Every year, the CPT Editorial Panel of the American Medical Association (AMA) releases new, revised and deleted codes for all specialties including radiology. Along with the annual changes, there are also quarterly updates and guidelines. As a radiology medical coding company, we stay up to date with these changes to help radiology departments and practices report services accurately. Here, we discuss the expected radiology coding changes for 2022.

In 2021, radiology witnessed several coding changes as a result of bundling mandates from the AMA. In May, the American College of Radiology (ACR) notified providers of two Category 3 CPT updates from the American Medical Association pertaining to quantitative, multi-parametric MRI. CPT codes 0648T and 0649T for this new technology came into effect on July 1.

Though the changes and revisions to radiology coding and guidelines for 2022 released by the ACR have not been finalized, radiology providers, physicians, medical coding service providers, and healthcare regulatory and compliance teams need to be aware of the updates to expect.

New Category I Radiology Codes in 2022

Category I divided describe distinct medical procedures or services furnished by QHPs. New Category I CPT codes are released annually. The radiology code set will have new Category I diagnostic codes effective Jan. 1 2022.

  • Diagnostic Radiology: Trabecular Bone Score (TBS): There will be 4 new codes for reporting trabecular bone score (TBS). The new CPT codes will significantly help provide better access to TBS.

About TBS: It is estimated that an osteoporotic fracture occurs every three seconds. According to the National Osteoporosis Foundation, the cost of these fractures per year in the USA is $52 billion and with the aging population, this number is expected to grow steadily. The main reason for this is that 75% of high-risk patients are not diagnosed in a timely manner. Bone mineral density (BMD) measures quantity but not quality of bone. On the other hand, TBS is a bone texture analysis related to bone micro-architecture that can improve fracture risk assessment in osteoporosis, categorize patients based on their fracture risk, and improve patient management.

  • Diagnostic Radiology: Destruction of Intraosseous Basivertebral Nerve: There will be 2 new codes to report thermal destruction of the intraosseous basivertebral nerve. This is a new procedure that provides effective relief for patients suffering from certain types of chronic low-back pain.

About thermal destruction of the intraosseous basivertebral nerve: Intravertebral disc degeneration is a common problem related to aging. It is a key reason for spine stiffness, neck pain, back pain, and other impairments and disability among middle aged and older individuals. Invertebral body endplate changes and degeneration (upper and low portion of the bones that make up the spine) can be seen on MRI. The basivertebral nerve that innervates the degenerated vertebral body endplates sends pain signals to the brain. Thermal destruction of the intraosseous basivertebral nerve is an advanced treatment for chronic low back pain, which has historically been a challenge to treat.

  • Another update is the addition of a parenthetical note to direct users to these new codes that will be added in the Percutaneous Vertebroplasty and Vertebral Augmentation subsection of the Musculoskeletal section of the CPT 2022 code set.

Radiology medical billing is complex as it is difficult to stay up-to-date on the individual payer changes and regulation changes. Outsourced medical billing companies have expert teams of certified coding and billing personnel that stay current on coding changes, payer rules, and industry developments. Partnering with a reliable radiology medical billing and coding company can help providers stay compliant, and ensure accurate claims submission and appropriate reimbursement.