI Safety
A new CPT subsection has been established for reporting six new codes describing MR safety services, including implant or foreign body evaluation, safety consultation, electronics preparation, and implant positioning or immobilization. The new Magnetic Resonance (MR) Safety Implant/Foreign Body Procedures of the Radiology/Diagnostic Radiology (Diagnostic Imaging) subsection of the CPT code book contains the codes and the guidelines for reporting them. These new codes describe the work that takes place prior to an MRI study that includes the proper assessment, consultation, and medical physics customization for patients who have an implant, device, or foreign body.
The new MRI Safety procedures are as follows:
| CPT Code | Description | RVU Value |
Medicare Fee |
|---|---|---|---|
| 76014 | MR safety implant and/or foreign body assessment, initial 15 minutes | G - 0.33 | $10.67 |
| 76015 Add-on |
Each additional 30 minutes | G - 1.59 | $51.43 |
| 76016 | MR safety determination by physician or qualified healthcare professional responsible for the safety of the MR procedure | G - 2.20 PC - 0.84 |
$71.16 $27.17 |
| 76017 | MR Safety Medical Physics Exam Customization | G - 6.79 PC - 1.07 |
$219.63 $34.61 |
| 76018 | MR Safety Implant Electronics Preparation | G - 3.45 PC - 1.05 |
$111.60 $33.96 |
| 76019 | MR Safety Implant Positioning and/or Immobilization | G - 4.50 PC – 0.83 |
$145.56 $26.85 |
| Note: G = Global, PC = Professional Component. Medicare Fee represents the national level using the CF of $32.3465 in effect as of this writing. | |||
Note that 76014 and 76015 are technical component codes that reflect the work of an MRI technologist and/or a medical physicist. They do not include any physician work value, but they would be available in the imaging center using global billing.
MRI-Monitored Transurethral Ultrasound Ablation (TULSA)
MRI-monitored TULSA utilizes robotically driven directional thermal ultrasound and closed-loop temperature feedback control software to deliver predictable physician-prescribed ablation of prostate tissue for treatment of prostate cancer. The following codes are available for reporting this procedure.
| CPT Code | Description | RVU Value | Medicare Fee |
|---|---|---|---|
| 51721 | Insertion of transurethral ablation transducers for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorectal cooling device, when performed. | G-16.25 PC-6.47 |
$525.63 $209.28 |
| 55881 | Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation. | G-263.05 PC-14.56 |
$8,508.75 $470.97 |
| 55882 | Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound transducers for delivery of the thermal ultrasound, including suprapubic tube placement and placement of an endorectal cooling device, when performed. | G-272.21 PC-17.91 |
$8,805.04 $579.33 |
MRI-Guided High Intensity Focused Ultrasound (MRgFUS)
The existing Category III[iii]code 0398T MRI-guided high intensity focused ultrasound, stereotactic ablation lesion, intracranial for movement disorder including stereotactic navigation and frame placement when performed will be deleted and replaced by these three new Category I codes.
| CPT Code | Description | RVU Value | Medicare Fee |
|---|---|---|---|
| 61715 | Stereotactic computer-assisted (navigational) procedure; with high-intensity focused ultrasound (HIFU) ablation, including magnetic resonance (MR) guidance; | 36.47 | $1,179.68 |
| 61735 | with frame-based stereotactic navigation. | 48.96 | $1,583.68 |
| 61736 | with frameless stereotactic navigation. | 37.11 | $1,200.38 |
These codes are designed to capture the comprehensive components of the MRgFUS procedure, including treatment planning, probe insertion, and the ablation process. This update reflects the procedure's established clinical use and is expected to facilitate broader adoption in treating conditions such as intracranial movement disorders.
Transcranial Doppler
Three new add-on codes will be available to report procedures performed along with CPT Code 93886 Transcranial Doppler study of intracranial arteries, complete.
| CPT Code | Description | RVU Value | Medicare Fee |
|---|---|---|---|
| 93896 Add-on |
Vasoreactivity study with transcranial Doppler of intracranial arteries, complete | G-5.35 PC-1.21 |
$173.05 $39.14 |
| 93897 Add-on |
Emboli detection without intravenous microbubble injection performed with transcranial Doppler, complete | G-6.73 PC-1.10 |
$217.69 $35.58 |
| 93898 Add-on |
Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial Doppler study, complete | G-7.05 PC-1.29 |
$228.04 $41.73 |
Code 93893 Transcranial Doppler study of the intracranial arteries; emboli detection with intravenous microbubble injection has been revised to describe venous-arterial shunt detection and code 93890 Transcranial Doppler study of the intracranial arteries; vasoreactivity study has been deleted.
The Cerebrovascular Arterial Studies guidelines will be revised to clarify when the existing transcranial Doppler study codes 93886, 93888, 93892, and 93893 and the new add-on codes are to be reported.
Erin Stephens.
Interventional radiology
Percutaneous RF Ablation of Thyroid
There have been no CPT codes to report RF ablation of the thyroid under imaging guidance. Category III code 0673T had been used for ablation of benign thyroid nodules. Beginning in 2025, there is a new code to report percutaneous radiofrequency ablation of thyroid plus an add-on code to report ablation of additional nodule(s).
| CPT Code | Description | RVU Value | Medicare Fee |
|---|---|---|---|
| 60660 | Ablation of one or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency | G-73.92 PC-9.49 |
$2,391.05 $306.97 |
| 60661 Add-on |
Each additional lobe | G-11.99 PC-6.57 |
$387.83 $212.52 |
Fascial Plane Blocks (FPB)
Six new codes have been created to report specific fascial plane block infiltration (injection or infusion) of the thoracic, lower extremity, and abdominal regions in postoperative pain management.
| CPT Code | Description | RVU Value | Medicare Fee |
|---|---|---|---|
| Thoracic fascial pain block, including imaging guidance when performed | |||
| 64466 | unilateral; by injection(s) | G-3.71 PC-1.97 |
$120.01 $63.72 |
| 64467 | unilateral; by infusion(s) | G-6.86 PC-2.27 |
$221.90 $73.43 |
| 64468 | bilateral; by injection(s) | G-4.28 PC-2.19 |
$138.44 $70.84 |
| 64469 | bilateral; by infusion(s) | G-10.47 PC-2.38 |
$338.67 $76.98 |
| Lower extremity fascial plane block, including imaging guidance when performed | |||
| 64473 | unilateral; by injection(s) | G-3.50 PC-1.76 |
$113.21 $56.93 |
| 64474 | unilateral; by infusion(s) | G-6.78 PC-2.19 |
$219.31 $70.84 |
Codes 64486-64489 will be editorially revised to specify reporting of Transversus abdominis plane (TAP) block, and the guidelines in the Introduction/Injection of Anesthetic Agent (Nerve Block), Diagnostic or Therapeutic Somatic Nerves will also be revised to reflect these changes.
Vascular Procedures Guidelines
Guidelines in the Vascular Procedures subsection of the Radiology section will be revised to clarify that add-on code 75774, Angiography, selective, each additional vessel studied after basic examination, radiological supervision and interpretation (List separately in addition to code for primary procedure), may be reported for both arteries and veins for each additional vessel. The cross-reference parenthetical notes following code 75774 that direct users to codes 75600-75756 (angiography) and 36215-36248 (catheterization) will be deleted.
Evaluation and Management
Telemedicine Office Visits
17 new telemedicine codes and guidelines will be added to a new Evaluation and Management (E/M) subsection for Telemedicine Services within the E/M Office Visits or Other Outpatient Services subsection of the CPT code book. Medicare has not yet recognized these new codes, although other payers might possibly reimburse them. The new codes allow reporting of the work involved with telemedicine (audio-visual and audio-only) office visits and will be structured like the current office and other outpatient E/M codes (four levels depending on medical decision-making or time, as well as separate codes for new and established patients).
Codes 99441, 99442, and 99443 describing telephone evaluation and management services will be deleted.
Category III codes
For 2025 several new Category III codes related to radiology practice will be available, as follows:
| CPT Code | Description |
|---|---|
| 0901T | Placement of bone marrow sampling port, including imaging guidance when performed |
| 0944T | 3D contour simulation of target liver lesion(s) and margins for image guided percutaneous microwave ablation |
| 0946T | Orthopedic implant movement analysis using paired CT exam of the target structure, including data acquisition, data preparation and transmission, interpretation, and report (including CT scan of the joint or extremity performed with paired views) |
Diagnosis coding
The following ICD-10 code changes are relevant to radiologists:
Anal, Rectal, and Anorectal Fistulas
New 5th and 6th character codes provide greater specificity, distinguishing between simple and complex cases, and identifying initial, persistent, or recurrent conditions. Detailed documentation of these aspects is essential for accurate coding.
- K60.30 - Anal fistula, unspecified
- K60.31 - Anal fistula, simple
- K60.32 - Anal fistula, complex
- K60.33 - Anal fistula, persistent
- K60.34 - Anal fistula, recurrent
Pulmonary Embolism Expanded codes now specify causes, including cement or fat embolism, enhancing the precision of radiological reporting.
- I26.92 - Other pulmonary embolism without acute cor pulmonale
- I26.93 - Other pulmonary embolism with acute cor pulmonale
Synovitis and Tenosynovitis Additional codes allow for precise location specification of unspecified synovitis and tenosynovitis, aiding in detailed imaging reports.
- M65.871 - Other synovitis and tenosynovitis, right ankle and foot
- M65.872 - Other synovitis and tenosynovitis, left ankle and foot
- M65.879 - Other synovitis and tenosynovitis, unspecified ankle and foot
Lymphoma Updates offer further specificity in types of lymphoma and include expanded codes to identify cases in remission, which is crucial for imaging follow-ups.
- C83.33 - Diffuse large B-cell lymphoma, intrathoracic lymph nodes
- C83.36 - Diffuse large B-cell lymphoma, intrapelvic lymph nodes
- C85.88 - Other specified types of non-Hodgkin lymphoma, other sites
Hypoglycemia and Obesity Both conditions are now categorized into levels 1-3, necessitating detailed documentation to support appropriate imaging studies.
- E16.3 - Other specified hypoglycemia
- E66.01 - Morbid (severe) obesity due to excess calories
- E66.09 - Other obesity due to excess calories
Breast Cancer Biomarkers New Z codes indicate PR and HER-2 status, to be used alongside breast cancer diagnoses, facilitating tailored imaging protocols.
- Z85.850 - Personal history of malignant neoplasm of breast
- Z17.0 - Estrogen receptor positive status [ER+]
- Z17.1 - Estrogen receptor negative status [ER-]
- Z17.2 - Progesterone receptor positive status [PR+]
- Z17.3 - Progesterone receptor negative status [PR-]
- Z17.4 - HER-2 positive status
Personal History of Colon Polyps Expanded codes specify adenomatous/serrated, hyperplastic, or other types of colon polyps, important for imaging surveillance strategies.
- Z86.010 - Personal history of adenomatous polyps of colon
- Z86.011 - Personal history of hyperplastic polyps of colon
- Z86.012 - Personal history of other specified polyps of colon
Erin Stephens is senior client manager, education for Healthcare Administrative Partners.
The comments and observations expressed herein do not necessarily reflect the opinions of AuntMinnie.com, nor should they be construed as an endorsement or admonishment of any particular vendor, analyst, industry consultant, or consulting group.
References
[i] Current Procedural Terminology is a copyrighted code set developed and maintained by the American Medical Association, and CPT is a registered trademark.
[ii] ICD stands for International Classification of Diseases, the system owned and copyrighted by the World Health Organization that is used to report diagnoses when submitting claims for reimbursement of physician services, among many other purposes. ICD-10 is the 10th edition of this coding system. CM stands for the Clinical Modification of the classification system.
[iii] Category III codes are temporary codes that allow for data collection for emerging technologies, services, procedures, and service paradigms. They are not routinely reimbursed by most payers, including Medicare, when they are initially issued but that can change as they become more accepted and eventually transitioned into a Category I classification with regular reimbursement.
