33929 · 2018. 2. 8. · Auditory. Code Description Advice 0485T Optical coherence tomography (OCT)...

00731 Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; not otherwise specified

01/01/2018

00732 Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; endoscopic retrograde cholangiopancreatography (ERCP)

01/01/2018

00811 Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; not otherwise specified

01/01/2018

00812 Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; screening colonoscopy

01/01/2018

00813 Anesthesia for combined upper and lower gastrointestinal endoscopic procedures, endoscope introduced both proximal to and distal to the duodenum

01/01/2018

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1/3/2018 AAPC Coder

https://coder.aapc.com/cpt-code-changes-2018/code-category/Auditory 1/1

Auditory

Code Description Advice

0485T Optical coherencetomography(OCT) of middleear, withinterpretation andreport; unilateral

CPT® 2018 adds Category III code 0485T and 0486T totrack the use and efficacy of optical coherence tomography(OCT) of the middle ear, unilateral and bilateralrespectively. OCT is a noninvasive imaging that uses lightwaves to process and provide three-dimensional images.

0486T Optical coherencetomography(OCT) of middleear, withinterpretation andreport; bilateral

CPT® 2018 adds Category III code 0485T and 0486T totrack the use and efficacy of optical coherence tomography(OCT) of the middle ear, unilateral and bilateralrespectively. OCT is a noninvasive imaging that uses lightwaves to process and provide three-dimensional images.

NEW Revised Deleted

https://coder.aapc.com/cpt-code-changes-2018/code-category/Auditory#



33927 Implantation of a total replacement heart system (artificial heart) with recipient cardiectomy

01/01/2018

33928 Removal and replacement of total replacement heart system (artificial heart)

01/01/2018

33929 Removal of a total replacement heart system (artificial heart) for heart transplantation (List separately in addition to code for primary procedure)

01/01/2018

34701 Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the aortic bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the aortic bifurcation; for other than rupture (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer)

01/01/2018

34702 Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the aortic bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the aortic bifurcation; for rupture including temporary aortic and/or iliac balloon occlusion, when performed (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer, traumatic disruption)

01/01/2018

34703 Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the iliac bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the iliac bifurcation;

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for other than rupture (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer)

34704 Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the iliac bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the iliac bifurcation; for rupture including temporary aortic and/or iliac balloon occlusion, when performed (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer, traumatic disruption)

01/01/2018

34705 Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the iliac bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the iliac bifurcation; for other than rupture (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer)

01/01/2018

34706 Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the iliac bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the iliac bifurcation; for rupture including temporary aortic and/or iliac balloon occlusion, when performed (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer, traumatic disruption)

01/01/2018

34707 Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and all endograft extension(s) proximally to the aortic bifurcation and distally to the iliac bifurcation, and treatment zone angioplasty/stenting, when performed, unilateral; for other than rupture (eg, for aneurysm, pseudoaneurysm, dissection, arteriovenous malformation)

01/01/2018

34708 Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and all endograft extension(s) proximally to the aortic bifurcation and distally to the iliac bifurcation, and treatment zone angioplasty/stenting, when performed, unilateral; for rupture including temporary aortic and/or iliac balloon occlusion, when performed (eg, for aneurysm, pseudoaneurysm, dissection, arteriovenous malformation, traumatic disruption)

01/01/2018












































































34709 Placement of extension prosthesis(es) distal to the common iliac artery(ies) or proximal to the renal artery(ies) for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, penetrating ulcer, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and treatment zone angioplasty/stenting, when performed, per vessel treated (List separately in addition to code for primary procedure)

01/01/2018

34710 Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, endoleak, or endograft migration, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and treatment zone angioplasty/stenting, when performed; initial vessel treated

01/01/2018

34711 Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, endoleak, or endograft migration, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and treatment zone angioplasty/stenting, when performed; each additional vessel treated (List separately in addition to code for primary procedure)

01/01/2018

34712 Transcatheter delivery of enhanced fixation device(s) to the endograft (eg, anchor, screw, tack) and all associated radiological supervision and interpretation

01/01/2018

34713 Percutaneous access and closure of femoral artery for delivery of endograft through a large sheath (12 French or larger), including ultrasound guidance, when performed, unilateral (List separately in addition to code for primary procedure)

01/01/2018

34714 Open femoral artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by groin incision, unilateral (List separately in addition to code for primary procedure)

01/01/2018































































































34715 Open axillary/subclavian artery exposure for delivery of endovascular prosthesis by infraclavicular or supraclavicular incision, unilateral (List separately in addition to code for primary procedure)

01/01/2018

34716 Open axillary/subclavian artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by infraclavicular or supraclavicular incision, unilateral (List separately in addition to code for primary procedure)

01/01/2018

36465 Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; single incompetent extremity truncal vein (eg, great saphenous vein, accessory saphenous vein)

01/01/2018

36466 Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; multiple incompetent truncal veins (eg, great saphenous vein, accessory saphenous vein), same leg

01/01/2018

36482 Endovenous ablation therapy of incompetent vein, extremity, by transcatheter delivery of a chemical adhesive (eg, cyanoacrylate) remote from the access site, inclusive of all imaging guidance and monitoring, percutaneous; first vein treated

01/01/2018

36483 Endovenous ablation therapy of incompetent vein, extremity, by transcatheter delivery of a chemical adhesive (eg, cyanoacrylate) remote from the access site, inclusive of all imaging guidance and monitoring, percutaneous; subsequent vein(s) treated in a single extremity, each through separate access sites (List separately in addition to code for primary procedure)

01/01/2018

















































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38222 Diagnostic bone marrow; biopsy(ies) and aspiration(s)

01/01/2018

38573 Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling, peritoneal washings, peritoneal biopsy(ies), omentectomy, and diaphragmatic washings, including diaphragmatic and other serosal biopsy(ies), when performed

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1/3/2018 AAPC Coder

https://coder.aapc.com/cpt-code-changes-2018/code-category/CategoryII 1/8

Category II


0479T Fractional ablative laserfenestration of burn andtraumatic scars forfunctional improvement;first 100 cm2 or partthereof, or 1% of bodysurface area of infantsand children

CPT® 2018 adds category III codes 0479T and+0480T to report the creation of openings orwindows (fenestrations) in burns and traumaticscars in infants and children using a fractionalablative laser technique. The burn or scar tissue isfirst destroyed and then an opening is createdsurgically to drain the fluid. Use this code to reportfor the treatment of the first 100 sq cm or 1 percentof body surface area (BSA) in infants and children.For each additional 100 sq cm or 1 percent of BSA,report +0480T in addition to this code.

0480T Fractional ablative laserfenestration of burn andtraumatic scars forfunctional improvement;each additional 100 cm2,or each additional 1% ofbody surface area ofinfants and children, orpart thereof (Listseparately in addition tocode for primaryprocedure)

CPT® 2018 adds category III codes 0479T and+0480T to report the creation of openings orwindows (fenestrations) in burns and traumaticscars in infants and children using a fractionalablative laser technique. The burn or scar tissue isfirst destroyed and then an opening is createdsurgically to drain the fluid. Use +0480T to reporttreatment of the each additional 100 sq cm or 1percent of body surface area (BSA) in addition to0479T for the first 100 sq cm or 1 percent of totalBSA.

0481T Injection(s), autologouswhite blood cellconcentrate (autologousprotein solution), any site,including imageguidance, harvesting andpreparation, whenperformed

CPT® 2018 adds Category III code 0481T forautologous white blood cell (WBC) concentrateinjection, at any location by imaging guidance. Italso includes harvesting and preparation.Autologous means that blood or some of itscomponents are reinfused into the same patientfrom which the blood was removed. White bloodcells help fight infections, so a patient with acompromised immune system, such as oneundergoing chemotherapy for cancer, may have alow white blood cell count and be particularlyvulnerable to infection. Injections or infusions ofwhite blood cells are rare because WBCs remainviable for only a few hours in the blood. This codewas added to track the use and efficacy of this rareprocedure. This code will be effective beginningJanuary 1, 2018.

0482T Absolute quantitation ofmyocardial blood flow,positron emissiontomography (PET), restand stress (List

CPT® 2018 adds Category III code +0482T as anadd-on code to be reported with CPT 78491 or78492 on the same day. Measuring myocardialblood flow with PET helps provide a better

NEW Revised Deleted

https://coder.aapc.com/cpt-code-changes-2018/code-category/CategoryII#



1/3/2018 AAPC Coder


separately in addition tocode for primaryprocedure)

assessment of heart disease and overcomeshortcomings of visual method. In this procedure, aradioactive tracer is instilled or injected into thepatient, a PET scan performed with the patient atrest and under stress, and myocardial blood flow isanalyzed and quantified (measured) using acomputer.

0483T Transcatheter mitralvalveimplantation/replacement(TMVI) with prostheticvalve; percutaneousapproach, includingtransseptal puncture,when performed

The 2018 code set adds 0483T and 0484T wereadded to track the use and efficacy of transcathetermitral valve replacement (MVR). Unliketranscatheter aortic valve replacement, which is anestablished procedure, MVR via a catheter remainsan emerging technology. For 0483T, the providermakes a small incision through the skin, inserts acatheter, and threads it through the vessel to the leftventricle of the heart. He implants an artificial valvebetween the left ventricle and atrium. The proceduremay require puncture of the septum between thetwo chambers. For 0484T, the provider inserts thecatheter after opening the chest (thoracotomy) andapproaches the valve through the apex (top) of theventricle (transapical approach).

0484T Transcatheter mitralvalveimplantation/replacement(TMVI) with prostheticvalve; transthoracicexposure (eg,thoracotomy, transapical)


0485T Optical coherencetomography (OCT) ofmiddle ear, withinterpretation and report;unilateral

CPT® 2018 adds Category III code 0485T and0486T to track the use and efficacy of opticalcoherence tomography (OCT) of the middle ear,unilateral and bilateral respectively. OCT is anoninvasive imaging that uses light waves toprocess and provide three-dimensional images.

0486T Optical coherencetomography (OCT) ofmiddle ear, withinterpretation and report;bilateral


1/3/2018 AAPC Coder


0487T Biomechanical mapping,transvaginal, with report

CPT® 2018 adds Category III code 0487T to trackthe use and efficacy of a relatively new, but FDA-approved technology, i.e. transvaginalbiomechanical mapping. In this procedure, theprovider inserts a probe with tactile sensors on itssurface into the vagina. The probe senses pelvicmuscle contractions and relaxation and sends thedata to a computer where the data is interpreted andpelvic floor muscle function mapped. The technologyhelps diagnose vaginal and pelvic floorabnormalities.

0488T Preventive behaviorchange, online/electronicstructured intensiveprogram for prevention ofdiabetes using astandardized diabetesprevention programcurriculum, provided toan individual, per 30 days

CPT® 2018 adds Category III code 0488T to reporta structured diabetes prevention program thataddresses stress, nutrition, weight management,and exercise, delivered online or via electronictechnology by a lifestyle coach who has completednationally recognized training.

0489T Autologous adipose-derived regenerative celltherapy for sclerodermain the hands; adiposetissue harvesting,isolation and preparationof harvested cellsincluding incubation withcell dissociationenzymes, removal ofnon-viable cells anddebris, determination ofconcentration and dilutionof regenerative cells

CPT® 2018 adds Category III code 0489T and0490T to track the use and efficacy of autologousadipose-derived regenerative therapy for handscleroderma. Use 0489T for a single injection; toreport multiple injections, use 0490T. Scleroderma isa type of autoimmune disease characterized byhardening and thickening of the skin and causingskin tightness; it can also involve connective tissueand vessels and affect joints and organs. Theprocedure uses fat cells taken (harvested) from thepatient; the cells are processed to a certainconcentration and dilution and returned to thepatient.

0490T Autologous adipose-derived regenerative celltherapy for sclerodermain the hands; multipleinjections in one or bothhands


0491T Ablative laser treatment,non-contact, full field andfractional ablation, openwound, per day, totaltreatment surface area;first 20 sq cm or less

The 2018 code set adds 0491T and +0492T to trackthe use and efficacy of full field and fractional,noncontact laser ablation of open wounds.Fractional laser ablation is an accepted technologyfor skin resurfacing and scar revision, but its use to

1/3/2018 AAPC Coder


promote healing of open wounds is still underinvestigation. In this procedure, the provider useslaser ablation (heat produced by adjustable focusedlight energy) to destroy necrotic (dead) tissue andpromote granulation in an open wound. Report0491T for treatment of the first 20 sq cm or less perday and +0492T, in addition to 0491T, for eachadditional 20 sq cm or less.

0492T Ablative laser treatment,non-contact, full field andfractional ablation, openwound, per day, totaltreatment surface area;each additional 20 sq cm,or part thereof (Listseparately in addition tocode for primaryprocedure)

The 2018 code set adds 0491T and +0492T to trackthe use and efficacy of full field and fractional,noncontact laser ablation of open wounds.Fractional laser ablation is an accepted technologyfor skin resurfacing and scar revision, but its use topromote healing of open wounds is still underinvestigation. In this procedure, the provider useslaser ablation (heat produced by adjustable focusedlight energy) to destroy necrotic (dead) tissue andpromote granulation in an open wound. Report0491T for treatment of the first 20 sq cm or less perday and +0492T, in addition to 0491T, for eachadditional 20 sq cm or less.

0493T Near-infraredspectroscopy studies oflower extremity wounds(eg, for oxyhemoglobinmeasurement)

The 2018 code set adds 0493T to track the use andefficacy of near-infrared spectroscopy to measureoxygen saturation in the tissues of lower extremitywounds. Near-infrared spectroscopy uses theabsorption and emission of near-infrared spectrumphotons reflected by wound tissue, in this case, toassess the amount of oxygen in the tissues. Oxygenis carried by hemoglobin in the blood and is criticalto wound healing, so being able to assessoxygenation in wound tissues is predictive ofhealing. Of note, 0286T with the same descriptorwas retired in 2017.

0494T Surgical preparation andcannulation of marginal(extended) cadaver donorlung(s) to ex vivo organperfusion system,including decannulation,separation from theperfusion system, andcold preservation of theallograft prior toimplantation, whenperformed

The 2018 code set adds 0494T to report the surgicalpreparation and preservation of cadaver donorlung(s) including attaching the lung to an organperfusion system and its removal for implantation.Donor organ perfusion technology uses ventilationand perfusion of the donor lung to reproduce the invivo (in the body) environment, increasing itsviability for a longer period. The system alsoassesses the function of marginal lungs andexpands the number of acceptable donor lungs.See also 0495T and +0496T for monitoring of donorlung function after attachment to an organ perfusionsystem by a qualified healthcare professional usingvarious parameters.

0495T Initiation and monitoringmarginal (extended)cadaver donor lung(s)

The 2018 code set add 0495T and 0496T to reportmarginal donor lung monitoring by a qualified

1/3/2018 AAPC Coder


organ perfusion systemby physician or qualifiedhealth care professional,including physiologicaland laboratoryassessment (eg,pulmonary artery flow,pulmonary arterypressure, left atrialpressure, pulmonaryvascular resistance,mean/peak and plateauairway pressure, dynamiccompliance and perfusategas analysis), includingbronchoscopy and X raywhen performed; first twohours in sterile field

healthcare professional. Report 0495T for the firsttwo hours of monitoring, using various parameters,including visual physiologic assessment, variouslaboratory pulmonary function studies, and evenbronchoscopy and X-ray. For each additional hour ofmonitoring, report +0496T with 0495T. The code setalso adds 0494T to report the surgical preparationand preservation of cadaver donor lung(s) includingattaching the lung to an organ perfusion system andits removal for implantation. Donor organ perfusiontechnology uses ventilation and perfusion of thedonor lung to reproduce the in vivo (in the body)environment, increasing its viability for a longerperiod. The system also assesses the function ofmarginal lungs and expands the number ofacceptable donor lungs.

0496T Initiation and monitoringmarginal (extended)cadaver donor lung(s)organ perfusion systemby physician or qualifiedhealth care professional,including physiologicaland laboratoryassessment (eg,pulmonary artery flow,pulmonary arterypressure, left atrialpressure, pulmonaryvascular resistance,mean/peak and plateauairway pressure, dynamiccompliance and perfusategas analysis), includingbronchoscopy and X raywhen performed; eachadditional hour (Listseparately in addition tocode for primaryprocedure)

The 2018 code set add 0495T and +0496T to reportmarginal donor lung monitoring by a qualifiedhealthcare professional. Report 0495T for the firsttwo hours of monitoring, using various parameters,including visual physiologic assessment, variouslaboratory pulmonary function studies, and evenbronchoscopy and X-ray. For each additional hour ofmonitoring, report +0496T with 0495T. The code setalso adds 0494T to report the surgical preparationand preservation of cadaver donor lung(s) includingattaching the lung to an organ perfusion system andits separation from the organ perfusion system forimplantation. Donor organ perfusion technologyuses ventilation and perfusion of the donor lung toreproduce the in vivo (in the body) environment,increasing its viability for a longer period. Thesystem also assesses the function of marginal lungsand expands the number of acceptable donor lungs.

0497T External patient-activated, physician- orother qualified healthcare professional-prescribed,electrocardiographicrhythm derived eventrecorder without 24 hourattended monitoring; in-office connection

The 2018 code set adds 0497T and 0498T toelectrocardiographic rhythm-derived event recordermonitoring activated by the patient and wornexternally. Report 0497T for the prescription and in-office connection for the device and 0498T forreview and interpretation for a 30-day period with atleast one patient-generated triggered event. Thepurpose of these devices is to track the occurrenceand frequency of rhythm disturbances of the heart.In this case, the patient presses a button when hesenses a rhythm disturbance to initiate the recordingand to send the recording via an in-officeconnection. There are devices which continuouslyrecord the patient’s heart rhythm and other devices

1/3/2018 AAPC Coder


that are auto-sensing, but this device initiates arecording when activated by the patient.

0498T External patient-activated, physician- orother qualified healthcare professional-prescribed,electrocardiographicrhythm derived eventrecorder without 24 hourattended monitoring;review and interpretationby a physician or otherqualified health careprofessional per 30 dayswith at least one patient-generated triggered event

The 2018 code set adds 0497T and 0498T toelectrocardiographic rhythm-derived event recordermonitoring activated by the patient and wornexternally. Report 0497T for the prescription and in-office connection for the device and 0498T forreview and interpretation for a 30-day period with atleast one patient-generated triggered event. Thepurpose of these devices is to track the occurrenceand frequency of rhythm disturbances of the heart.In this case, the patient presses a button when hesenses a rhythm disturbance to initiate the recordingand to send the recording via an in-officeconnection. There are other types of devices whichcontinuously record the patient’s heart rhythm andother devices that are auto-sensing, but this deviceiniatiates the recording when the patient activates it.

0499T Cystourethroscopy, withmechanical dilation andurethral therapeutic drugdelivery for urethralstricture or stenosis,including fluoroscopy,when performed

The 2018 code set adds 0499T to track the use andefficacy of instillation of a drug through the urethraduring cystourethroscopy and mechanical dilationfor stricture or stenosis. Drugs such as steroids havebeen instilled into the urethra following surgicaltreatment of a stricture or stenosis to promotehealing and prevent scarring or repeat stricture.Cystourethroscopy is a procedure in which theprovider views and examines the bladder andurethra using a flexible or rigid tube with a camera atthe end that is inserted through the urethra into thebladder to examine the urethra and urinary tract.Instruments such as dilators can be inserted throughthe scope to dilate a narrowed urethra. Theprocedure is sometimes done using fluoroscopicguidance, a live X-ray where the image appears ona monitor.

0500T Infectious agent detectionby nucleic acid (DNA orRNA), HumanPapillomavirus (HPV) forfive or more separatelyreported high-risk HPVtypes (eg, 16, 18, 31, 33,35, 39, 45, 51, 52, 56, 58,59, 68) (ie, genotyping)

CPT® 2018 adds 0500T as a Category III code forhuman papillomavirus (HPV) genotyping thatidentifies five or more separately reported high-riskHPV types such as the examples given in the codedescriptor. Distinguish 0500T from similar codes forinfectious agent antigen detection by nucleic acid87624, which you should reserve for reporting fouror fewer high risk HPV types, or 87625, which youshould reserve for reporting high-risk HPV types 16,18 and 45.

0501T Noninvasive estimatedcoronary fractional flowreserve (FFR) derivedfrom coronary computedtomography angiography

CPT® 2018 adds four Category III codes 0501T-0504T to track the use and efficacy of noninvasiveestimated coronary fractional flow reserve (FFR)computed tomography (CT), an emerging

1/3/2018 AAPC Coder


data using computationfluid dynamicsphysiologic simulationsoftware analysis offunctional data to assessthe severity of coronaryartery disease; datapreparation andtransmission, analysis offluid dynamics andsimulated maximalcoronary hyperemia,generation of estimatedFFR model, withanatomical data review incomparison withestimated FFR model toreconcile discordant data,interpretation and report

technology. FFR-CT is a diagnostic imagingtechnique which helps diagnose intermediatecoronary artery stenosis and improves decision-making. FFR-CT provides a detailed description ofthe blood flow in heart vessels with anatomicaldetails. Report 0501T for the full study—imaging,analysis, estimated FFR model generation, andreconciliation of anatomical data with the estimatedFFR as well as interpretation and report. Forcomponents of the study, report 0502T for datapreparation and transmission, 0503T for fluiddynamics analysis, simulated maximal coronaryhyperemia, and estimated FFR model generation,and 0504T for reconciliation of anatomical data withthe estimated FFR and interpretation and report.Codes 0502T-0504T cannot be reported inconjunction with 0501T; no code should be reportedmore than once per coronary CT angiography.

0502T Noninvasive estimatedcoronary fractional flowreserve (FFR) derivedfrom coronary computedtomography angiographydata using computationfluid dynamicsphysiologic simulationsoftware analysis offunctional data to assessthe severity of coronaryartery disease; datapreparation andtransmission

CPT® 2018 adds four Category III codes 0501T-0504T to track the use and efficacy of noninvasiveestimated coronary fractional flow reserve (FFR)computed tomography (CT), an emergingtechnology. FFR-CT is a diagnostic imagingtechnique which helps diagnose intermediatecoronary artery stenosis and improves decision-making. FFR-CT provides a detailed description ofthe blood flow in heart vessels with anatomicaldetails. Report 0501T for the full study—imaging,analysis, estimated FFR model generation, andreconciliation of anatomical data with the estimatedFFR as well as interpretation and report. Forcomponents of the study, report 0502T for datapreparation and transmission, 0503T for fluiddynamics analysis, simulated maximal coronaryhyperemia, and estimated FFR model generation,and 0504T for reconciliation of anatomical data withthe estimated FFR and interpretation and report.Codes 0502T-0504T cannot be reported inconjunction with 0501T; no code should be reportedmore than once per coronary CT angiography.

0503T Noninvasive estimatedcoronary fractional flowreserve (FFR) derivedfrom coronary computedtomography angiographydata using computationfluid dynamicsphysiologic simulationsoftware analysis offunctional data to assessthe severity of coronaryartery disease; analysisof fluid dynamics and

CPT® 2018 adds four Category III codes 0501T-0504T to track the use and efficacy of noninvasiveestimated coronary fractional flow reserve (FFR)computed tomography (CT), an emergingtechnology. FFR-CT is a diagnostic imagingtechnique which helps diagnose intermediatecoronary artery stenosis and improves decision-making. FFR-CT provides a detailed description ofthe blood flow in heart vessels with anatomicaldetails. Report 0501T for the full study—imaging,

1/3/2018 AAPC Coder


simulated maximalcoronary hyperemia, andgeneration of estimatedFFR model

analysis, estimated FFR model generation, andreconciliation of anatomical data with the estimatedFFR as well as interpretation and report. Forcomponents of the study, report 0502T for datapreparation and transmission, 0503T for fluiddynamics analysis, simulated maximal coronaryhyperemia, and estimated FFR model generation,and 0504T for reconciliation of anatomical data withthe estimated FFR and interpretation and report.Codes 0502T-0504T cannot be reported inconjunction with 0501T; no code should be reportedmore than once per coronary CT angiography.

0504T Noninvasive estimatedcoronary fractional flowreserve (FFR) derivedfrom coronary computedtomography angiographydata using computationfluid dynamicsphysiologic simulationsoftware analysis offunctional data to assessthe severity of coronaryartery disease;anatomical data review incomparison withestimated FFR model toreconcile discordant data,interpretation and report


1/3/2018 AAPC Coder

https://coder.aapc.com/cpt-code-changes-2018/code-category/CategoryIII 1/8

Category III


0479T Fractional ablative laserfenestration of burn andtraumatic scars forfunctional improvement;first 100 cm2 or partthereof, or 1% of bodysurface area of infantsand children

CPT® 2018 adds category III codes 0479T and+0480T to report the creation of openings orwindows (fenestrations) in burns and traumaticscars in infants and children using a fractionalablative laser technique. The burn or scar tissue isfirst destroyed and then an opening is createdsurgically to drain the fluid. Use this code to reportfor the treatment of the first 100 sq cm or 1 percentof body surface area (BSA) in infants and children.For each additional 100 sq cm or 1 percent of BSA,report +0480T in addition to this code.

0480T Fractional ablative laserfenestration of burn andtraumatic scars forfunctional improvement;each additional 100 cm2,or each additional 1% ofbody surface area ofinfants and children, orpart thereof (Listseparately in addition tocode for primaryprocedure)

CPT® 2018 adds category III codes 0479T and+0480T to report the creation of openings orwindows (fenestrations) in burns and traumaticscars in infants and children using a fractionalablative laser technique. The burn or scar tissue isfirst destroyed and then an opening is createdsurgically to drain the fluid. Use +0480T to reporttreatment of the each additional 100 sq cm or 1percent of body surface area (BSA) in addition to0479T for the first 100 sq cm or 1 percent of totalBSA.

0481T Injection(s), autologouswhite blood cellconcentrate (autologousprotein solution), any site,including imageguidance, harvesting andpreparation, whenperformed

CPT® 2018 adds Category III code 0481T forautologous white blood cell (WBC) concentrateinjection, at any location by imaging guidance. Italso includes harvesting and preparation.Autologous means that blood or some of itscomponents are reinfused into the same patientfrom which the blood was removed. White bloodcells help fight infections, so a patient with acompromised immune system, such as oneundergoing chemotherapy for cancer, may have alow white blood cell count and be particularlyvulnerable to infection. Injections or infusions ofwhite blood cells are rare because WBCs remainviable for only a few hours in the blood. This codewas added to track the use and efficacy of this rareprocedure. This code will be effective beginningJanuary 1, 2018.

0482T Absolute quantitation ofmyocardial blood flow,positron emissiontomography (PET), restand stress (List

CPT® 2018 adds Category III code +0482T as anadd-on code to be reported with CPT 78491 or78492 on the same day. Measuring myocardialblood flow with PET helps provide a better

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separately in addition tocode for primaryprocedure)

assessment of heart disease and overcomeshortcomings of visual method. In this procedure, aradioactive tracer is instilled or injected into thepatient, a PET scan performed with the patient atrest and under stress, and myocardial blood flow isanalyzed and quantified (measured) using acomputer.

0483T Transcatheter mitralvalveimplantation/replacement(TMVI) with prostheticvalve; percutaneousapproach, includingtransseptal puncture,when performed


0484T Transcatheter mitralvalveimplantation/replacement(TMVI) with prostheticvalve; transthoracicexposure (eg,thoracotomy, transapical)


0485T Optical coherencetomography (OCT) ofmiddle ear, withinterpretation and report;unilateral


0486T Optical coherencetomography (OCT) ofmiddle ear, withinterpretation and report;bilateral


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CPT® 2018 adds Category III code 0487T to trackthe use and efficacy of a relatively new, but FDA-approved technology, i.e. transvaginalbiomechanical mapping. In this procedure, theprovider inserts a probe with tactile sensors on itssurface into the vagina. The probe senses pelvicmuscle contractions and relaxation and sends thedata to a computer where the data is interpreted andpelvic floor muscle function mapped. The technologyhelps diagnose vaginal and pelvic floorabnormalities.

0488T Preventive behaviorchange, online/electronicstructured intensiveprogram for prevention ofdiabetes using astandardized diabetesprevention programcurriculum, provided toan individual, per 30 days

CPT® 2018 adds Category III code 0488T to reporta structured diabetes prevention program thataddresses stress, nutrition, weight management,and exercise, delivered online or via electronictechnology by a lifestyle coach who has completednationally recognized training.

0489T Autologous adipose-derived regenerative celltherapy for sclerodermain the hands; adiposetissue harvesting,isolation and preparationof harvested cellsincluding incubation withcell dissociationenzymes, removal ofnon-viable cells anddebris, determination ofconcentration and dilutionof regenerative cells


0490T Autologous adipose-derived regenerative celltherapy for sclerodermain the hands; multipleinjections in one or bothhands


0491T Ablative laser treatment,non-contact, full field andfractional ablation, openwound, per day, totaltreatment surface area;first 20 sq cm or less

The 2018 code set adds 0491T and +0492T to trackthe use and efficacy of full field and fractional,noncontact laser ablation of open wounds.Fractional laser ablation is an accepted technologyfor skin resurfacing and scar revision, but its use to

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promote healing of open wounds is still underinvestigation. In this procedure, the provider useslaser ablation (heat produced by adjustable focusedlight energy) to destroy necrotic (dead) tissue andpromote granulation in an open wound. Report0491T for treatment of the first 20 sq cm or less perday and +0492T, in addition to 0491T, for eachadditional 20 sq cm or less.

0492T Ablative laser treatment,non-contact, full field andfractional ablation, openwound, per day, totaltreatment surface area;each additional 20 sq cm,or part thereof (Listseparately in addition tocode for primaryprocedure)

The 2018 code set adds 0491T and +0492T to trackthe use and efficacy of full field and fractional,noncontact laser ablation of open wounds.Fractional laser ablation is an accepted technologyfor skin resurfacing and scar revision, but its use topromote healing of open wounds is still underinvestigation. In this procedure, the provider useslaser ablation (heat produced by adjustable focusedlight energy) to destroy necrotic (dead) tissue andpromote granulation in an open wound. Report0491T for treatment of the first 20 sq cm or less perday and +0492T, in addition to 0491T, for eachadditional 20 sq cm or less.

0493T Near-infraredspectroscopy studies oflower extremity wounds(eg, for oxyhemoglobinmeasurement)

The 2018 code set adds 0493T to track the use andefficacy of near-infrared spectroscopy to measureoxygen saturation in the tissues of lower extremitywounds. Near-infrared spectroscopy uses theabsorption and emission of near-infrared spectrumphotons reflected by wound tissue, in this case, toassess the amount of oxygen in the tissues. Oxygenis carried by hemoglobin in the blood and is criticalto wound healing, so being able to assessoxygenation in wound tissues is predictive ofhealing. Of note, 0286T with the same descriptorwas retired in 2017.

0494T Surgical preparation andcannulation of marginal(extended) cadaver donorlung(s) to ex vivo organperfusion system,including decannulation,separation from theperfusion system, andcold preservation of theallograft prior toimplantation, whenperformed

The 2018 code set adds 0494T to report the surgicalpreparation and preservation of cadaver donorlung(s) including attaching the lung to an organperfusion system and its removal for implantation.Donor organ perfusion technology uses ventilationand perfusion of the donor lung to reproduce the invivo (in the body) environment, increasing itsviability for a longer period. The system alsoassesses the function of marginal lungs andexpands the number of acceptable donor lungs.See also 0495T and +0496T for monitoring of donorlung function after attachment to an organ perfusionsystem by a qualified healthcare professional usingvarious parameters.

0495T Initiation and monitoringmarginal (extended)cadaver donor lung(s)

The 2018 code set add 0495T and 0496T to reportmarginal donor lung monitoring by a qualified

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organ perfusion systemby physician or qualifiedhealth care professional,including physiologicaland laboratoryassessment (eg,pulmonary artery flow,pulmonary arterypressure, left atrialpressure, pulmonaryvascular resistance,mean/peak and plateauairway pressure, dynamiccompliance and perfusategas analysis), includingbronchoscopy and X raywhen performed; first twohours in sterile field

healthcare professional. Report 0495T for the firsttwo hours of monitoring, using various parameters,including visual physiologic assessment, variouslaboratory pulmonary function studies, and evenbronchoscopy and X-ray. For each additional hour ofmonitoring, report +0496T with 0495T. The code setalso adds 0494T to report the surgical preparationand preservation of cadaver donor lung(s) includingattaching the lung to an organ perfusion system andits removal for implantation. Donor organ perfusiontechnology uses ventilation and perfusion of thedonor lung to reproduce the in vivo (in the body)environment, increasing its viability for a longerperiod. The system also assesses the function ofmarginal lungs and expands the number ofacceptable donor lungs.

0496T Initiation and monitoringmarginal (extended)cadaver donor lung(s)organ perfusion systemby physician or qualifiedhealth care professional,including physiologicaland laboratoryassessment (eg,pulmonary artery flow,pulmonary arterypressure, left atrialpressure, pulmonaryvascular resistance,mean/peak and plateauairway pressure, dynamiccompliance and perfusategas analysis), includingbronchoscopy and X raywhen performed; eachadditional hour (Listseparately in addition tocode for primaryprocedure)

The 2018 code set add 0495T and +0496T to reportmarginal donor lung monitoring by a qualifiedhealthcare professional. Report 0495T for the firsttwo hours of monitoring, using various parameters,including visual physiologic assessment, variouslaboratory pulmonary function studies, and evenbronchoscopy and X-ray. For each additional hour ofmonitoring, report +0496T with 0495T. The code setalso adds 0494T to report the surgical preparationand preservation of cadaver donor lung(s) includingattaching the lung to an organ perfusion system andits separation from the organ perfusion system forimplantation. Donor organ perfusion technologyuses ventilation and perfusion of the donor lung toreproduce the in vivo (in the body) environment,increasing its viability for a longer period. Thesystem also assesses the function of marginal lungsand expands the number of acceptable donor lungs.

0497T External patient-activated, physician- orother qualified healthcare professional-prescribed,electrocardiographicrhythm derived eventrecorder without 24 hourattended monitoring; in-office connection

The 2018 code set adds 0497T and 0498T toelectrocardiographic rhythm-derived event recordermonitoring activated by the patient and wornexternally. Report 0497T for the prescription and in-office connection for the device and 0498T forreview and interpretation for a 30-day period with atleast one patient-generated triggered event. Thepurpose of these devices is to track the occurrenceand frequency of rhythm disturbances of the heart.In this case, the patient presses a button when hesenses a rhythm disturbance to initiate the recordingand to send the recording via an in-officeconnection. There are devices which continuouslyrecord the patient’s heart rhythm and other devices

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that are auto-sensing, but this device initiates arecording when activated by the patient.

0498T External patient-activated, physician- orother qualified healthcare professional-prescribed,electrocardiographicrhythm derived eventrecorder without 24 hourattended monitoring;review and interpretationby a physician or otherqualified health careprofessional per 30 dayswith at least one patient-generated triggered event

The 2018 code set adds 0497T and 0498T toelectrocardiographic rhythm-derived event recordermonitoring activated by the patient and wornexternally. Report 0497T for the prescription and in-office connection for the device and 0498T forreview and interpretation for a 30-day period with atleast one patient-generated triggered event. Thepurpose of these devices is to track the occurrenceand frequency of rhythm disturbances of the heart.In this case, the patient presses a button when hesenses a rhythm disturbance to initiate the recordingand to send the recording via an in-officeconnection. There are other types of devices whichcontinuously record the patient’s heart rhythm andother devices that are auto-sensing, but this deviceiniatiates the recording when the patient activates it.


The 2018 code set adds 0499T to track the use andefficacy of instillation of a drug through the urethraduring cystourethroscopy and mechanical dilationfor stricture or stenosis. Drugs such as steroids havebeen instilled into the urethra following surgicaltreatment of a stricture or stenosis to promotehealing and prevent scarring or repeat stricture.Cystourethroscopy is a procedure in which theprovider views and examines the bladder andurethra using a flexible or rigid tube with a camera atthe end that is inserted through the urethra into thebladder to examine the urethra and urinary tract.Instruments such as dilators can be inserted throughthe scope to dilate a narrowed urethra. Theprocedure is sometimes done using fluoroscopicguidance, a live X-ray where the image appears ona monitor.

0500T Infectious agent detectionby nucleic acid (DNA orRNA), HumanPapillomavirus (HPV) forfive or more separatelyreported high-risk HPVtypes (eg, 16, 18, 31, 33,35, 39, 45, 51, 52, 56, 58,59, 68) (ie, genotyping)

CPT® 2018 adds 0500T as a Category III code forhuman papillomavirus (HPV) genotyping thatidentifies five or more separately reported high-riskHPV types such as the examples given in the codedescriptor. Distinguish 0500T from similar codes forinfectious agent antigen detection by nucleic acid87624, which you should reserve for reporting fouror fewer high risk HPV types, or 87625, which youshould reserve for reporting high-risk HPV types 16,18 and 45.

0501T Noninvasive estimatedcoronary fractional flowreserve (FFR) derivedfrom coronary computedtomography angiography

CPT® 2018 adds four Category III codes 0501T-0504T to track the use and efficacy of noninvasiveestimated coronary fractional flow reserve (FFR)computed tomography (CT), an emerging

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data using computationfluid dynamicsphysiologic simulationsoftware analysis offunctional data to assessthe severity of coronaryartery disease; datapreparation andtransmission, analysis offluid dynamics andsimulated maximalcoronary hyperemia,generation of estimatedFFR model, withanatomical data review incomparison withestimated FFR model toreconcile discordant data,interpretation and report

technology. FFR-CT is a diagnostic imagingtechnique which helps diagnose intermediatecoronary artery stenosis and improves decision-making. FFR-CT provides a detailed description ofthe blood flow in heart vessels with anatomicaldetails. Report 0501T for the full study—imaging,analysis, estimated FFR model generation, andreconciliation of anatomical data with the estimatedFFR as well as interpretation and report. Forcomponents of the study, report 0502T for datapreparation and transmission, 0503T for fluiddynamics analysis, simulated maximal coronaryhyperemia, and estimated FFR model generation,and 0504T for reconciliation of anatomical data withthe estimated FFR and interpretation and report.Codes 0502T-0504T cannot be reported inconjunction with 0501T; no code should be reportedmore than once per coronary CT angiography.



0503T Noninvasive estimatedcoronary fractional flowreserve (FFR) derivedfrom coronary computedtomography angiographydata using computationfluid dynamicsphysiologic simulationsoftware analysis offunctional data to assessthe severity of coronaryartery disease; analysisof fluid dynamics and

CPT® 2018 adds four Category III codes 0501T-0504T to track the use and efficacy of noninvasiveestimated coronary fractional flow reserve (FFR)computed tomography (CT), an emergingtechnology. FFR-CT is a diagnostic imagingtechnique which helps diagnose intermediatecoronary artery stenosis and improves decision-making. FFR-CT provides a detailed description ofthe blood flow in heart vessels with anatomicaldetails. Report 0501T for the full study—imaging,

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simulated maximalcoronary hyperemia, andgeneration of estimatedFFR model

analysis, estimated FFR model generation, andreconciliation of anatomical data with the estimatedFFR as well as interpretation and report. Forcomponents of the study, report 0502T for datapreparation and transmission, 0503T for fluiddynamics analysis, simulated maximal coronaryhyperemia, and estimated FFR model generation,and 0504T for reconciliation of anatomical data withthe estimated FFR and interpretation and report.Codes 0502T-0504T cannot be reported inconjunction with 0501T; no code should be reportedmore than once per coronary CT angiography.

0504T Noninvasive estimatedcoronary fractional flowreserve (FFR) derivedfrom coronary computedtomography angiographydata using computationfluid dynamicsphysiologic simulationsoftware analysis offunctional data to assessthe severity of coronaryartery disease;anatomical data review incomparison withestimated FFR model toreconcile discordant data,interpretation and report


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Digestive


00731 Anesthesia for uppergastrointestinal endoscopicprocedures, endoscopeintroduced proximal toduodenum; not otherwisespecified

The 2018 code set adds 00731 and 00732 toreplace 00740 (Anesthesia for uppergastrointestinal endoscopic procedures,endoscope introduced proximal to duodenum).CPT® adds 00731 to report anesthesia for anunspecified upper GI endoscopic procedure whenthe scope has been inserted to but not beyondthe duodenum (the first part of the small intestine)and 00732 when the same procedure has beenperformed for an endoscopic retrogradecholangiopancreatography [ERCP]). An ERCP isa diagnostic procedure that combines upperendoscopy and retrograde (reverse) injection ofcontrast material, a type of dye, into the biliaryducts to obtain fluoroscopic images of thegallbladder, pancreas, and bile ducts.

00732 Anesthesia for uppergastrointestinal endoscopicprocedures, endoscopeintroduced proximal toduodenum; endoscopicretrogradecholangiopancreatography(ERCP)

The 2018 code set adds 00731 and 00732 toreplace 00740 (Anesthesia for uppergastrointestinal endoscopic procedures,endoscope introduced proximal to duodenum).CPT® adds 00731 to report anesthesia for anunspecified upper GI endoscopic procedure whenthe scope has been inserted to but not beyondthe duodenum (the first part of the small intestine)and 00732 when the same procedure has beenperformed for an endoscopic retrogradecholangiopancreatography [ERCP]). An ERCP isa diagnostic procedure that combines upperendoscopy and retrograde (reverse) injection ofcontrast material, a type of dye, into the biliaryducts to obtain fluoroscopic images of thegallbladder, pancreas, and bile ducts.

00811 Anesthesia for lowerintestinal endoscopicprocedures, endoscopeintroduced distal toduodenum; not otherwisespecified

The 2018 code set adds 00811, 00812, and00813 to replace 00810. CPT® adds new codes00811 and 00812 to report anesthesia for lowerintestinal endoscopic procedures and 00813 toreport anesthesia for a combined upper and lowerGI endoscopic procedure. Choose 00811 if theservice is for an unspecified lower intestinalendoscopic procedure and the endoscope isintroduced to but not into the duodenum (the firstpart of the small intestine). Choose 00812 for ascreening colonoscopy when the endoscope doesnot enter the duodenum. Choose 00813 for a

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combined upper and lower gastrointestinalendoscopic procedures in which the endoscope isintroduced both proximal to and distal to theduodenum.

00812 Anesthesia for lowerintestinal endoscopicprocedures, endoscopeintroduced distal toduodenum; screeningcolonoscopy

The 2018 code set adds 00811, 00812, and00813 to replace 00810. CPT® adds new codes00811 and 00812 to report anesthesia for lowerintestinal endoscopic procedures and 00813 toreport anesthesia for a combined upper and lowerGI endoscopic procedure. Choose 00811 if theservice is for an unspecified lower intestinalendoscopic procedure and the endoscope isintroduced to but not into the duodenum (the firstpart of the small intestine). Choose 00812 for ascreening colonoscopy when the endoscope doesnot enter the duodenum. Choose 00813 for acombined upper and lower gastrointestinalendoscopic procedures in which the endoscope isintroduced both proximal to and distal to theduodenum.

00813 Anesthesia for combinedupper and lowergastrointestinal endoscopicprocedures, endoscopeintroduced both proximal toand distal to the duodenum

The 2018 code set adds 00811, 00812, and00813 to replace 00810. CPT® added new codes00811 and 00812 to report anesthesia for lowerintestinal endoscopic procedures and 00813 toreport anesthesia for a combined upper and lowerGI endoscopic procedure. Choose 00811 if theservice is for an unspecified lower intestinalendoscopic procedure and the endoscope isintroduced to but not into the duodenum (the firstpart of the small intestine). Choose 00812 for ascreening colonoscopy when the endoscope doesnot enter the duodenum. Choose 00813 for acombined upper and lower gastrointestinalendoscopic procedures in which the endoscope isintroduced both proximal to (above) and distal to(below) the duodenum.

38573 Laparoscopy, surgical; withbilateral total pelviclymphadenectomy and peri-aortic lymph node sampling,peritoneal washings,peritoneal biopsy(ies),omentectomy, anddiaphragmatic washings,including diaphragmatic andother serosal biopsy(ies),when performed

The 2018 code set adds 38573 to report surgicallaparoscopy with removal of all pelvic lymphnodes from both sides of the pelvis along withbiopsies of nodes near the aorta and theperitoneum (and the diaphragm and other serosaltissues when performed), peritoneal anddiaphragmatic washings, and excision ofomentum (the membrane lining the abdominalcavity). This codes takes into account a muchmore extensive procedure than 38572(Laparoscopy, surgical; with bilateral total pelviclymphadenectomy and periaortic lymph nodesampling [biopsy, single or multiple] and other

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laparoscopic procedures (38570-38571) forlaparoscopic biopsy of pelvic lymph nodes.

43286 Esophagectomy, total ornear total, with laparoscopicmobilization of theabdominal and mediastinalesophagus and proximalgastrectomy, withlaparoscopic pyloricdrainage procedure ifperformed, with opencervicalpharyngogastrostomy oresophagogastrostomy (ie,laparoscopic transhiatalesophagectomy)

Code 43286 is one of three new codes added toreport total or near-total esophagectomy,commonly performed to treat cancer. This codeincludes laparoscopic removal of all or most of theesophagus along with mediastinal and abdominalmobilization, removal of proximal part of stomach,and creation of a cervical anastomosis betweenthe pharynx and stomach or the esophagealremnant and stomach. See also 43287 and 43288for other extensive esophagectomy procedures.See also revised code 43112 for McKeownesophagectomy or tri-incisional esophagectomy.

43287 Esophagectomy, distal two-thirds, with laparoscopicmobilization of theabdominal and lowermediastinal esophagus andproximal gastrectomy, withlaparoscopic pyloricdrainage procedure ifperformed, with separatethoracoscopic mobilizationof the middle and uppermediastinal esophagus andthoracicesophagogastrostomy (ie,laparoscopic thoracoscopicesophagectomy, Ivor Lewisesophagectomy)

Code 43287 is one of three new codes addedtotal or near-total esophagectomy (in this case,two-thirds of the esophagus), commonlyperformed to treat cancer. This code includeslaparoscopic removal of two thirds of theesophagus along with mediastinal and abdominalmobilization, removal of the proximal part ofstomach and widening the opening at the bottomof the stomach if performed. The procedure alsoincludes a separate thoracoscopic incision usedfor mobilization of the middle and uppermediastinal esophagus and creation of an artificialcommunication between the esophagus and thestomach. See also 43286 and 43288 for otherextensive esophagectomy procedures.See also revised code 43112 for McKeownesophagectomy or tri-incisional esophagectomy.

43288 Esophagectomy, total ornear total, withthoracoscopic mobilizationof the upper, middle, andlower mediastinalesophagus, with separatelaparoscopic proximalgastrectomy, withlaparoscopic pyloricdrainage procedure ifperformed, with opencervicalpharyngogastrostomy oresophagogastrostomy (ie,thoracoscopic, laparoscopicand cervical incisionesophagectomy, McKeownesophagectomy, tri-incisional esophagectomy)

Code 43288 is one of three new codes added toreport removal of all or most of the esophagus,commonly performed to treat cancer. This codeincludes thoracoscopic removal of most of theesophagus along with upper, middle, and lowermediastinal mobilization. A separate laparoscopicincision in the stomach is used for removal of theproximal part of stomach, and creation of acervical anastomosis between the pharynx andstomach or the esophageal remnant andstomach. The code also includes pyloric drainage(a procedure to widen the opening at the bottomof the stomach) if performed. See also 43286 and43287 for other extensive esophagectomyprocedures.See also revised code 43112 for McKeownesophagectomy or tri-incisional esophagectomy.

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Evaluation & Management


93792 Patient/caregiver training for initiation of homeinternational normalized ratio (INR) monitoringunder the direction of a physician or other qualifiedhealth care professional, face-to-face, including useand care of the INR monitor, obtaining bloodsample, instructions for reporting home INR testresults, and documentation of patient's/caregiver'sability to perform testing and report results

The 2018 code set adds93792 and 93793 toreplace 99363 and99364. Report 93792when a physician or otherqualified healthcareprovider initiates homeinternational normalizedratio (INR) monitoring andtrains a patient orcaregiver in person (face-to-face) to obtain bloodsamples and monitor andreport home INR testresults and documentsthe patient's orcaregiver's ability toperform testing and reportresults. Report 93793 foranticoagulantmanagement for a patienttaking warfarin, whichincludes review andinterpretation of newinternational normalizedratio (INR) test result(whether performed in thehome, office, or lab) andinstructing the patient aswell as adjusting thedosage when necessaryand scheduling additionaltest(s), when performed.

93793 Anticoagulant management for a patient takingwarfarin, must include review and interpretation of anew home, office, or lab international normalizedratio (INR) test result, patient instructions, dosageadjustment (as needed), and scheduling ofadditional test(s), when performed

The 2018 code set adds93792 and 93793 toreplace 99363 and99364. Report 93792when a physician or otherqualified healthcareprovider initiates homeinternational normalizedratio (INR) monitoring andtrains a patient orcaregiver in person (face-

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to-face) to obtain bloodsamples and monitor andreport home INR testresults and documentsthe patient's orcaregiver's ability toperform testing and reportresults. Report 93793 foranticoagulantmanagement for a patienttaking warfarin, whichincludes review andinterpretation of newinternational normalizedratio (INR) test result(whether performed in thehome, office, or lab) andinstructing the patient aswell as adjusting thedosage when necessaryand scheduling additionaltest(s), when performed.

97127 Therapeutic interventions that focus on cognitivefunction (eg, attention, memory, reasoning,executive function, problem solving, and/orpragmatic functioning) and compensatory strategiesto manage the performance of an activity (eg,managing time or schedules, initiating, organizingand sequencing tasks), direct (one-on-one) patientcontact

The 2018 code set adds97127 to replace 97532for reporting cognitiveskills development. Code97127 removes the timespecification (each 15minutes), retains thedirect (one-on-one)patient contactspecification, andincludes expandedexamples of cognitivefunction (attention,memory, reasoning,executive function,problem solving, and/orpragmatic functioning[verbal and socialinteraction]) andcompensatory strategies(managing time orschedules, initiating,organizing, andsequencing tasks).

97763 Orthotic(s)/prosthetic(s) management and/ortraining, upper extremity(ies), lower extremity(ies),and/or trunk, subsequent orthotic(s)/prosthetic(s)encounter, each 15 minutes

The 2018 code set adds97763 to replace 97762for management of apatient with orthotics or

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prosthetics. Code 97763removes the establishedpatient specification andis reported for each 15minutes of subsequentmanagement and/ortraining of patients withupper or lower extremityand/or trunk orthotics orprosthetics. An orthosissupports a weak ordeformed body part orrestricts or eliminatesmotion in a diseased orinjured body part whereasa prosthesis is an artificialor manmade replacementfor a body part.Of note, the 2018 codeset also revised 97760 foreach 15 minutes of initialmanagement and trainingof patients with upper orlower extremity and/ortrunk orthotics and 97761to report each 15 minutesof an initial encounter forprosthetics training. Code97763 covers subsequentmanagement for bothorthotics and prosthetics.

99483 Assessment of and care planning for a patient withcognitive impairment, requiring an independenthistorian, in the office or other outpatient, home ordomiciliary or rest home, with all of the followingrequired elements: Cognition-focused evaluationincluding a pertinent history and examination;Medical decision making of moderate or highcomplexity; Functional assessment (eg, basic andinstrumental activities of daily living), includingdecision-making capacity; Use of standardizedinstruments for staging of dementia (eg, functionalassessment staging test [FAST], clinical dementiarating [CDR]); Medication reconciliation and reviewfor high-risk medications; Evaluation forneuropsychiatric and behavioral symptoms,including depression, including use of standardizedscreening instrument(s); Evaluation of safety (eg,home), including motor vehicle operation;Identification of caregiver(s), caregiver knowledge,caregiver needs, social supports, and thewillingness of caregiver to take on caregiving tasks;Development, updating or revision, or review of anAdvance Care Plan; Creation of a written care plan,including initial plans to address anyneuropsychiatric symptoms, neuro-cognitive

CPT® 2018 adds 99483for care planning of apatient with cognitiveimpairment in evaluationand managementservices. The codeincludes cognition-focused pertinent history,examination andmoderate to highcomplexity medicaldecision making. Thephysician typically spends50 minutes face-to-facewith the patient, family, orcaregiver.

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symptoms, functional limitations, and referral tocommunity resources as needed (eg, rehabilitationservices, adult day programs, support groups)shared with the patient and/or caregiver with initialeducation and support. Typically, 50 minutes arespent face-to-face with the patient and/or family orcaregiver.

99484 Care management services for behavioral healthconditions, at least 20 minutes of clinical staff time,directed by a physician or other qualified health careprofessional, per calendar month, with the followingrequired elements: initial assessment or follow-upmonitoring, including the use of applicable validatedrating scales; behavioral health care planning inrelation to behavioral/psychiatric health problems,including revision for patients who are notprogressing or whose status changes; facilitatingand coordinating treatment such as psychotherapy,pharmacotherapy, counseling and/or psychiatricconsultation; and continuity of care with adesignated member of the care team.

CPT® 2018 adds 99492,99493 and +99494 inplace of G0502, G0503and G0504; the newcodes retain the samedescriptors without anychange. Collaborativecare management(CoCM) is an approach tobehavioral health carethat enhances typicalprimary care bycoordinating psychiatriccare with primary care forpatients receivingbehavioral healthtreatment, particularlyregarding patients whoseconditions are notimproving. Report 99492for the initial 70 minutesof CoCM in the firstcalendar month and99493 for the first 60minutes in a subsequentmonth. Report +99494 inaddition to 99492 or99493 for each additional30 minutes in a calendarmonth.

99492 Initial psychiatric collaborative care management,first 70 minutes in the first calendar month ofbehavioral health care manager activities, inconsultation with a psychiatric consultant, anddirected by the treating physician or other qualifiedhealth care professional, with the following requiredelements: outreach to and engagement in treatmentof a patient directed by the treating physician orother qualified health care professional; initialassessment of the patient, including administrationof validated rating scales, with the development ofan individualized treatment plan; review by thepsychiatric consultant with modifications of the planif recommended; entering patient in a registry andtracking patient follow-up and progress using theregistry, with appropriate documentation, andparticipation in weekly caseload consultation withthe psychiatric consultant; and provision of briefinterventions using evidence-based techniques such

CPT® 2018 adds 99492,99493 and +99494; thenew codes have thesame descriptors asG0502, G0503 andG0504. Collaborativecare management(CoCM) is an approach tobehavioral health carethat enhances typicalprimary care bycoordinating psychiatriccare with primary care forpatients receivingbehavioral health

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as behavioral activation, motivational interviewing,and other focused treatment strategies.

treatment, particularlyregarding patients whoseconditions are notimproving. Report 99492for the initial 70 minutesof CoCM in the firstcalendar month and99493 for the first 60minutes in a subsequentmonth. Report +99494 inaddition to 99492 or99493 for each additional30 minutes in a calendarmonth.

99493 Subsequent psychiatric collaborative caremanagement, first 60 minutes in a subsequentmonth of behavioral health care manager activities,in consultation with a psychiatric consultant, anddirected by the treating physician or other qualifiedhealth care professional, with the following requiredelements: tracking patient follow-up and progressusing the registry, with appropriate documentation;participation in weekly caseload consultation withthe psychiatric consultant; ongoing collaborationwith and coordination of the patient's mental healthcare with the treating physician or other qualifiedhealth care professional and any other treatingmental health providers; additional review ofprogress and recommendations for changes intreatment, as indicated, including medications,based on recommendations provided by thepsychiatric consultant; provision of briefinterventions using evidence-based techniques suchas behavioral activation, motivational interviewing,and other focused treatment strategies; monitoringof patient outcomes using validated rating scales;and relapse prevention planning with patients asthey achieve remission of symptoms and/or othertreatment goals and are prepared for discharge fromactive treatment.

CPT® 2018 adds 99492,99493 and +99494; thenew codes have thesame descriptors asG0502, G0503 andG0504. Collaborativecare management(CoCM) is an approach tobehavioral health carethat enhances typicalprimary care bycoordinating psychiatriccare with primary care forpatients receivingbehavioral healthtreatment, particularlyregarding patients whoseconditions are notimproving. Report 99492for the initial 70 minutesof CoCM in the firstcalendar month and99493 for the first 60minutes in a subsequentmonth. Report +99494 inaddition to 99492 or99493 for each additional30 minutes in a calendarmonth.

99494 Initial or subsequent psychiatric collaborative caremanagement, each additional 30 minutes in acalendar month of behavioral health care manageractivities, in consultation with a psychiatricconsultant, and directed by the treating physician orother qualified health care professional (Listseparately in addition to code for primary procedure)

CPT® 2018 adds 99492,99493 and +99494; thenew codes have thesame descriptors asG0502, G0503 andG0504. Collaborativecare management

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(CoCM) is an approach tobehavioral health carethat enhances typicalprimary care bycoordinating psychiatriccare with primary care forpatients receivingbehavioral healthtreatment, particularlyregarding patients whoseconditions are notimproving. Report 99492for the initial 70 minutesof CoCM in the firstcalendar month and99493 for the first 60minutes in a subsequentmonth. Report +99494 inaddition to 99492 or99493 for each additional30 minutes in a calendarmonth.

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Eye & Ocular Adnexa


No New CPT® code for 2018

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Genitourinary


0021U Oncology(prostate),detection of 8autoantibodies(ARF 6, NKX3-1,5’-UTR-BMI1, CEP164, 3’-UTR-Ropporin,Desmocollin,AURKAIP-1,CSNK2A2),multiplexedimmunoassay andflow cytometryserum, algorithmreported as riskscore

CPT® adds 0021U for the proprietary Apifiny® fromArmune BioScience, Inc., which uses multiplexedimmunoassay and flow cytometry to analyze a patient’sserum for 8 autoantibodies associated with prostatecancer. An algorithm is applied to the results to produce arisk score for prostate cancer.Immunoassay detects an antibody/antigen reaction in ablood or body fluid sample using an immunologicalreaction to an enzyme (enzyme immunoassay test) orradioactively labeled substance (radioimmunoassay test).In flow cytometry, a stream of stained or fluorescentlymarked blood cells are suspended in fluid in an electronicdetector (flow cytometer); the cells travel in a single linepast a focused light or laser beam that causes the stainedcells to fluoresce and scatter light according to their DNAand nuclear structure; the fluorescence and light scatterare measured with a photodetector and analyzed; this testcan be used to identify antigens and cancer cells as wellas for staging.This code became effective October 1, 2017, and willappear for the first time in the 2019 CPT® manual.“U” codes are a new addition to the CPT® code set andidentify specific proprietary laboratory analyses (PLA)tests; use this code for only the Apifiny® test from ArmuneBioScience, Inc.

0499T Cystourethroscopy,with mechanicaldilation andurethral therapeuticdrug delivery forurethral stricture orstenosis, includingfluoroscopy, whenperformed

The 2018 code set adds 0499T to track the use andefficacy of instillation of a drug through the urethra duringcystourethroscopy and mechanical dilation for stricture orstenosis. Drugs such as steroids have been instilled intothe urethra following surgical treatment of a stricture orstenosis to promote healing and prevent scarring or repeatstricture. Cystourethroscopy is a procedure in which theprovider views and examines the bladder and urethrausing a flexible or rigid tube with a camera at the end thatis inserted through the urethra into the bladder to examinethe urethra and urinary tract. Instruments such as dilatorscan be inserted through the scope to dilate a narrowedurethra. The procedure is sometimes done usingfluoroscopic guidance, a live X-ray where the imageappears on a monitor.

0500T Infectious agentdetection bynucleic acid (DNAor RNA), HumanPapillomavirus

CPT® 2018 adds 0500T as a Category III code for humanpapillomavirus (HPV) genotyping that identifies five ormore separately reported high-risk HPV types such as theexamples given in the code descriptor. Distinguish 0500T

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(HPV) for five ormore separatelyreported high-riskHPV types (eg, 16,18, 31, 33, 35, 39,45, 51, 52, 56, 58,59, 68) (ie,genotyping)

from similar codes for infectious agent antigen detection bynucleic acid 87624, which you should reserve for reportingfour or fewer high risk HPV types, or 87625, which youshould reserve for reporting high-risk HPV types 16, 18and 45.

19294 Preparation oftumor cavity, withplacement of aradiation therapyapplicator forintraoperativeradiation therapy(IORT) concurrentwith partialmastectomy (Listseparately inaddition to code forprimary procedure)

The 2018 code set adds +19294 as an add-on code to bereported with a primary partial mastectomy procedure.Report 19294 for preparation of a tumor cavity andplacement of a radiation therapy applicator forintraoperative radiation therapy (IORT).

55874 Transperinealplacement ofbiodegradablematerial, peri-prostatic, single ormultipleinjection(s),including imageguidance, whenperformed

The 2018 code set adds 55874 to replace 0438T. This newcode retains the description of the category III code butclarifies the wording by replacing “via needle” with“injection(s)” after “single or multiple” and adding “whenperformed” to qualify image guidance. Report 55874 forplacement of one or more pieces of absorbable materialvia injections through the perineum into the areasurrounding the prostate under image guidance toseparate the anterior rectal wall from the prostate andreduce the amount of radiation the rectum is exposed toduring radiotherapy for prostate cancer.

58575 Laparoscopy,surgical, totalhysterectomy forresection ofmalignancy (tumordebulking), withomentectomyincluding salpingo-oophorectomy,unilateral orbilateral, whenperformed

The 2018 code set adds code 58575 to report surgicallaparoscopic removal of the uterus, cervix, fallopian tubes(salpingo) and ovaries (oophor) on one or both sides alongwith removal of omentum (the membrane lining theabdominal cavity) for surgical removal of malignant tumor.Unlike existing laparoscopic total hysterectomy codes58570-58573, this code does not specify the size of theuterus, and existing codes do not specify removal of thecervix (although the cervix is included in a totalhysterectomy) nor do they include removal of fallopiantubes and ovaries or omentectomy.

15730 Midface flap (ie, zygomaticofacial flap) with preservation of vascular pedicle(s)

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15733 Muscle, myocutaneous, or fasciocutaneous flap; head and neck with named vascular pedicle (ie, buccinators, genioglossus, temporalis, masseter, sternocleidomastoid, levator scapulae)

01/01/2018

19294 Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (IORT) concurrent with partial mastectomy (List separately in addition to code for primary procedure)

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Maternity Care & Delivery


0487T Biomechanicalmapping,transvaginal,with report

CPT® 2018 adds Category III code 0487T to track the use andefficacy of a relatively new, but FDA-approved technology, i.e.transvaginal biomechanical mapping. In this procedure, theprovider inserts a probe with tactile sensors on its surface intothe vagina. The probe senses pelvic muscle contractions andrelaxation and sends the data to a computer where the data isinterpreted and pelvic floor muscle function mapped. Thetechnology helps diagnose vaginal and pelvic floorabnormalities.

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https://coder.aapc.com/cpt-code-changes-2018/code-category/Medicine 1/2

Medicine


90756 Influenza virus vaccine,quadrivalent (ccIIV4),derived from cell cultures,subunit, antibiotic free,0.5 mL dosage, forintramuscular use

The 2018 code set adds 90756 to report the supplyof 0.5 mL antibiotic-free, 4–strain influenza virusvaccine, developed from cell cultures, foradministration by injection into a muscle. This codeis for the supply of a vaccine that covers four strainsof influenza, subtypes A and B. Reportadministration separately.See also codes 90653-90668 for other influenzavirus vaccines.

93792 Patient/caregiver trainingfor initiation of homeinternational normalizedratio (INR) monitoringunder the direction of aphysician or otherqualified health careprofessional, face-to-face, including use andcare of the INR monitor,obtaining blood sample,instructions for reportinghome INR test results,and documentation ofpatient's/caregiver'sability to perform testingand report results

The 2018 code set adds 93792 and 93793 toreplace 99363 and 99364. Report 93792 when aphysician or other qualified healthcare providerinitiates home international normalized ratio (INR)monitoring and trains a patient or caregiver inperson (face-to-face) to obtain blood samples andmonitor and report home INR test results anddocuments the patient's or caregiver's ability toperform testing and report results. Report 93793 foranticoagulant management for a patient takingwarfarin, which includes review and interpretation ofnew international normalized ratio (INR) test result(whether performed in the home, office, or lab) andinstructing the patient as well as adjusting thedosage when necessary and scheduling additionaltest(s), when performed.

93793 Anticoagulantmanagement for a patienttaking warfarin, mustinclude review andinterpretation of a newhome, office, or labinternational normalizedratio (INR) test result,patient instructions,dosage adjustment (asneeded), and schedulingof additional test(s), whenperformed

The 2018 code set adds 93792 and 93793 toreplace 99363 and 99364. Report 93792 when aphysician or other qualified healthcare providerinitiates home international normalized ratio (INR)monitoring and trains a patient or caregiver inperson (face-to-face) to obtain blood samples andmonitor and report home INR test results anddocuments the patient's or caregiver's ability toperform testing and report results. Report 93793 foranticoagulant management for a patient takingwarfarin, which includes review and interpretation ofnew international normalized ratio (INR) test result(whether performed in the home, office, or lab) andinstructing the patient as well as adjusting thedosage when necessary and scheduling additionaltest(s), when performed.

94617 Exercise test forbronchospasm, includingpre- and post-spirometry,

The 2018 code set adds 94617 to report an exercisetest to assess exercise-induced bronchospasm and

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electrocardiographicrecording(s), and pulseoximetry

includes recording spirometry before and aftervigorous exercise, recording of patient’s oxygensaturation, and continuous electrocardiogramrecording during the exercise by placement of chestelectrodes.See also new code 94618 for pulmonary stresstesting and revised code 94621 for extensivecardiopulmonary stress testing.

94618 Pulmonary stress testing(eg, 6-minute walk test),including measurement ofheart rate, oximetry, andoxygen titration, whenperformed

The 2018 code set adds 94618 to replace 94620.Report 94618 for pulmonary stress testing whenexercise, such as a 6-minute walk test, is performedto assess pulmonary (lung) function and includesheart rate and oxygen saturation measurement. Ifthe patient is receiving oxygen during the procedureand the amount of oxygen received is adjusted(titrated) to provide better oxygen saturation duringexercise, that, too, is included. Code 94618 iscommonly used to assess lung function in patientswith dyspnea. For more extensive cardiopulmonarystress testing that includes electrocardiographicrecordings, see revised code 94621.

95249 Ambulatory continuousglucose monitoring ofinterstitial tissue fluid viaa subcutaneous sensorfor a minimum of 72hours; patient-providedequipment, sensorplacement, hook-up,calibration of monitor,patient training, andprintout of recording

The 2018 code set adds 95249 to report ambulatorycontinuous glucose monitoring when the patientprovides the equipment. Ambulatory continuousglucose monitoring systems monitor and recordblood glucose levels by measuring glucose ininterstitial fluid. The code includes monitoring of theinterstitial glucose levels at regular intervals viasubcutaneously implanted sensors for a minimum of72 hours along with sensor placement, hookup,monitor calibration, patient training, sensor removal,and recording printout.See revised code 95250 if the physician or otherqualified health care professional (office) providedthe equipment and revised code 92251 for theprofessional component of the service that includesanalysis, interpretation, and creation of the report.

1/3/2018 AAPC Coder

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Modifiers


96 Habilitative Services

97 Rehabilitative Services

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20939 Bone marrow aspiration for bone grafting, spine surgery only, through separate skin or fascial incision (List separately in addition to code for primary procedure)

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Nervous


64912 Nerve repair; with nerve allograft, each nerve, firststrand (cable)

Code 64912 is one ofthe two new codesadded to report nerverepairs with nerveallograft (a nerve tissuegraft harvested fromone person for another;donors includecadavers and livingindividuals related orunrelated to therecipient). This code isfor the first strand ofeach nerve graft repair;for each additionalnerve strand, see add-on code +64913. Nerveallografts are still indevelopment with onlyone FDA-approvednerve allograftcurrently. It is aproprietary humannerve allograft that hasbeen processed in alaboratory; its approveduse is to repair cuts inperipheral nerves andsupport regeneration ofthe nerve across thedefect.

64913 Nerve repair; with nerve allograft, each additionalstrand (List separately in addition to code for primaryprocedure)

Code +64913 is one oftwo new codes addedto report nerve repairswith nerve allograft (anerve tissue graftharvested from oneperson for another;donors includecadavers and livingindividuals related orunrelated to therecipient). Code 64912is for the first strand of

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each nerve graft repair;report +64913 inaddition to 64912 foreach additional nervestrand. Nerve allograftsare still in developmentwith only one FDA-approved nerveallograft currently. It isa proprietary humannerve allograft that hasbeen processed in alaboratory; its approveduse is to repair cuts inperipheral nerves andsupport regeneration ofthe nerve across thedefect.

99483 Assessment of and care planning for a patient withcognitive impairment, requiring an independenthistorian, in the office or other outpatient, home ordomiciliary or rest home, with all of the followingrequired elements: Cognition-focused evaluationincluding a pertinent history and examination; Medicaldecision making of moderate or high complexity;Functional assessment (eg, basic and instrumentalactivities of daily living), including decision-makingcapacity; Use of standardized instruments for stagingof dementia (eg, functional assessment staging test[FAST], clinical dementia rating [CDR]); Medicationreconciliation and review for high-risk medications;Evaluation for neuropsychiatric and behavioralsymptoms, including depression, including use ofstandardized screening instrument(s); Evaluation ofsafety (eg, home), including motor vehicle operation;Identification of caregiver(s), caregiver knowledge,caregiver needs, social supports, and the willingnessof caregiver to take on caregiving tasks; Development,updating or revision, or review of an Advance CarePlan; Creation of a written care plan, including initialplans to address any neuropsychiatric symptoms,neuro-cognitive symptoms, functional limitations, andreferral to community resources as needed (eg,rehabilitation services, adult day programs, supportgroups) shared with the patient and/or caregiver withinitial education and support. Typically, 50 minutes arespent face-to-face with the patient and/or family orcaregiver.

CPT® 2018 adds99483 for careplanning of a patientwith cognitiveimpairment inevaluation andmanagement services.The code includescognition-focusedpertinent history,examination andmoderate to highcomplexity medicaldecision making. Thephysician typicallyspends 50 minutesface-to-face with thepatient, family, orcaregiver.

99484 Care management services for behavioral healthconditions, at least 20 minutes of clinical staff time,directed by a physician or other qualified health careprofessional, per calendar month, with the followingrequired elements: initial assessment or follow-upmonitoring, including the use of applicable validatedrating scales; behavioral health care planning inrelation to behavioral/psychiatric health problems,including revision for patients who are not progressingor whose status changes; facilitating and coordinatingtreatment such as psychotherapy, pharmacotherapy,

CPT® 2018 adds99492, 99493 and+99494 in place ofG0502, G0503 andG0504; the new codesretain the samedescriptors without anychange. Collaborative

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counseling and/or psychiatric consultation; andcontinuity of care with a designated member of thecare team.

care management(CoCM) is an approachto behavioral healthcare that enhancestypical primary care bycoordinating psychiatriccare with primary carefor patients receivingbehavioral healthtreatment, particularlyregarding patientswhose conditions arenot improving. Report99492 for the initial 70minutes of CoCM in thefirst calendar monthand 99493 for the first60 minutes in asubsequent month.Report +99494 inaddition to 99492 or99493 for eachadditional 30 minutesin a calendar month.

99492 Initial psychiatric collaborative care management, first70 minutes in the first calendar month of behavioralhealth care manager activities, in consultation with apsychiatric consultant, and directed by the treatingphysician or other qualified health care professional,with the following required elements: outreach to andengagement in treatment of a patient directed by thetreating physician or other qualified health careprofessional; initial assessment of the patient,including administration of validated rating scales, withthe development of an individualized treatment plan;review by the psychiatric consultant with modificationsof the plan if recommended; entering patient in aregistry and tracking patient follow-up and progressusing the registry, with appropriate documentation, andparticipation in weekly caseload consultation with thepsychiatric consultant; and provision of briefinterventions using evidence-based techniques suchas behavioral activation, motivational interviewing, andother focused treatment strategies.

CPT® 2018 adds99492, 99493 and+99494; the new codeshave the samedescriptors as G0502,G0503 and G0504.Collaborative caremanagement (CoCM)is an approach tobehavioral health carethat enhances typicalprimary care bycoordinating psychiatriccare with primary carefor patients receivingbehavioral healthtreatment, particularlyregarding patientswhose conditions arenot improving. Report99492 for the initial 70minutes of CoCM in thefirst calendar monthand 99493 for the first60 minutes in asubsequent month.Report +99494 in

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addition to 99492 or99493 for eachadditional 30 minutesin a calendar month.

99493 Subsequent psychiatric collaborative caremanagement, first 60 minutes in a subsequent monthof behavioral health care manager activities, inconsultation with a psychiatric consultant, and directedby the treating physician or other qualified health careprofessional, with the following required elements:tracking patient follow-up and progress using theregistry, with appropriate documentation; participationin weekly caseload consultation with the psychiatricconsultant; ongoing collaboration with andcoordination of the patient's mental health care withthe treating physician or other qualified health careprofessional and any other treating mental healthproviders; additional review of progress andrecommendations for changes in treatment, asindicated, including medications, based onrecommendations provided by the psychiatricconsultant; provision of brief interventions usingevidence-based techniques such as behavioralactivation, motivational interviewing, and other focusedtreatment strategies; monitoring of patient outcomesusing validated rating scales; and relapse preventionplanning with patients as they achieve remission ofsymptoms and/or other treatment goals and areprepared for discharge from active treatment.

CPT® 2018 adds99492, 99493 and+99494; the new codeshave the samedescriptors as G0502,G0503 and G0504.Collaborative caremanagement (CoCM)is an approach tobehavioral health carethat enhances typicalprimary care bycoordinating psychiatriccare with primary carefor patients receivingbehavioral healthtreatment, particularlyregarding patientswhose conditions arenot improving. Report99492 for the initial 70minutes of CoCM in thefirst calendar monthand 99493 for the first60 minutes in asubsequent month.Report +99494 inaddition to 99492 or99493 for eachadditional 30 minutesin a calendar month.

99494 Initial or subsequent psychiatric collaborative caremanagement, each additional 30 minutes in a calendarmonth of behavioral health care manager activities, inconsultation with a psychiatric consultant, and directedby the treating physician or other qualified health careprofessional (List separately in addition to code forprimary procedure)

CPT® 2018 adds99492, 99493 and+99494; the new codeshave the samedescriptors as G0502,G0503 and G0504.Collaborative caremanagement (CoCM)is an approach tobehavioral health carethat enhances typicalprimary care bycoordinating psychiatriccare with primary carefor patients receiving

1/3/2018 AAPC Coder


behavioral healthtreatment, particularlyregarding patientswhose conditions arenot improving. Report99492 for the initial 70minutes of CoCM in thefirst calendar monthand 99493 for the first60 minutes in asubsequent month.Report +99494 inaddition to 99492 or99493 for eachadditional 30 minutesin a calendar month.

1/3/2018 AAPC Coder

https://coder.aapc.com/cpt-code-changes-2018/code-category/Oncology 1/4


0018U Oncology (thyroid),microRNA profilingby RT-PCR of 10microRNAsequences,utilizing fineneedle aspirate,algorithm reportedas a positive ornegative result formoderate to highrisk of malignancy

CPT® adds 0018U for the proprietary ThyraMIR® geneexpression assay from Interpace Diagnostics, a secondgeneration molecular assay performed on fine needleaspirate (FNA) biopsy samples from patients with priorindeterminate cytopathology results for the diagnosis ofthyroid cancer. The test is useful to help patients whosenodules were actually benign avoid unnecessary surgery.Reverse transcrioptase-polymerase chain reaction (RT-PCR) is a rapid technique for making more copies(amplifying) of a DNA or RNA sequence using acomplementary DNA sequence from a template of RNA.This code became effective October 1, 2017, and willappear for the first time in the 2019 CPT® manual.“U” codes are a new addition to the CPT® code set andidentify specific proprietary laboratory analyses (PLA) tests;use this code for only the ThyraMIR® gene expressionassay from Interpace Diagnostics.

0019U Oncology, RNA,gene expressionby wholetranscriptomesequencing,formalin-fixedparaffin embeddedtissue or freshfrozen tissue,predictivealgorithm reportedas potential targetsfor therapeuticagents

CPT® adds 0019U for the proprietaryOncoTarget™/OncoTreat™ developed at the ColumbiaUniversity Department of Pathology and Cell Biology forDarwin Health™, RNA gene expression tests using wholetranscriptone sequencing on formalin-fixed paraffinembedded tissue or fresh frozen tissue. Using a proprietaryalgorithm and the results the combination test, tumortargets at all stages of progression and invasiveness areidentified and matched to current and investigational drugsto optimize therapeutic approaches for cancer.This code became effective October 1, 2017, and willappear for the first time in the 2019 CPT® manual.“U” codes are a new addition to the CPT® code set andidentify specific proprietary laboratory analyses (PLA) tests;use this code for only the Darwin Health™OncoTarget™/OncoTreat™ test developed at the ColumbiaUniversity Department of Pathology and Cell Biology.

0021U Oncology(prostate),detection of 8autoantibodies(ARF 6, NKX3-1,5’-UTR-BMI1, CEP164, 3’-UTR-Ropporin,Desmocollin,AURKAIP-1,CSNK2A2),multiplexedimmunoassay andflow cytometryserum, algorithm

CPT® adds 0021U for the proprietary Apifiny® fromArmune BioScience, Inc., which uses multiplexedimmunoassay and flow cytometry to analyze a patient’sserum for 8 autoantibodies associated with prostatecancer. An algorithm is applied to the results to produce arisk score for prostate cancer.Immunoassay detects an antibody/antigen reaction in ablood or body fluid sample using an immunological reactionto an enzyme (enzyme immunoassay test) or radioactivelylabeled substance (radioimmunoassay test). In flowcytometry, a stream of stained or fluorescently markedblood cells are suspended in fluid in an electronic detector

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reported as riskscore

(flow cytometer); the cells travel in a single line past afocused light or laser beam that causes the stained cells tofluoresce and scatter light according to their DNA andnuclear structure; the fluorescence and light scatter aremeasured with a photodetector and analyzed; this test canbe used to identify antigens and cancer cells as well as forstaging.This code became effective October 1, 2017, and willappear for the first time in the 2019 CPT® manual.“U” codes are a new addition to the CPT® code set andidentify specific proprietary laboratory analyses (PLA) tests;use this code for only the Apifiny® test from ArmuneBioScience, Inc.

0023U Oncology (acutemyelogenousleukemia), DNA,genotyping ofinternal tandemduplication,p.D835, p.I836,using mononuclearcells, reported asdetection or non-detection of FLT3mutation andindication for oragainst the use ofmidostaurin

CPT® adds 0023U for the proprietary LeukoStrat® CDxFLT3 Mutation Assay, LabPMM LLC, InvivoscribeTechnologies, Inc., a DNA genotyping test that usespolymerase chain reaction (PCR) to detect the presence orabsence of the FLT3 mutation and determine whethermidostaurin would be an effective agent to treat acutemyelogenous leukemia.Polymerase chain reaction (PCR) is a rapid technique formaking more copies (amplifying) of a DNA or RNAsequence used in the laboratory.This code became effective October 1, 2017, and willappear for the first time in the 2019 CPT® manual.“U” codes are a new addition to the CPT® code set andidentify specific proprietary laboratory analyses (PLA) tests;use this code for only the LeukoStrat® CDx FLT3 MutationAssay, LabPMM LLC, Invivoscribe Technologies, Inc.

19294 Preparation oftumor cavity, withplacement of aradiation therapyapplicator forintraoperativeradiation therapy(IORT) concurrentwith partialmastectomy (Listseparately inaddition to codefor primaryprocedure)

The 2018 code set adds +19294 as an add-on code to bereported with a primary partial mastectomy procedure.Report 19294 for preparation of a tumor cavity andplacement of a radiation therapy applicator forintraoperative radiation therapy (IORT).

32994 Ablation therapyfor reduction oreradication of 1 ormore pulmonarytumor(s) includingpleura or chestwall when involvedby tumorextension,percutaneous,including imagingguidance when

The 2018 code set adds 32994 to replace 0340T. This newCPT® code specifies that this procedure is for eitherreduction or complete destruction of one or morepulmonary tumors. The provider makes a small incisionthrough the skin and inserts a cryoprobe (a thin needleused to freeze abnormal tissue) and extends it underimaging guidance to the site of the tumor(s) on one side ofthe lungs or chest wall. This code specifies tumordestruction by cryoablation; see 32998 for a similar

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performed,unilateral;cryoablation

procedure using radiofrequency ablation (the use of heatproduced by focused radio waves).This code represents a unilateral service, meaningperformed on one side. Append modifier 50 or RT/LT,depending on payer preference, if the provider performsthe procedure bilaterally.

81520 Oncology (breast),mRNA geneexpressionprofiling by hybridcapture of 58genes (50 contentand 8housekeeping),utilizing formalin-fixed paraffin-embedded tissue,algorithm reportedas a recurrencerisk score

CPT® 2018 adds 81520 to the section for multianalyteassays with algorithmic analyses (MAAAs). Prior to thisaddition, CPT® listed this test in Appendix O asadministrative code 0008M. Clinicians use this test toevaluate formalin-fixed paraffin-embedded (FFPE) tissuefor an mRNA gene expression profile of 58 genes. As withall MAAAs, the code describes both the lab test as well asan algorithm that uses the test results and possibly otherpatient data to calculate a probability or risk score. In thiscase, the MAAA establishes a numerical value thatcorrelates with the probability of distant breast cancerrecurrence within 10 years.

81521 Oncology (breast),mRNA, microarraygene expressionprofiling of 70content genes and465 housekeepinggenes, utilizingfresh frozen orformalin-fixedparaffin-embeddedtissue, algorithmreported as indexrelated to risk ofdistant metastasis

CPT® 2018 adds 81521 to the section for multianalyteassays with algorithmic analyses (MAAAs). Clinicians usethis test to evaluate fresh frozen or formalin-fixed paraffin-embedded (FFPE) tissue for expression of 70 contentgenes that predict the breast cancer’s ability to spread ormetastasize. As with all MAAAs, the code describes boththe lab test, in this case, microarray gene analysis, and analgorithm that uses the test results and possibly otherpatient data to report a probability or risk score. The 81521test results in a low or high risk score for breast cancerrecurrence, which clinicians may use along with other dateto evaluate treatment options.

81541 Oncology(prostate), mRNAgene expressionprofiling by real-time RT-PCR of 46genes (31 contentand 15housekeeping),utilizing formalin-fixed paraffin-embedded tissue,algorithm reportedas a disease-specific mortalityrisk score

CPT® 2018 adds 81541 to the section for multianalyteassays with algorithmic analyses (MAAAs). Clinicians usethis test to evaluate formalin-fixed paraffin-embedded(FFPE) tissue for expression of 46 genes that help predictdisease aggressiveness. As with all MAAAs, the codedescribes both the lab test, in this case, mRNA geneexpression profiling by real-time polymerase chain reaction(RT-PCR), and an algorithm that uses the test results andpossibly other patient data to report a probability or riskscore. The 81541 test results in a disease-specific mortalityrisk score that can aid treatment decisions for patients witha current prostate cancer diagnosis, or help predict post-prostatectomy risk of recurrence.

81551 Oncology(prostate),promotermethylationprofiling by real-time PCR of 3genes (GSTP1,APC, RASSF1),

CPT® 2018 adds 81551 to the section for multianalyteassays with algorithmic analyses (MAAAs). Clinicians usethis test to evaluate three genes listed in the code usingformalin-fixed paraffin-embedded (FFPE) tissue. As with allMAAAs, the code describes both the lab test, in this case,methylation specific real-time polymerase chain reaction

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utilizing formalin-fixed paraffin-embedded tissue,algorithm reportedas a likelihood ofprostate cancerdetection onrepeat biopsy

(RT-PCR) functioning as a prostate cancer biomarker, andan algorithm that uses the test results and possibly otherpatient data to report a probability or risk score. The 81551test results in a score indicating likelihood of prostatecancer detection on repeat biopsy for a patient with priornegative prostate biopsy.

1/3/2018 AAPC Coder

https://coder.aapc.com/cpt-code-changes-2018/code-category/Otolaryngology 1/2


31241 Nasal/sinusendoscopy,surgical; withligation ofsphenopalatineartery

CPT® 2018 adds 31241 for ligation of sphenopalatine arteryvia surgical nasal/sinus endoscopy. To ligate means to close,tie off, repair, or encircle a vessel or other structure withsutures or wire. This code joins a plethora of existing and newcodes for surgical nasal/sinus endoscopy procedures; see31237-31297 for existing codes and 31253-31298 for newcodes for 2018.

31253 Nasal/sinusendoscopy,surgical withethmoidectomy;total (anteriorand posterior),including frontalsinusexploration,with removal oftissue fromfrontal sinus,whenperformed

CPT® 2018 adds three new codes to report surgicalnasal/sinus endoscopy with partial or total ethmoidectomy.The new codes are for much more complex procedures thanexisting nasal endoscopy with ethmoidectomy codes (31254-31255) and involve the frontal and sphenoid sinuses. For total(anterior and posterior) nasal/sinus endoscopy withethmoidectomy with exploration of the frontal sinus andpossible removal of tissue, report 31253. Report 31257 forsurgical nasal/sinus endoscopy and ethmoidectomy withexcision of the sphenoid sinus (sphenoidectomy) as opposedto sphenoidotomy and 31259 for surgical nasal/sinusendoscopy with ethmoidectomy and incision into the sphenoidsinus (sphenoidotomy) for removal of tissue.Of note, the code set also adds 31298 for balloon dilation(widening) of the frontal and sphenoid sinus ostia and 31241for ligation of the sphenopalatine artery, both procedures viasurgical nasal/sinus endoscopy.

31257 Nasal/sinusendoscopy,surgical withethmoidectomy;total (anteriorand posterior),includingsphenoidotomy

CPT® 2018 adds three new codes to report surgicalnasal/sinus endoscopy with partial or total ethmoidectomy.The new codes are for much more complex procedures thanexisting nasal endoscopy with ethmoidectomy codes (31254-31255) and involve the frontal and sphenoid sinuses. Report31257 for surgical nasal/sinus endoscopy and ethmoidectomywith excision of the sphenoid sinus (sphenoidectomy) asopposed to sphenoidotomy. For total (anterior and posterior)nasal/sinus endoscopy with ethmoidectomy with exploration ofthe frontal sinus and possible removal of tissue, report 31253.Report 31259 for surgical nasal/sinus endoscopy withethmoidectomy and incision into the sphenoid sinus(sphenoidotomy) for removal of tissue.Of note, the code set also adds 31298 for balloon dilation(widening) of the frontal and sphenoid sinus ostia and 31241for ligation of the sphenopalatine artery, both procedures viasurgical nasal/sinus endoscopy.

31259 Nasal/sinusendoscopy,surgical withethmoidectomy;total (anteriorand posterior),includingsphenoidotomy,

CPT® 2018 adds three new codes to report surgicalnasal/sinus endoscopy with partial or total ethmoidectomy.The new codes are for much more complex procedures thanexisting nasal endoscopy with ethmoidectomy codes (31254-31255) and involve the frontal and sphenoid sinuses. Report31259 for surgical nasal/sinus endoscopy with ethmoidectomy

1/3/2018 AAPC Coder

https://coder.aapc.com/cpt-code-changes-2018/code-category/Otolaryngology 2/2

with removal oftissue from thesphenoid sinus

and incision into the sphenoid sinus (sphenoidotomy) forremoval of tissue. For total (anterior and posterior) nasal/sinusendoscopy with ethmoidectomy with exploration of the frontalsinus and possible removal of tissue, report 31253. When theprocedure includes excision of the sphenoid sinus(sphenoidectomy) as opposed to sphenoidotomy and tissueremoval, report 31257.Of note, the code set also adds 31298 for balloon dilation(widening) of the frontal and sphenoid sinus ostia and 31241for ligation of the sphenopalatine artery, both procedures viasurgical nasal/sinus endoscopy.

31298 Nasal/sinusendoscopy,surgical; withdilation offrontal andsphenoid sinusostia (eg,balloon dilation)

CPT® 2018 adds 31298 for balloon dilation (widening) of thefrontal and sphenoid sinus ostia via nasal/sinus endoscopy.Of note, the code set also adds three other new codes toreport surgical nasal/sinus endoscopy with partial or totalethmoidectomy. The new codes are for much more complexprocedures than existing nasal endoscopy withethmoidectomy codes (31254-31255) and involve the frontaland sphenoid sinuses. For total (anterior and posterior)nasal/sinus endoscopy with ethmoidectomy with exploration ofthe frontal sinus and possible removal of tissue, report 31253.When the procedure includes sphenoidectomy (excision of thesphenoid sinus), report 31257, and for the same procedurewith incision into the sphenoid sinus (sphenoidotomy) forremoval of tissue, report 31259. In addition, 31241 is added toreport surgical nasal/sinus endoscopy with ligation of thesphenopalatine artery.

1/3/2018 AAPC Coder

https://coder.aapc.com/cpt-code-changes-2018/code-category/PathLab 1/15

Pathology and Lab


0018U Oncology (thyroid),microRNA profiling by RT-PCR of 10 microRNAsequences, utilizing fineneedle aspirate, algorithmreported as a positive ornegative result formoderate to high risk ofmalignancy

CPT® adds 0018U for the proprietary ThyraMIR®gene expression assay from InterpaceDiagnostics, a second generation molecular assayperformed on fine needle aspirate (FNA) biopsysamples from patients with prior indeterminatecytopathology results for the diagnosis of thyroidcancer. The test is useful to help patients whosenodules were actually benign avoid unnecessarysurgery.Reverse transcrioptase-polymerase chain reaction(RT-PCR) is a rapid technique for making morecopies (amplifying) of a DNA or RNA sequenceusing a complementary DNA sequence from atemplate of RNA.This code became effective October 1, 2017, andwill appear for the first time in the 2019 CPT®manual.“U” codes are a new addition to the CPT® codeset and identify specific proprietary laboratoryanalyses (PLA) tests; use this code for onlythe ThyraMIR® gene expression assay fromInterpace Diagnostics.

0019U Oncology, RNA, geneexpression by wholetranscriptome sequencing,formalin-fixed paraffinembedded tissue or freshfrozen tissue, predictivealgorithm reported aspotential targets fortherapeutic agents

CPT® adds 0019U for the proprietaryOncoTarget™/OncoTreat™ developed at theColumbia University Department of Pathology andCell Biology for Darwin Health™, RNA geneexpression tests using whole transcriptonesequencing on formalin-fixed paraffin embeddedtissue or fresh frozen tissue. Using a proprietaryalgorithm and the results the combination test,tumor targets at all stages of progression andinvasiveness are identified and matched to currentand investigational drugs to optimize therapeuticapproaches for cancer.This code became effective October 1, 2017, andwill appear for the first time in the 2019 CPT®manual.“U” codes are a new addition to the CPT® codeset and identify specific proprietary laboratoryanalyses (PLA) tests; use this code for onlythe Darwin Health™ OncoTarget™/OncoTreat™test developed at the Columbia UniversityDepartment of Pathology and Cell Biology.

0020U Drug test(s), presumptive, CPT® adds 0020U for the proprietary ToxLok™,

NEW Revised Deleted

https://coder.aapc.com/cpt-code-changes-2018/code-category/PathLab#



1/3/2018 AAPC Coder


with definitive confirmationof positive results, anynumber of drug classes,urine, with specimenverification including DNAauthentication incomparison to buccal DNA,per date of service

InSource Diagnostics, Agena Bioscience, Inc. aDNA-verified urine drug test which detectscontrolled substances and confirms that the urinesample is from the same individual as aconcomitant cheek swab. The test also identifieswhether the sample is synthetic urine. The test isused to identify illicit drug use, prevent patientsfrom substituting false urine samples, and monitorpatient compliance. This code may be reportedonly once per date of service.This code became effective October 1, 2017, andwill appear for the first time in the 2019 CPT®manual.“U” codes are a new addition to the CPT® codeset and identify specific proprietary laboratoryanalyses (PLA) tests; use this code for only theToxLok™, InSource Diagnostics, AgenaBioscience, Inc.

0495T Initiation and monitoringmarginal (extended)cadaver donor lung(s)organ perfusion system byphysician or qualifiedhealth care professional,including physiological andlaboratory assessment (eg,pulmonary artery flow,pulmonary artery pressure,left atrial pressure,pulmonary vascularresistance, mean/peak andplateau airway pressure,dynamic compliance andperfusate gas analysis),including bronchoscopyand X ray when performed;first two hours in sterilefield

The 2018 code set add 0495T and 0496T to reportmarginal donor lung monitoring by a qualifiedhealthcare professional. Report 0495T for the firsttwo hours of monitoring, using various parameters,including visual physiologic assessment, variouslaboratory pulmonary function studies, and evenbronchoscopy and X-ray. For each additional hourof monitoring, report +0496T with 0495T. The codeset also adds 0494T to report the surgicalpreparation and preservation of cadaver donorlung(s) including attaching the lung to an organperfusion system and its removal for implantation.Donor organ perfusion technology uses ventilationand perfusion of the donor lung to reproduce the invivo (in the body) environment, increasing itsviability for a longer period. The system alsoassesses the function of marginal lungs andexpands the number of acceptable donor lungs.

0496T Initiation and monitoringmarginal (extended)cadaver donor lung(s)organ perfusion system byphysician or qualifiedhealth care professional,including physiological andlaboratory assessment (eg,pulmonary artery flow,pulmonary artery pressure,left atrial pressure,pulmonary vascularresistance, mean/peak andplateau airway pressure,dynamic compliance andperfusate gas analysis),including bronchoscopyand X ray when performed;

The 2018 code set add 0495T and +0496T toreport marginal donor lung monitoring by aqualified healthcare professional. Report 0495T forthe first two hours of monitoring, using variousparameters, including visual physiologicassessment, various laboratory pulmonaryfunction studies, and even bronchoscopy and X-ray. For each additional hour of monitoring, report+0496T with 0495T. The code set also adds 0494Tto report the surgical preparation and preservationof cadaver donor lung(s) including attaching thelung to an organ perfusion system and itsseparation from the organ perfusion system forimplantation. Donor organ perfusion technology

1/3/2018 AAPC Coder


each additional hour (Listseparately in addition tocode for primaryprocedure)

uses ventilation and perfusion of the donor lung toreproduce the in vivo (in the body) environment,increasing its viability for a longer period. Thesystem also assesses the function of marginallungs and expands the number of acceptabledonor lungs.

81105 Human Platelet Antigen 1genotyping (HPA-1), ITGB3(integrin, beta 3 [plateletglycoprotein IIIa], antigenCD61 [GPIIIa]) (eg,neonatal alloimmunethrombocytopenia [NAIT],post-transfusion purpura),gene analysis, commonvariant, HPA-1a/b (L33P)

CPT® 2018 adds 81105 as one of eight new Tier 1molecular codes in the range 81105-81112 todescribe common variant genotyping for eightbiallelic systems of human platelet antigens (HPA).At the same time, CPT® 2018 deletes tests foreach of the same eight HPA antigens from Tier 2molecular pathology code 81400. Beginning Jan.1, you should use the appropriate new code fromthe range 81005-81112 instead of 81400 to reportthese tests. Clinicians may order genotyping forone or more HPA biallelic systems to aid in riskevaluation or diagnosis of conditions such asneonatal alloimmune thrombocytopenia (NAIT),post-transfusion purpura (PTP), andthrombocytopenia. Code 81105 specificallydescribes HPA-1a/b genotyping, and the codedefinition provides alternate antigen nomenclature,such as L33P.

81106 Human Platelet Antigen 2genotyping (HPA-2),GP1BA (glycoprotein Ib[platelet], alpha polypeptide[GPIba]) (eg, neonatalalloimmunethrombocytopenia [NAIT],post-transfusion purpura),gene analysis, commonvariant, HPA-2a/b (T145M)

CPT® 2018 adds 81106 as one of eight new Tier 1molecular codes in the range 81105-81112 todescribe common variant genotyping for eightbiallelic systems of human platelet antigens (HPA).At the same time, CPT® 2018 deletes tests foreach of the same eight HPA antigens from Tier 2molecular pathology code 81400. Beginning Jan.1, you should use the appropriate new code fromthe range 81005-81112 instead of 81400 to reportthese tests. Clinicians may order genotyping forone or more HPA biallelic systems to aid in riskevaluation or diagnosis of conditions such asneonatal alloimmune thrombocytopenia (NAIT),post-transfusion purpura (PTP), andthrombocytopenia. Code 81106 specificallydescribes HPA-2a/b genotyping, and the codedefinition provides alternate antigen nomenclature,such as T145M.

81107 Human Platelet Antigen 3genotyping (HPA-3),ITGA2B (integrin, alpha 2b[platelet glycoprotein IIb ofIIb/IIIa complex], antigenCD41 [GPIIb]) (eg,neonatal alloimmunethrombocytopenia [NAIT],post-transfusion purpura),

CPT® 2018 adds 81107 as one of eight new Tier 1molecular codes in the range 81105-81112 todescribe common variant genotyping for eightbiallelic systems of human platelet antigens (HPA).At the same time, CPT® 2018 deletes tests foreach of the same eight HPA antigens from Tier 2molecular pathology code 81400. Beginning Jan.1, you should use the appropriate new code from

1/3/2018 AAPC Coder


gene analysis, commonvariant, HPA-3a/b (I843S)

the range 81005-81112 instead of 81400 to reportthese tests. Clinicians may order genotyping forone or more HPA biallelic systems to aid in riskevaluation or diagnosis of conditions such asneonatal alloimmune thrombocytopenia (NAIT),post-transfusion purpura (PTP), andthrombocytopenia. Code 81107 specificallydescribes HPA-3a/b genotyping, and the codedefinition provides alternate antigen nomenclature,such as I843S.

81108 Human Platelet Antigen 4genotyping (HPA-4), ITGB3(integrin, beta 3 [plateletglycoprotein IIIa], antigenCD61 [GPIIIa]) (eg,neonatal alloimmunethrombocytopenia [NAIT],post-transfusion purpura),gene analysis, commonvariant, HPA-4a/b (R143Q)

CPT® 2018 adds 81108 as one of eight new Tier 1molecular codes in the range 81105-81112 todescribe common variant genotyping for eightbiallelic systems of human platelet antigens (HPA).At the same time, CPT® 2018 deletes tests foreach of the same eight HPA antigens from Tier 2molecular pathology code 81400. Beginning Jan.1, you should use the appropriate new code fromthe range 81005-81112 instead of 81400 to reportthese tests. Clinicians may order genotyping forone or more HPA biallelic systems to aid in riskevaluation or diagnosis of conditions such asneonatal alloimmune thrombocytopenia (NAIT),post-transfusion purpura (PTP), andthrombocytopenia. Code 81108 specificallydescribes HPA-4a/b genotyping, and the codedefinition provides alternate antigen nomenclature,such as R143Q.

81109 Human Platelet Antigen 5genotyping (HPA-5), ITGA2(integrin, alpha 2 [CD49B,alpha 2 subunit of VLA-2receptor] [GPIa]) (eg,neonatal alloimmunethrombocytopenia [NAIT],post-transfusion purpura),gene analysis, commonvariant (eg, HPA-5a/b(K505E))

CPT® 2018 adds 81109 as one of eight new Tier 1molecular codes in the range 81105-81112 todescribe common variant genotyping for eightbiallelic systems of human platelet antigens (HPA).At the same time, CPT® 2018 deletes tests foreach of the same eight HPA antigens from Tier 2molecular pathology code 81400. Beginning Jan.1, you should use the appropriate new code fromthe range 81005-81112 instead of 81400 to reportthese tests. Clinicians may order genotyping forone or more HPA biallelic systems to aid in riskevaluation or diagnosis of conditions such asneonatal alloimmune thrombocytopenia (NAIT),post-transfusion purpura (PTP), andthrombocytopenia. Code 81109 specificallydescribes HPA-5a/b genotyping, and the codedefinition provides alternate antigen nomenclature,such as K505E.

81110 Human Platelet Antigen 6genotyping (HPA-6w),ITGB3 (integrin, beta 3[platelet glycoprotein IIIa,antigen CD61] [GPIIIa])

CPT® 2018 adds 81110 as one of eight new Tier 1molecular codes in the range 81105-81112 todescribe common variant genotyping for eightbiallelic systems of human platelet antigens (HPA).

1/3/2018 AAPC Coder


(eg, neonatal alloimmunethrombocytopenia [NAIT],post-transfusion purpura),gene analysis, commonvariant, HPA-6a/b (R489Q)

At the same time, CPT® 2018 deletes tests foreach of the same eight HPA antigens from Tier 2molecular pathology code 81400. Beginning Jan.1, you should use the appropriate new code fromthe range 81005-81112 instead of 81400 to reportthese tests. Clinicians may order genotyping forone or more HPA biallelic systems to aid in riskevaluation or diagnosis of conditions such asneonatal alloimmune thrombocytopenia (NAIT),post-transfusion purpura (PTP), andthrombocytopenia. Code 81110 specificallydescribes HPA-6a/b genotyping, and the codedefinition provides alternate antigen nomenclature,such as R489Q.

81111 Human Platelet Antigen 9genotyping (HPA-9w),ITGA2B (integrin, alpha 2b[platelet glycoprotein IIb ofIIb/IIIa complex, antigenCD41] [GPIIb]) (eg,neonatal alloimmunethrombocytopenia [NAIT],post-transfusion purpura),gene analysis, commonvariant, HPA-9a/b (V837M)

CPT® 2018 adds 81111 as one of eight new Tier 1molecular codes in the range 81105-81112 todescribe common variant genotyping for eightbiallelic systems of human platelet antigens (HPA).At the same time, CPT® 2018 deletes tests foreach of the same eight HPA antigens from Tier 2molecular pathology code 81400. Beginning Jan.1, you should use the appropriate new code fromthe range 81005-81112 instead of 81400 to reportthese tests. Clinicians may order genotyping forone or more HPA biallelic systems to aid in riskevaluation or diagnosis of conditions such asneonatal alloimmune thrombocytopenia (NAIT),post-transfusion purpura (PTP), andthrombocytopenia. Code 81111 specificallydescribes HPA-9a/b genotyping, and the codedefinition provides alternate antigen nomenclature,such as V837M.

81112 Human Platelet Antigen 15genotyping (HPA-15),CD109 (CD109 molecule)(eg, neonatal alloimmunethrombocytopenia [NAIT],post-transfusion purpura),gene analysis, commonvariant, HPA-15a/b(S682Y)

CPT® 2018 adds 81112 as one of eight new Tier 1molecular codes in the range 81105-81112 todescribe common variant genotyping for eightbiallelic systems of human platelet antigens (HPA).At the same time, CPT® 2018 deletes tests foreach of the same eight HPA antigens from Tier 2molecular pathology code 81400. Beginning Jan.1, you should use the appropriate new code fromthe range 81005-81112 instead of 81400 to reportthese tests. Clinicians may order genotyping forone or more HPA biallelic systems to aid in riskevaluation or diagnosis of conditions such asneonatal alloimmune thrombocytopenia (NAIT),post-transfusion purpura (PTP), andthrombocytopenia. Code 81112 specificallydescribes HPA-15a/b genotyping, and the codedefinition provides alternate antigen nomenclature,such as S682Y.

1/3/2018 AAPC Coder


81120 IDH1 (isocitratedehydrogenase 1 [NADP+],soluble) (eg, glioma),common variants (eg,R132H, R132C)

CPT® 2018 adds 81120 in the Tier 1 molecularpathology section to describe a test for commonvariant analysis of the gene IDH1 (isocitratedehydrogenase 1 [NADP+], soluble). At the sametime, CPT® 2018 deletes this test from the Tier 2molecular pathology code 81403 test list.Beginning Jan. 1, you should use 81120 for IDH1common variant gene analysis instead of 81403.The results of the 81120 test may have indicationsfor the grade, prognosis, and treatment of glioma.

81121 IDH2 (isocitratedehydrogenase 2 [NADP+],mitochondrial) (eg, glioma),common variants (eg,R140W, R172M)

CPT® 2018 adds 81121 in the Tier 1 molecularpathology section to describe a test for commonvariant analysis of the gene IDH2 (isocitratedehydrogenase 2 [NADP+], mitochondrial). At thesame time, CPT® 2018 deletes this test from theTier 2 molecular pathology code 81403 test list.Beginning Jan. 1, you should use 81121 for IDH2common variant gene analysis instead of 81403.The results of the 81121 test may have indicationsfor the grade, prognosis, and treatment of glioma.

81175 ASXL1 (additional sexcombs like 1,transcriptional regulator)(eg, myelodysplasticsyndrome,myeloproliferativeneoplasms, chronicmyelomonocytic leukemia),gene analysis; full genesequence

CPT® 2018 adds 81175 as one of two new Tier 1molecular pathology codes in the range 81175-81176 to describe a gene analysis test for ASXL1(additional sex combs like 1, transcriptionalregulator). Code 81175 describes the full genesequence analysis. Prior to the addition of thiscode, you may have reported this test with anunlisted code such as 81479, because no othercode described ASXL1 gene analysis. You shoulddistinguish 81175 from related new code 81176,which describes ASXL1 targeted gene sequenceanalysis. Results of testing for this gene may haveimplications for prognosis and treatment ofmalignant myeloid diseases such asmyeloproliferative neoplasms (MPN),myelodysplastic syndromes (MDS), chronicmyelomonocytic leukemia (CMML) and acutemyeloid leukemia (AML).

81176 ASXL1 (additional sexcombs like 1,transcriptional regulator)(eg, myelodysplasticsyndrome,myeloproliferativeneoplasms, chronicmyelomonocytic leukemia),gene analysis; targetedsequence analysis (eg,exon 12)

CPT® 2018 adds 81176 as one of two new Tier 1molecular pathology codes in the range 81175-81176 to describe a gene analysis test for ASXL1(additional sex combs like 1, transcriptionalregulator). Code 81176 describes a targeted genesequence analysis, such as exon 12. Prior to theaddition of this code, you may have reported thistest with an unlisted code such as 81479, becauseno other code described ASXL1 gene analysis.You should distinguish 81176 from related newcode 81175, which describes ASXL1 full genesequence analysis. Results of testing for this gene

1/3/2018 AAPC Coder


may have implications for prognosis and treatmentof malignant myeloid diseases such asmyeloproliferative neoplasms (MPN),myelodysplastic syndromes (MDS), chronicmyelomonocytic leukemia (CMML) and acutemyeloid leukemia (AML).

81230 CYP3A4 (cytochrome P450family 3 subfamily Amember 4) (eg, drugmetabolism), geneanalysis, commonvariant(s) (eg, *2, *22)

CPT® 2018 adds 81230 in the Tier 1 molecularpathology section to describe a test for commonvariant gene analysis for CYP3A4 (cytochromeP450 family 3 subfamily A member 4). At the sametime, CPT® 2018 deletes this test from the Tier 2molecular pathology code 81401 test list.Beginning Jan. 1, you should use 81230 forCYP3A4 common variant gene analysis, such as*2 and*22, instead of 81401. The results of the81230 test may have indications for dosing fordrugs metabolized by CYP3A4.

81231 CYP3A5 (cytochrome P450family 3 subfamily Amember 5) (eg, drugmetabolism), geneanalysis, common variants(eg, *2, *3, *4, *5, *6, *7)

CPT® 2018 adds 81231 in the Tier 1 molecularpathology section to describe a test for commonvariant gene analysis for CYP3A5 (cytochromeP450 family 3 subfamily A member 5). At the sametime, CPT® 2018 deletes this test from the Tier 2molecular pathology code 81400 test list.Beginning Jan. 1, you should use 81231 forCYP3A5 common variant gene analysis, such as*2, *3, *4, *5, *6, *7, instead of 81400. The resultsof the 81231 test may have indications for dosingfor drugs metabolized by CYP3A5.

81232 DPYD (dihydropyrimidinedehydrogenase) (eg, 5-fluorouracil/5-FU andcapecitabine drugmetabolism), geneanalysis, commonvariant(s) (eg, *2A, *4, *5,*6)

CPT® 2018 adds 81232 in the Tier 1 molecularpathology section to describe a test for commonvariant gene analysis for DPYD (dihydropyrimidinedehydrogenase). At the same time, CPT® 2018deletes a similar test from the Tier 2 molecularpathology code 81400 test list. Beginning Jan. 1,you should use 81232 for DPYD common variantgene analysis, such as *2A, *4, *5, *6, instead of81400. The results of the 81232 test may haveindications for evaluating patients with increasedrisk of toxicity for certain chemotherapy treatmentsmetabolized by DPYD.

81238 F9 (coagulation factor IX)(eg, hemophilia B), fullgene sequence

CPT® 2018 adds 81238 in the Tier 1 molecularpathology section to describe a test for full genesequence analysis for F9 (coagulation factor IX).At the same time, CPT® 2018 deletes this testfrom the Tier 2 molecular pathology code 81405test list. Beginning Jan. 1, you should use 81238for F9 full gene sequence analysis instead of81405. Results of testing for this gene may haveimplications for carrier testing and identifying

1/3/2018 AAPC Coder


possible F9 gene mutation implicated inhemophilia B.

81247 G6PD (glucose-6-phosphate dehydrogenase)(eg, hemolytic anemia,jaundice), gene analysis;common variant(s) (eg, A,A-)

CPT® 2018 adds 81247 as one of three new Tier1 molecular pathology codes in the range 81247-81249 to describe genotyping for G6PD (glucose-6-phosphate dehydrogenase). Code 81247describes common variant gene sequenceanalysis. Prior to the addition of this code, youmay have reported this test with an unlisted codesuch as 81479, because no other code describedG6PD gene analysis. Make sure to distinguish81247 from 81248 for known familiar variants and81249 for full gene sequence analysis. Results oftesting for G6PD mutations could aid in thediagnosis of G6PD deficiency associated withjaundice or drug-induced acute hemolytic anemia,or aid in identifying G6PD deficiency carrier status.

81248 G6PD (glucose-6-phosphate dehydrogenase)(eg, hemolytic anemia,jaundice), gene analysis;known familial variant(s)

CPT® 2018 adds 81248 as one of three new Tier1 molecular pathology codes in the range 81247-81249 to describe genotyping for G6PD (glucose-6-phosphate dehydrogenase). Code 81248describes known familial variant gene sequenceanalysis. Prior to the addition of this code, youmay have reported this test with an unlisted codesuch as 81479, because no other code describedG6PD gene analysis. Make sure to distinguish81248 from 81247 for common variants and 81249for full gene sequence analysis. Results of testingfor G6PD mutations could aid in the diagnosis ofG6PD deficiency associated with jaundice or drug-induced acute hemolytic anemia, or aid inidentifying G6PD deficiency carrier status.

81249 G6PD (glucose-6-phosphate dehydrogenase)(eg, hemolytic anemia,jaundice), gene analysis;full gene sequence

CPT® 2018 adds 81249 as one of three new Tier1 molecular pathology codes in the range 81247-81249 to describe genotyping for G6PD (glucose-6-phosphate dehydrogenase). Code 81249describes full gene sequence analysis. Prior to theaddition of this code, you may have reported thistest with an unlisted code such as 81479, becauseno other code described G6PD gene analysis.Make sure to distinguish 81249 from 81247 forcommon variants and 81248 for known familialvariants. Results of testing for G6PD mutationscould aid in the diagnosis of G6PD deficiencyassociated with jaundice or drug-induced acutehemolytic anemia, or aid in identifying G6PDdeficiency carrier status.

81258 HBA1/HBA2 (alpha globin1 and alpha globin 2) (eg,alpha thalassemia, Hb Bart

CPT® 2018 adds 81258 as one of three new Tier1 molecular pathology codes in the range 81258-

1/3/2018 AAPC Coder


hydrops fetalis syndrome,HbH disease), geneanalysis; known familialvariant

81259 and 81269 (which is out of numericalsequence) to describe gene analysis forHBA1/HBA2 (alpha globin 1 and alpha globin 2).Code 81258 describes analysis of known familialvariants. Prior to the addition of this code, you mayhave reported this test with an unlisted code suchas 81479, because no other code describedHBA1/HBA2 gene analysis. Make sure todistinguish 81258 from 81259 for full genesequence analysis and 81269 for knownduplication/deletion variants. For common deletionvariants of alpha globin 1 and alpha globin 2genes, use 81257. Results of testing forHBA1/HBA2 mutations may aid in diagnosis ofalpha globin genetic abnormalities involved inconditions such as certain types of alphathalassemia, which is a hemoglobin disorder.

81259 HBA1/HBA2 (alpha globin1 and alpha globin 2) (eg,alpha thalassemia, Hb Barthydrops fetalis syndrome,HbH disease), geneanalysis; full genesequence

CPT® 2018 adds 81259 as one of three new Tier1 molecular pathology codes in the range 81258-81259 and 81269 (which is out of numericalsequence) to describe gene analysis forHBA1/HBA2 (alpha globin 1 and alpha globin 2).Code 81259 describes HBA1/HBA1 full genesequence analysis, which CPT® 2018 deletesfrom the Tier 2 molecular pathology code 81405test list. Beginning Jan. 1, you should use 81259for HBA1/HBA2 full gene sequence analysisinstead of 81405. Make sure to distinguish 81259from 81258 for known familial variant genesequence analysis and 81269 for knownduplication/deletion variants of HBA1/HBA2. Forcommon deletion variants of alpha globin 1 andalpha globin 2 genes, use 81257. Results oftesting for HBA1/HBA2 mutations may aid indiagnosis of alpha globin genetic abnormalitiesinvolved in conditions such as certain types ofalpha thalassemia, which is a hemoglobindisorder.

81269 HBA1/HBA2 (alpha globin1 and alpha globin 2) (eg,alpha thalassemia, Hb Barthydrops fetalis syndrome,HbH disease), geneanalysis;duplication/deletionvariants

CPT® 2018 adds 81269 as one of three new Tier1 molecular pathology codes in the range 81258-81259 and 81269 (which is out of numericalsequence) to describe gene analysis forHBA1/HBA2 (alpha globin 1 and alpha globin 2).Code 81269 describes HBA1/HBA1 duplicationdeletion genetic analysis, which CPT® 2018deletes from the Tier 2 molecular pathology code81404 test list. Beginning Jan. 1, you should use81269 for HBA1/HBA2 duplication deletionanalysis instead of 81404. Make sure todistinguish 81269 from 81258 for known familial

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variant gene sequence analysis and 81259 for fullgene sequence analysis of HBA1/HBA2. Forcommon deletion variants of alpha globin 1 andalpha globin 2 genes, use 81257. Results oftesting for HBA1/HBA2 mutations may aid indiagnosis of alpha globin genetic abnormalitiesinvolved in conditions such as certain types ofalpha thalassemia, which is a hemoglobindisorder.

81283 IFNL3 (interferon, lambda3) (eg, drug response),gene analysis, rs12979860variant

CPT® 2018 adds 81283 in the Tier 1 molecularpathology section to describe a test for IFNL3(interferon, lambda 3) rs12979860 variant geneanalysis. At the same time, CPT® 2018 deletesthis test from the Tier 2 molecular pathology code81400 test list under the older name for the samegene, IL28B (interleukin 28B [interferon, lambda3]). Beginning Jan. 1, you should use 81283 for anIFNL3 rs12979860 variant gene analysis insteadof 81400. The results of this test may impacttreatment therapy selection, especially related tosimeprevir, for patients with Hepatitis C virus(HCV) genotype 1 infections.

81328 SLCO1B1 (solute carrierorganic anion transporterfamily, member 1B1) (eg,adverse drug reaction),gene analysis, commonvariant(s) (eg, *5)

CPT® 2018 adds 81328 in the Tier 1 molecularpathology section to describe a test for SLCO1B1(solute carrier organic anion transporter family,member 1B1) common variant gene analysis. Atthe same time, CPT® 2018 deletes this test fromthe Tier 2 molecular pathology code 81400 testlist. Beginning Jan. 1, you should use 81328 for aSLCO1B1common variant gene analysis insteadof 81400. The results of this test may help predictadverse drug reaction when treating patients withcholesterol-lowering statin therapy.

81334 RUNX1 (runt relatedtranscription factor 1) (eg,acute myeloid leukemia,familial platelet disorderwith associated myeloidmalignancy), geneanalysis, targetedsequence analysis (eg,exons 3-8)

CPT® 2018 adds 81334 in the Tier 1 molecularpathology section to describe a test for RUNX1(runt related transcription factor 1) targeted genesequence analysis, for example, for exons 3-8.Prior to the addition of this code, you may havereported this test with an unlisted code such as81479, because no other code described RUNX1targeted gene sequence analysis. Distinguish81334 from other RUNX1 genetic tests, such as81401 for RUNX1/RUNX1T1 translocationanalysis. The results of the 81334 test may haveindications for therapy resistance and outcomesfor acute myeloid leukemia (AML) patients.

81335 TPMT (thiopurine S-methyltransferase) (eg,drug metabolism), gene

CPT® 2018 adds 81335 in the Tier 1 molecularpathology section to describe a test for commonvariant gene analysis of TPMT (thiopurine S-

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analysis, common variants(eg, *2, *3)

methyltransferase), such as *2, *3. At the sametime, CPT® 2018 deletes this test from the Tier 2molecular pathology code 81401 test list.Beginning Jan. 1, you should use 81335 forcommon variant TPMT gene analysis instead of81401. The results of this test may help predictadverse drug reaction in thiopurine drug therapyfor immunosuppression in conditions such asacute lymphoblastic leukemia (ALL), certainautoimmune disorders, and organ transplant.

81346 TYMS (thymidylatesynthetase) (eg, 5-fluorouracil/5-FU drugmetabolism), geneanalysis, commonvariant(s) (eg, tandemrepeat variant)

CPT® 2018 adds 81346 in the Tier 1 molecularpathology section to describe a test for commonvariant gene analysis of TYMS (thymidylatesynthetase), such as tandem repeat variant. At thesame time, CPT® 2018 deletes this test from theTier 2 molecular pathology code 81401 test list.Beginning Jan. 1, you should use 81346 forcommon variant TPMT gene analysis instead of81401. The results of this test may help predicteffectiveness and possible toxicity ofchemotherapeutic agent 5-fluorouracil (5-FU) forsolid tumors such as colorectal cancer.

81361 HBB (hemoglobin, subunitbeta) (eg, sickle cellanemia, beta thalassemia,hemoglobinopathy);common variant(s) (eg,HbS, HbC, HbE)

CPT® 2018 adds 81361 as one of four new Tier 1molecular pathology codes in the range 81361-81364 to describe genotyping for HBB(hemoglobin, subunit beta). Code 81361 describesa test for HBB common variants, such as HbS,HbC, HbE, which CPT® 2018 deletes from Tier 2molecular pathology code 81401. Beginning Jan.1, you should report 81361 for HBB commonvariant genetic testing instead of 81401. Makesure to distinguish this test from codes 81362 forHBB known familial variants, 81363 for HBBduplication/deletion variant(s), and 81364 for HBBfull gene sequence analysis. Clinicians may orderHBB common variant testing to help confirmsuspected genetic mutation linked to a conditionsuch as sickle cell anemia, beta thalassemia, orother hemoglobinopathy.

81362 HBB (hemoglobin, subunitbeta) (eg, sickle cellanemia, beta thalassemia,hemoglobinopathy); knownfamilial variant(s)

CPT® 2018 adds 81362 as one of four new Tier 1molecular pathology codes in the range 81361-81364 to describe genotyping for HBB(hemoglobin, subunit beta). Code 81362 describesa test for HBB known familial variants. Prior to theaddition of this code, you may have reported thistest with an unlisted code such as 81479, becauseno other code described HBB known familialvariant analysis. Make sure to distinguish this testfrom codes 81361 for HBB common variants,81363 for HBB duplication/deletion variant(s), and

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81364 for HBB full gene sequence analysis.Clinicians may order HBB known familial varianttesting to screen for beta hemoglobin disorder(s)such as sickle cell anemia, beta thalassemia, orother hemoglobinopathy based on family history.

81363 HBB (hemoglobin, subunitbeta) (eg, sickle cellanemia, beta thalassemia,hemoglobinopathy);duplication/deletionvariant(s)

CPT® 2018 adds 81363 as one of four new Tier 1molecular pathology codes in the range 81361-81364 to describe genotyping for HBB(hemoglobin, subunit beta). Code 81363 describesa test for HBB duplication/deletion variants, whichCPT® 2018 deletes from Tier 2 molecularpathology code 81403. Beginning Jan. 1, youshould report 81363 for HBB duplication/deletiontesting instead of 81403. Make sure to distinguishthis test from codes 81361 for HBB commonvariants, 81362 for HBB known familial variants,and 81364 for HBB full gene sequence analysis.Clinicians may order HBB duplication/deletiontesting to help confirm suspected genetic mutationlinked to a condition such as sickle cell anemia,beta thalassemia, or other hemoglobinopathy.

81364 HBB (hemoglobin, subunitbeta) (eg, sickle cellanemia, beta thalassemia,hemoglobinopathy); fullgene sequence

CPT® 2018 adds 81364 as one of four new Tier 1molecular pathology codes in the range 81361-81364 to describe genotyping for HBB(hemoglobin, subunit beta). Code 81364 describesa full gene sequence analysis for HBB, whichCPT® 2018 deletes from Tier 2 molecularpathology code 81404. Beginning Jan. 1, youshould report 81364 for HBB full gene sequenceanalysis instead of 81404. Make sure todistinguish this test from codes 81361 for HBBcommon variants, 81362 for HBB known familialvariants, and 81363 for HBB duplication/deletionanalysis. Clinicians may order HBB full genesequence testing to aid in the diagnosis of geneticmutation linked to conditions such as sickle cellanemia, beta thalassemia, or otherhemoglobinopathy.

81448 Hereditary peripheralneuropathies (eg, Charcot-Marie-Tooth, spasticparaplegia), genomicsequence analysis panel,must include sequencing ofat least 5 peripheralneuropathy-related genes(eg, BSCL2, GJB1, MFN2,MPZ, REEP1, SPAST,SPG11, SPTLC1)

CPT® 2018 adds 81448 in the Tier 1 molecularpathology section to describe a genomic sequenceanalysis panel for at least five peripheral-neuropathy-related genes, such as the exampleslisted in the code, that may help diagnose orindicate a genetic predisposition to conditions suchas Charcot-Marie-Tooth (CMT) or spasticparaplegia. Report one unit of 81448 for thecomplete panel of five or more peripheral-neuropathy-related genes. If the lab tests fewerthan five of these genes, you should not use thiscode but should instead report the appropriate

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code for each individual test, such as 81407 forSPG11.

81520 Oncology (breast), mRNAgene expression profilingby hybrid capture of 58genes (50 content and 8housekeeping), utilizingformalin-fixed paraffin-embedded tissue,algorithm reported as arecurrence risk score

CPT® 2018 adds 81520 to the section formultianalyte assays with algorithmic analyses(MAAAs). Prior to this addition, CPT® listed thistest in Appendix O as administrative code 0008M.Clinicians use this test to evaluate formalin-fixedparaffin-embedded (FFPE) tissue for an mRNAgene expression profile of 58 genes. As with allMAAAs, the code describes both the lab test aswell as an algorithm that uses the test results andpossibly other patient data to calculate aprobability or risk score. In this case, the MAAAestablishes a numerical value that correlates withthe probability of distant breast cancer recurrencewithin 10 years.

81521 Oncology (breast), mRNA,microarray geneexpression profiling of 70content genes and 465housekeeping genes,utilizing fresh frozen orformalin-fixed paraffin-embedded tissue,algorithm reported as indexrelated to risk of distantmetastasis

CPT® 2018 adds 81521 to the section formultianalyte assays with algorithmic analyses(MAAAs). Clinicians use this test to evaluate freshfrozen or formalin-fixed paraffin-embedded (FFPE)tissue for expression of 70 content genes thatpredict the breast cancer’s ability to spread ormetastasize. As with all MAAAs, the codedescribes both the lab test, in this case, microarraygene analysis, and an algorithm that uses the testresults and possibly other patient data to report aprobability or risk score. The 81521 test results ina low or high risk score for breast cancerrecurrence, which clinicians may use along withother date to evaluate treatment options.

81541 Oncology (prostate),mRNA gene expressionprofiling by real-time RT-PCR of 46 genes (31content and 15housekeeping), utilizingformalin-fixed paraffin-embedded tissue,algorithm reported as adisease-specific mortalityrisk score

CPT® 2018 adds 81541 to the section formultianalyte assays with algorithmic analyses(MAAAs). Clinicians use this test to evaluateformalin-fixed paraffin-embedded (FFPE) tissue forexpression of 46 genes that help predict diseaseaggressiveness. As with all MAAAs, the codedescribes both the lab test, in this case, mRNAgene expression profiling by real-time polymerasechain reaction (RT-PCR), and an algorithm thatuses the test results and possibly other patientdata to report a probability or risk score. The81541 test results in a disease-specific mortalityrisk score that can aid treatment decisions forpatients with a current prostate cancer diagnosis,or help predict post-prostatectomy risk ofrecurrence.

81551 Oncology (prostate),promoter methylationprofiling by real-time PCRof 3 genes (GSTP1, APC,

CPT® 2018 adds 81551 to the section formultianalyte assays with algorithmic analyses(MAAAs). Clinicians use this test to evaluate three

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RASSF1), utilizingformalin-fixed paraffin-embedded tissue,algorithm reported as alikelihood of prostatecancer detection on repeatbiopsy

genes listed in the code using formalin-fixedparaffin-embedded (FFPE) tissue. As with allMAAAs, the code describes both the lab test, inthis case, methylation specific real-timepolymerase chain reaction (RT-PCR) functioningas a prostate cancer biomarker, and an algorithmthat uses the test results and possibly other patientdata to report a probability or risk score. The81551 test results in a score indicating likelihoodof prostate cancer detection on repeat biopsy for apatient with prior negative prostate biopsy.

86008 Allergen specific IgE;quantitative orsemiquantitative,recombinant or purifiedcomponent, each

CPT® 2018 adds code 86008 to the immunologysection for a test that analyzes a patient specimenfor immunoglobulin E (IgE) to a specific allergencomponent. Each component is a specificallergenic molecule purified from a crude allergenextract, typically prepared for testing usingrecombinant DNA. Contrast this test to 86003,which CPT® 2018 revises to describe IgE testingusing crude allergen extract. The result of this testis quantitative or semiquantitative, and you use asingle unit of this code for each purified allergencomponent tested.

86794 Antibody; Zika virus, IgM CPT® 2018 adds code 86794 to the Immunologysection for a test to evaluate a patient specimenfor immunoglobulin M (IgM) antibodies to Zikavirus. Patients are typically IgM positive a week to12 weeks following Zika exposure or symptomonset. Clinicians may order the test for patientswho are symptomatic, or pregnant patients whomay have been exposed to the virus. Prior to theaddition of this code, the unlisted virus antibodycode 86790 described this test.

87634 Infectious agent detectionby nucleic acid (DNA orRNA); respiratory syncytialvirus, amplified probetechnique

CPT® 2018 adds code 87634 to the Microbiologysection for a test to evaluate a patient specimenfor respiratory syncytial virus (RSV) antigens. Thetest uses amplified probe technique for RSVnucleic acid detection to aid in diagnosis ofrespiratory infection. Distinguish this code fromother RSV antigen detection codes by othermethods, such as 87280, 87420, and 87807. Priorto the addition of this code, the unlisted amplified-probe virus antigen detection code 87798described this test.

87662 Infectious agent detectionby nucleic acid (DNA orRNA); Zika virus, amplifiedprobe technique

CPT® 2018 adds code 87662 to the Microbiologysection for a test to evaluate a patient specimensuch as blood or urine for Zika virus antigens. Thetest uses amplified probe technique for Zika RNAdetection to aid in determining possible patient

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exposure to the virus. Clinicians may order the testfor patients who are symptomatic, or pregnantpatients who may have been exposed to the virus.Prior to the addition of this code, the unlistedamplified-probe virus antigen detection code87798 described this test.

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https://coder.aapc.com/cpt-code-changes-2018/code-category/Psychiatry 1/4


0488T Preventive behavior change, online/electronicstructured intensive program for prevention of diabetesusing a standardized diabetes prevention programcurriculum, provided to an individual, per 30 days

CPT® 2018 addsCategory III code0488T to report astructured diabetesprevention programthat addresses stress,nutrition, weightmanagement, andexercise, deliveredonline or via electronictechnology by alifestyle coach who hascompleted nationallyrecognized training.

97127 Therapeutic interventions that focus on cognitivefunction (eg, attention, memory, reasoning, executivefunction, problem solving, and/or pragmaticfunctioning) and compensatory strategies to managethe performance of an activity (eg, managing time orschedules, initiating, organizing and sequencingtasks), direct (one-on-one) patient contact

The 2018 code setadds 97127 to replace97532 for reportingcognitive skillsdevelopment. Code97127 removes thetime specification (each15 minutes), retains thedirect (one-on-one)patient contactspecification, andincludes expandedexamples of cognitivefunction (attention,memory, reasoning,executive function,problem solving, and/orpragmatic functioning[verbal and socialinteraction]) andcompensatorystrategies (managingtime or schedules,initiating, organizing,and sequencing tasks).

99483 Assessment of and care planning for a patient withcognitive impairment, requiring an independenthistorian, in the office or other outpatient, home ordomiciliary or rest home, with all of the followingrequired elements: Cognition-focused evaluationincluding a pertinent history and examination; Medicaldecision making of moderate or high complexity;Functional assessment (eg, basic and instrumentalactivities of daily living), including decision-making

CPT® 2018 adds99483 for careplanning of a patientwith cognitiveimpairment inevaluation andmanagement services.

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capacity; Use of standardized instruments for stagingof dementia (eg, functional assessment staging test[FAST], clinical dementia rating [CDR]); Medicationreconciliation and review for high-risk medications;Evaluation for neuropsychiatric and behavioralsymptoms, including depression, including use ofstandardized screening instrument(s); Evaluation ofsafety (eg, home), including motor vehicle operation;Identification of caregiver(s), caregiver knowledge,caregiver needs, social supports, and the willingnessof caregiver to take on caregiving tasks; Development,updating or revision, or review of an Advance CarePlan; Creation of a written care plan, including initialplans to address any neuropsychiatric symptoms,neuro-cognitive symptoms, functional limitations, andreferral to community resources as needed (eg,rehabilitation services, adult day programs, supportgroups) shared with the patient and/or caregiver withinitial education and support. Typically, 50 minutes arespent face-to-face with the patient and/or family orcaregiver.

The code includescognition-focusedpertinent history,examination andmoderate to highcomplexity medicaldecision making. Thephysician typicallyspends 50 minutesface-to-face with thepatient, family, orcaregiver.

99484 Care management services for behavioral healthconditions, at least 20 minutes of clinical staff time,directed by a physician or other qualified health careprofessional, per calendar month, with the followingrequired elements: initial assessment or follow-upmonitoring, including the use of applicable validatedrating scales; behavioral health care planning inrelation to behavioral/psychiatric health problems,including revision for patients who are not progressingor whose status changes; facilitating and coordinatingtreatment such as psychotherapy, pharmacotherapy,counseling and/or psychiatric consultation; andcontinuity of care with a designated member of thecare team.

CPT® 2018 adds99492, 99493 and+99494 in place ofG0502, G0503 andG0504; the new codesretain the samedescriptors without anychange. Collaborativecare management(CoCM) is an approachto behavioral healthcare that enhancestypical primary care bycoordinating psychiatriccare with primary carefor patients receivingbehavioral healthtreatment, particularlyregarding patientswhose conditions arenot improving. Report99492 for the initial 70minutes of CoCM in thefirst calendar monthand 99493 for the first60 minutes in asubsequent month.Report +99494 inaddition to 99492 or99493 for eachadditional 30 minutesin a calendar month.

99492 Initial psychiatric collaborative care management, first70 minutes in the first calendar month of behavioral

CPT® 2018 adds

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health care manager activities, in consultation with apsychiatric consultant, and directed by the treatingphysician or other qualified health care professional,with the following required elements: outreach to andengagement in treatment of a patient directed by thetreating physician or other qualified health careprofessional; initial assessment of the patient,including administration of validated rating scales, withthe development of an individualized treatment plan;review by the psychiatric consultant with modificationsof the plan if recommended; entering patient in aregistry and tracking patient follow-up and progressusing the registry, with appropriate documentation, andparticipation in weekly caseload consultation with thepsychiatric consultant; and provision of briefinterventions using evidence-based techniques suchas behavioral activation, motivational interviewing, andother focused treatment strategies.

99492, 99493 and+99494; the new codeshave the samedescriptors as G0502,G0503 and G0504.Collaborative caremanagement (CoCM)is an approach tobehavioral health carethat enhances typicalprimary care bycoordinating psychiatriccare with primary carefor patients receivingbehavioral healthtreatment, particularlyregarding patientswhose conditions arenot improving. Report99492 for the initial 70minutes of CoCM in thefirst calendar monthand 99493 for the first60 minutes in asubsequent month.Report +99494 inaddition to 99492 or99493 for eachadditional 30 minutesin a calendar month.

99493 Subsequent psychiatric collaborative caremanagement, first 60 minutes in a subsequent monthof behavioral health care manager activities, inconsultation with a psychiatric consultant, and directedby the treating physician or other qualified health careprofessional, with the following required elements:tracking patient follow-up and progress using theregistry, with appropriate documentation; participationin weekly caseload consultation with the psychiatricconsultant; ongoing collaboration with andcoordination of the patient's mental health care withthe treating physician or other qualified health careprofessional and any other treating mental healthproviders; additional review of progress andrecommendations for changes in treatment, asindicated, including medications, based onrecommendations provided by the psychiatricconsultant; provision of brief interventions usingevidence-based techniques such as behavioralactivation, motivational interviewing, and other focusedtreatment strategies; monitoring of patient outcomesusing validated rating scales; and relapse preventionplanning with patients as they achieve remission ofsymptoms and/or other treatment goals and areprepared for discharge from active treatment.

CPT® 2018 adds99492, 99493 and+99494; the new codeshave the samedescriptors as G0502,G0503 and G0504.Collaborative caremanagement (CoCM)is an approach tobehavioral health carethat enhances typicalprimary care bycoordinating psychiatriccare with primary carefor patients receivingbehavioral healthtreatment, particularlyregarding patientswhose conditions arenot improving. Report99492 for the initial 70

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minutes of CoCM in thefirst calendar monthand 99493 for the first60 minutes in asubsequent month.Report +99494 inaddition to 99492 or99493 for eachadditional 30 minutesin a calendar month.

99494 Initial or subsequent psychiatric collaborative caremanagement, each additional 30 minutes in a calendarmonth of behavioral health care manager activities, inconsultation with a psychiatric consultant, and directedby the treating physician or other qualified health careprofessional (List separately in addition to code forprimary procedure)

CPT® 2018 adds99492, 99493 and+99494; the new codeshave the samedescriptors as G0502,G0503 and G0504.Collaborative caremanagement (CoCM)is an approach tobehavioral health carethat enhances typicalprimary care bycoordinating psychiatriccare with primary carefor patients receivingbehavioral healthtreatment, particularlyregarding patientswhose conditions arenot improving. Report99492 for the initial 70minutes of CoCM in thefirst calendar monthand 99493 for the first60 minutes in asubsequent month.Report +99494 inaddition to 99492 or99493 for eachadditional 30 minutesin a calendar month.

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https://coder.aapc.com/cpt-code-changes-2018/code-category/Radiology 1/13

Radiology


0482T Absolute quantitation ofmyocardial blood flow,positron emissiontomography (PET), restand stress (Listseparately in addition tocode for primaryprocedure)

CPT® 2018 adds Category III code +0482T as anadd-on code to be reported with CPT 78491 or78492 on the same day. Measuring myocardial bloodflow with PET helps provide a better assessment ofheart disease and overcome shortcomings of visualmethod. In this procedure, a radioactive tracer isinstilled or injected into the patient, a PET scanperformed with the patient at rest and under stress,and myocardial blood flow is analyzed and quantified(measured) using a computer.


CPT® 2018 adds Category III code 0487T to trackthe use and efficacy of a relatively new, but FDA-approved technology, i.e. transvaginal biomechanicalmapping. In this procedure, the provider inserts aprobe with tactile sensors on its surface into thevagina. The probe senses pelvic muscle contractionsand relaxation and sends the data to a computerwhere the data is interpreted and pelvic floor musclefunction mapped. The technology helps diagnosevaginal and pelvic floor abnormalities.

0495T Initiation and monitoringmarginal (extended)cadaver donor lung(s)organ perfusion systemby physician or qualifiedhealth care professional,including physiologicaland laboratoryassessment (eg,pulmonary artery flow,pulmonary arterypressure, left atrialpressure, pulmonaryvascular resistance,mean/peak and plateauairway pressure,dynamic compliance andperfusate gas analysis),including bronchoscopyand X ray whenperformed; first twohours in sterile field

The 2018 code set add 0495T and 0496T to reportmarginal donor lung monitoring by a qualifiedhealthcare professional. Report 0495T for the firsttwo hours of monitoring, using various parameters,including visual physiologic assessment, variouslaboratory pulmonary function studies, and evenbronchoscopy and X-ray. For each additional hour ofmonitoring, report +0496T with 0495T. The code setalso adds 0494T to report the surgical preparationand preservation of cadaver donor lung(s) includingattaching the lung to an organ perfusion system andits removal for implantation. Donor organ perfusiontechnology uses ventilation and perfusion of thedonor lung to reproduce the in vivo (in the body)environment, increasing its viability for a longerperiod. The system also assesses the function ofmarginal lungs and expands the number ofacceptable donor lungs.

0496T Initiation and monitoringmarginal (extended)cadaver donor lung(s)organ perfusion systemby physician or qualifiedhealth care professional,including physiological

The 2018 code set add 0495T and +0496T to reportmarginal donor lung monitoring by a qualifiedhealthcare professional. Report 0495T for the firsttwo hours of monitoring, using various parameters,including visual physiologic assessment, various

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and laboratoryassessment (eg,pulmonary artery flow,pulmonary arterypressure, left atrialpressure, pulmonaryvascular resistance,mean/peak and plateauairway pressure,dynamic compliance andperfusate gas analysis),including bronchoscopyand X ray whenperformed; eachadditional hour (Listseparately in addition tocode for primaryprocedure)

laboratory pulmonary function studies, and evenbronchoscopy and X-ray. For each additional hour ofmonitoring, report +0496T with 0495T. The code setalso adds 0494T to report the surgical preparationand preservation of cadaver donor lung(s) includingattaching the lung to an organ perfusion system andits separation from the organ perfusion system forimplantation. Donor organ perfusion technology usesventilation and perfusion of the donor lung toreproduce the in vivo (in the body) environment,increasing its viability for a longer period. The systemalso assesses the function of marginal lungs andexpands the number of acceptable donor lungs.


The 2018 code set adds 0499T to track the use andefficacy of instillation of a drug through the urethraduring cystourethroscopy and mechanical dilation forstricture or stenosis. Drugs such as steroids havebeen instilled into the urethra following surgicaltreatment of a stricture or stenosis to promotehealing and prevent scarring or repeat stricture.Cystourethroscopy is a procedure in which theprovider views and examines the bladder andurethra using a flexible or rigid tube with a camera atthe end that is inserted through the urethra into thebladder to examine the urethra and urinary tract.Instruments such as dilators can be inserted throughthe scope to dilate a narrowed urethra. Theprocedure is sometimes done using fluoroscopicguidance, a live X-ray where the image appears on amonitor.

0501T Noninvasive estimatedcoronary fractional flowreserve (FFR) derivedfrom coronary computedtomography angiographydata using computationfluid dynamicsphysiologic simulationsoftware analysis offunctional data to assessthe severity of coronaryartery disease; datapreparation andtransmission, analysis offluid dynamics andsimulated maximalcoronary hyperemia,generation of estimatedFFR model, withanatomical data reviewin comparison withestimated FFR model toreconcile discordant

CPT® 2018 adds four Category III codes 0501T-0504T to track the use and efficacy of noninvasiveestimated coronary fractional flow reserve (FFR)computed tomography (CT), an emergingtechnology. FFR-CT is a diagnostic imagingtechnique which helps diagnose intermediatecoronary artery stenosis and improves decision-making. FFR-CT provides a detailed description ofthe blood flow in heart vessels with anatomicaldetails. Report 0501T for the full study—imaging,analysis, estimated FFR model generation, andreconciliation of anatomical data with the estimatedFFR as well as interpretation and report. Forcomponents of the study, report 0502T for datapreparation and transmission, 0503T for fluiddynamics analysis, simulated maximal coronaryhyperemia, and estimated FFR model generation,and 0504T for reconciliation of anatomical data withthe estimated FFR and interpretation and report.

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data, interpretation andreport

Codes 0502T-0504T cannot be reported inconjunction with 0501T; no code should be reportedmore than once per coronary CT angiography.



0503T Noninvasive estimatedcoronary fractional flowreserve (FFR) derivedfrom coronary computedtomography angiographydata using computationfluid dynamicsphysiologic simulationsoftware analysis offunctional data to assessthe severity of coronaryartery disease; analysisof fluid dynamics andsimulated maximalcoronary hyperemia, andgeneration of estimatedFFR model


0504T Noninvasive estimatedcoronary fractional flowreserve (FFR) derived

CPT® 2018 adds four Category III codes 0501T-0504T to track the use and efficacy of noninvasiveestimated coronary fractional flow reserve (FFR)

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from coronary computedtomography angiographydata using computationfluid dynamicsphysiologic simulationsoftware analysis offunctional data to assessthe severity of coronaryartery disease;anatomical data reviewin comparison withestimated FFR model toreconcile discordantdata, interpretation andreport

computed tomography (CT), an emergingtechnology. FFR-CT is a diagnostic imagingtechnique which helps diagnose intermediatecoronary artery stenosis and improves decision-making. FFR-CT provides a detailed description ofthe blood flow in heart vessels with anatomicaldetails. Report 0501T for the full study—imaging,analysis, estimated FFR model generation, andreconciliation of anatomical data with the estimatedFFR as well as interpretation and report. Forcomponents of the study, report 0502T for datapreparation and transmission, 0503T for fluiddynamics analysis, simulated maximal coronaryhyperemia, and estimated FFR model generation,and 0504T for reconciliation of anatomical data withthe estimated FFR and interpretation and report.Codes 0502T-0504T cannot be reported inconjunction with 0501T; no code should be reportedmore than once per coronary CT angiography.

19294 Preparation of tumorcavity, with placement ofa radiation therapyapplicator forintraoperative radiationtherapy (IORT)concurrent with partialmastectomy (Listseparately in addition tocode for primaryprocedure)

The 2018 code set adds +19294 as an add-on codeto be reported with a primary partial mastectomyprocedure. Report 19294 for preparation of a tumorcavity and placement of a radiation therapyapplicator for intraoperative radiation therapy (IORT).

32994 Ablation therapy forreduction or eradicationof 1 or more pulmonarytumor(s) including pleuraor chest wall wheninvolved by tumorextension, percutaneous,including imagingguidance whenperformed, unilateral;cryoablation

The 2018 code set adds 32994 to replace0340T. This new CPT® code specifies that thisprocedure is for either reduction or completedestruction of one or more pulmonary tumors. Theprovider makes a small incision through the skin andinserts a cryoprobe (a thin needle used to freezeabnormal tissue) and extends it under imagingguidance to the site of the tumor(s) on one side ofthe lungs or chest wall. This code specifies tumordestruction by cryoablation; see 32998 for a similarprocedure using radiofrequency ablation (the use ofheat produced by focused radio waves).This code represents a unilateral service, meaningperformed on one side. Append modifier 50 or RT/LT,depending on payer preference, if the providerperforms the procedure bilaterally.

34701 Endovascular repair ofinfrarenal aorta bydeployment of an aorto-aortic tube endograftincluding pre-proceduresizing and deviceselection, allnonselective

The 2018 code set adds 34701 and 34702 to replace34800. The two new codes specify that theprocedure is repair of the infrarenal aorta andappend the indications at the end of the descriptor.Code 34702 is for rupture and 34701 for reasonsother than rupture. The new codes also specify that

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catheterization(s), allassociated radiologicalsupervision andinterpretation, allendograft extension(s)placed in the aorta fromthe level of the renalarteries to the aorticbifurcation, and allangioplasty/stentingperformed from the levelof the renal arteries tothe aortic bifurcation; forother than rupture (eg,for aneurysm,pseudoaneurysm,dissection, penetratingulcer)

the procedure includes radiological supervision andinterpretation, device sizing and selection prior to theprocedure, any device extensions and anyangioplasty or stents required between the renalarteries and the aortic bifurcation where it dividesinto two branches. Code 34702 adds trauma to thelist of indications (aneurysm, pseudoaneurysm,dissection, penetrating ulcer) for repair of theintrarenal aorta.For similar procedures to repair the infrarenal aortaand/or iliac artery, see 34704-34706 and for similarprocedures to repair just the iliac artery, see 34707-34708.

34702 Endovascular repair ofinfrarenal aorta bydeployment of an aorto-aortic tube endograftincluding pre-proceduresizing and deviceselection, allnonselectivecatheterization(s), allassociated radiologicalsupervision andinterpretation, allendograft extension(s)placed in the aorta fromthe level of the renalarteries to the aorticbifurcation, and allangioplasty/stentingperformed from the levelof the renal arteries tothe aortic bifurcation; forrupture includingtemporary aortic and/oriliac balloon occlusion,when performed (eg, foraneurysm,pseudoaneurysm,dissection, penetratingulcer, traumaticdisruption)

The 2018 code set adds 34701 and 34702 to replace34800. The two new codes specify that theprocedure is to report repair of the infrarenal aortausing an aorto-aortic tube, see 34701 and 34702. Italso clarifies that the procedure is repair of theinfrarenal aorta and append the indications for therepair at the end of the descriptors. In these twoprocedures, the tube graft is placed only in the aorta;it does not go beyond the aortic bifurcation where itdivides into two branches (the iliac arteries). Code34702 is for rupture and 34701 for reasons otherthan rupture. The new codes also specify that theprocedure includes radiological supervision andinterpretation, device sizing and selection prior to theprocedure, any graft extensions and any angioplastyor stents required between the renal arteries and theaortic bifurcation. Code 34702 adds trauma to the listof indications (aneurysm, pseudoaneurysm,dissection, penetrating ulcer, trauma) for repair of theintrarenal aorta.For similar procedures to repair the infrarenal aortaand/or iliac artery, see 34704-34706 and for similarprocedures to repair just the iliac artery, see 34707-34708.

34703 Endovascular repair ofinfrarenal aorta and/oriliac artery(ies) bydeployment of an aorto-uni-iliac endograftincluding pre-proceduresizing and deviceselection, allnonselectivecatheterization(s), allassociated radiologicalsupervision andinterpretation, allendograft extension(s)placed in the aorta from

The 2018 code set adds 34703 and 34704 to replace34802. The two new codes include repair of eitherthe infrarenal aorta or iliac artery, or both, andappend the indications for the repair at the end of thedescriptors. The endograft in these two proceduresis placed in the aorta and down one iliac arterybeyond the aortic bifurcation. Code 34704 is forrupture and 34703 for reasons other than rupture.The new codes also specify that the proceduresinclude radiological supervision and interpretation,device sizing and selection prior to the procedure,any graft extensions and any angioplasty or stents

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the level of the renalarteries to the iliacbifurcation, and allangioplasty/stentingperformed from the levelof the renal arteries tothe iliac bifurcation; forother than rupture (eg,for aneurysm,pseudoaneurysm,dissection, penetratingulcer)

required down to where the iliac arteries branch(bifurcation). They also include temporary aorticand/or iliac balloon occlusion (clamping off thearteries to prevent blood flow), when performed.Code 34704 adds trauma to the list of indications(aneurysm, pseudoaneurysm, dissection, penetratingulcer, trauma). For the same procedures using anaorto-bi-iliac endograft, see 34705-34706, for similarprocedures to repair only the infrarenal artery, see34701-34702, and for procedures to repair only theiliac artery, see 34707-34708.

34704 Endovascular repair ofinfrarenal aorta and/oriliac artery(ies) bydeployment of an aorto-uni-iliac endograftincluding pre-proceduresizing and deviceselection, allnonselectivecatheterization(s), allassociated radiologicalsupervision andinterpretation, allendograft extension(s)placed in the aorta fromthe level of the renalarteries to the iliacbifurcation, and allangioplasty/stentingperformed from the levelof the renal arteries tothe iliac bifurcation; forrupture includingtemporary aortic and/oriliac balloon occlusion,when performed (eg, foraneurysm,pseudoaneurysm,dissection, penetratingulcer, traumaticdisruption)

The 2018 code set adds 34703 and 34704 to replace34802. The two new codes include repair of eitherthe infrarenal aorta or iliac artery, or both, andappend the indications for the repair at the end of thedescriptors. The endograft in these two proceduresis placed in the aorta and down one iliac arterybeyond the aortic bifurcation. Code 34704 is forrupture and 34703 for reasons other than rupture.The new codes also specify that the proceduresinclude radiological supervision and interpretation,device sizing and selection prior to the procedure,any graft extensions and any angioplasty or stentsrequired down to where the iliac arteries branch(bifurcation). They also include temporary aorticand/or iliac balloon occlusion (clamping off thearteries to prevent blood flow), when performed.Code 34704 adds trauma to the list of indications(aneurysm, pseudoaneurysm, dissection, penetratingulcer, trauma). For the same procedures using anaorto-bi-iliac endograft, see 34705-34706, for similarprocedures to repair only the infrarenal artery, see34701-34702, and for procedures to repair only theiliac artery, see 34707-34708.

34705 Endovascular repair ofinfrarenal aorta and/oriliac artery(ies) bydeployment of an aorto-bi-iliac endograftincluding pre-proceduresizing and deviceselection, allnonselectivecatheterization(s), allassociated radiologicalsupervision andinterpretation, allendograft extension(s)placed in the aorta fromthe level of the renalarteries to the iliacbifurcation, and allangioplasty/stenting

The 2018 code set adds 34705 and 34706 to replace34803. CPT® 34705 and 34706 is added to reportrepair of the infrarenal aorta and/or the iliac arteryusing an aorto-bi-iliac endograft. The two new codesinclude repair of either the infrarenal aorta or iliacartery, or both, and append the indications for therepair at the end of the descriptors. The endograft inthese two procedures is placed in the aorta anddown both iliac arteries beyond the aortic bifurcation.Code 34706 is for rupture and 34705 for reasonsother than rupture. The new codes also specify thatthe procedures include radiological supervision andinterpretation, device sizing and selection prior to theprocedure, any graft extensions and any angioplastyor stents required down to where the iliac arteries

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performed from the levelof the renal arteries tothe iliac bifurcation; forother than rupture (eg,for aneurysm,pseudoaneurysm,dissection, penetratingulcer)

branch (bifurcation). They also include temporaryaortic and/or iliac balloon occlusion (clamping off thearteries to prevent blood flow), when performed.Code 34706 adds trauma to the list of indications(aneurysm, pseudoaneurysm, dissection, penetratingulcer, trauma). For the same procedures using anaorto-uni-iliac endograft, see 34703-34704 and forsimilar procedures to repair only the infrarenal artery,see 34701-34702, and for procedure to repair onlythe iliac artery, see 34707-34708.

34706 Endovascular repair ofinfrarenal aorta and/oriliac artery(ies) bydeployment of an aorto-bi-iliac endograftincluding pre-proceduresizing and deviceselection, allnonselectivecatheterization(s), allassociated radiologicalsupervision andinterpretation, allendograft extension(s)placed in the aorta fromthe level of the renalarteries to the iliacbifurcation, and allangioplasty/stentingperformed from the levelof the renal arteries tothe iliac bifurcation; forrupture includingtemporary aortic and/oriliac balloon occlusion,when performed (eg, foraneurysm,pseudoaneurysm,dissection, penetratingulcer, traumaticdisruption)

The 2018 code set adds 34705 and 34706 to replace34803. CPT® 34705 and 34706 are added to reportrepair of the infrarenal aorta and/or the iliac arteryusing an aorto-bi-iliac endograft. The two new codesinclude repair of either the infrarenal aorta or iliacartery, or both, and append the indications for therepair at the end of the descriptors. The endograft inthese two procedures is placed in the aorta anddown both iliac arteries beyond the aortic bifurcation.Code 34706 is for rupture and 34705 for reasonsother than rupture. The new codes also specify thatthe procedures include radiological supervision andinterpretation, device sizing and selection prior to theprocedure, any graft extensions and any angioplastyor stents required down to where the iliac arteriesbranch (bifurcation). They also include temporaryaortic and/or iliac balloon occlusion (closing off thearteries to prevent blood flow), when performed.Code 34706 adds trauma to the list of indications(aneurysm, pseudoaneurysm, dissection, penetratingulcer, trauma). For the same procedures using anaorto-uni-iliac endograft, see 34703-34704 and forsimilar procedures to repair only the infrarenal artery,see 34701-34702, and for procedures to repair onlythe iliac artery, see 34707-34708.

34707 Endovascular repair ofiliac artery bydeployment of an ilio-iliactube endograft includingpre-procedure sizing anddevice selection, allnonselectivecatheterization(s), allassociated radiologicalsupervision andinterpretation, and allendograft extension(s)proximally to the aorticbifurcation and distally tothe iliac bifurcation, andtreatment zoneangioplasty/stenting,when performed,unilateral; for other than

The 2018 code set adds 34707 and 34708 to replace34804, 34805, and 34806. Use 34707 and 34708 toreport repair of an iliac artery using a tube endograftplaced only in the iliac artery. The new codes appendthe indications for the repair at the end of thedescriptors and specify the placement of the tubegrafts (endografts). The codes that end in an evennumber are for rupture and add trauma to the list ofindications, and those ending in an odd number arefor reasons other than rupture and do not includetrauma in the indications. The new codes alsospecify that the procedure includes radiologicalsupervision and interpretation, device sizing andselection prior to the procedure, any graftextensions, and any angioplasty or stents required.

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rupture (eg, foraneurysm,pseudoaneurysm,dissection, arteriovenousmalformation)

A few other new codes (34701-34708) have beenadded to report repair of the infrarenal aorta or theiliac arteries, or both. See 34701 and 34702 forinfrarenal aorta repair using an aorto-aortic tubeendograft that does not extend beyond the aorticbifurcation into the iliac arteries. See 34703 and34704 for repair of the infrarenal aorta and/or iliacartery(ies) using an aorto-uni-iliac endograft thatextends into one branch below the bifurcation and34705 and 34706 when the provider places an aorto-bi-iliac endograft that extends into both branchesbelow the bifurcation. Codes 34705-34708 includetemporary aortic and/or iliac balloon occlusion(clamping off the arteries to prevent blood flow),when performed.

34708 Endovascular repair ofiliac artery bydeployment of an ilio-iliactube endograft includingpre-procedure sizing anddevice selection, allnonselectivecatheterization(s), allassociated radiologicalsupervision andinterpretation, and allendograft extension(s)proximally to the aorticbifurcation and distally tothe iliac bifurcation, andtreatment zoneangioplasty/stenting,when performed,unilateral; for ruptureincluding temporaryaortic and/or iliac balloonocclusion, whenperformed (eg, foraneurysm,pseudoaneurysm,dissection, arteriovenousmalformation, traumaticdisruption)

The 2018 code set adds 34707 and 34708 to replace34804, 34805, and 34806. Use 34707 and 34708 toreport repair of an iliac artery using a tube endograftplaced only in the iliac artery. The new codes appendthe indications for the repair at the end of thedescriptors and specify the placement of the tubegrafts (endografts). The codes that end in an evennumber are for rupture and add trauma to the list ofindications, and those ending in an odd number arefor reasons other than rupture and do not includetrauma in the indications. The new codes alsospecify that the procedure includes radiologicalsupervision and interpretation, device sizing andselection prior to the procedure, any graftextensions, and any angioplasty or stents required.A few other new codes (34701-34708) have beenadded to report repair of the infrarenal aorta or theiliac arteries, or both. See 34701 and 34702 forinfrarenal aorta repair using an aorto-aortic tubeendograft that does not extend beyond the aorticbifurcation into the iliac arteries. See 34703 and34704 for repair of the infrarenal aorta and/or iliacartery(ies) using an aorto-uni-iliac endograft thatextends into one branch below the bifurcation and34705 and 34706 when the provider places an aorto-bi-iliac endograft that extends into both branchesbelow the bifurcation. Codes 34705-34708 includetemporary aortic and/or iliac balloon occlusion(clamping off the arteries to prevent blood flow),when performed.

34709 Placement of extensionprosthesis(es) distal tothe common iliacartery(ies) or proximal tothe renal artery(ies) forendovascular repair ofinfrarenal abdominal

The 2018 code set adds +34709, 34710, +34711 toreplace 34825 and 34826. These new CPT® codesspecify placement of extension prosthesis(es) distalto the common iliac artery(ies) or proximal to therenal artery(ies); the code includes radiological

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aortic or iliac aneurysm,false aneurysm,dissection, penetratingulcer, including pre-procedure sizing anddevice selection, allnonselectivecatheterization(s), allassociated radiologicalsupervision andinterpretation, andtreatment zoneangioplasty/stenting,when performed, pervessel treated (Listseparately in addition tocode for primaryprocedure)

supervision and interpretation, device sizing andselection, and angioplasty or stenting, whenperformed, in the treatment zone. Report +34709 foreach vessel treated during a primary procedure andlist separately in addition to the code for the primaryprocedure. Report 34710 for delayed placement(rather than placement during a primary procedure)for the first vessel treated, and +34711 with 34710for each additional vessel treated.

34710 Delayed placement ofdistal or proximalextension prosthesis forendovascular repair ofinfrarenal abdominalaortic or iliac aneurysm,false aneurysm,dissection, endoleak, orendograft migration,including pre-proceduresizing and deviceselection, allnonselectivecatheterization(s), allassociated radiologicalsupervision andinterpretation, andtreatment zoneangioplasty/stenting,when performed; initialvessel treated

The 2018 code set adds +34709, 34710, +34711 toreplace 34825 and 34826. These new CPT® codesspecify placement of extension prosthesis(es) distalto the common iliac artery(ies) or proximal to therenal artery(ies); the code includes radiologicalsupervision and interpretation, device sizing andselection, and angioplasty or stenting, whenperformed, in the treatment zone. Report 34710 fordelayed placement (rather than placement during aprimary procedure) for the first vessel treated, and+34711 for each additional vessel treated. Report+34709 for each vessel treated during a primaryprocedure and list separately in addition to the codefor the primary procedure.

34711 Delayed placement ofdistal or proximalextension prosthesis forendovascular repair ofinfrarenal abdominalaortic or iliac aneurysm,false aneurysm,dissection, endoleak, orendograft migration,including pre-proceduresizing and deviceselection, allnonselectivecatheterization(s), allassociated radiologicalsupervision andinterpretation, andtreatment zoneangioplasty/stenting,when performed; eachadditional vessel treated(List separately inaddition to code forprimary procedure)


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34712 Transcatheter delivery ofenhanced fixationdevice(s) to theendograft (eg, anchor,screw, tack) and allassociated radiologicalsupervision andinterpretation

CPT® 2018 adds 34712 to report a new type offixation device delivered through the lumen of acatheter (transcatheter) to secure placement of anendograft (a tube introduced through endoscopicmethods) for endovascular repair of an artery. Thisprocedure also includes radiological supervision andinterpretation.

34713 Percutaneous accessand closure of femoralartery for delivery ofendograft through a largesheath (12 French orlarger), includingultrasound guidance,when performed,unilateral (List separatelyin addition to code forprimary procedure)

CPT® 2018 adds new add-on code +34713, one ofseveral new codes for adjunctive procedures forendovascular repair of an artery, to report accessand closure of the femoral artery percutaneously, aminimally invasive procedure performed through asmall incision in the skin. This procedure is used todeliver an endograft via a 12F or larger sheath toimprove or restore blood flow in an artery. Thisprocedure also includes ultrasound guidance whenperformed.Append modifier 50 or RT/LT, depending on payerpreference, if the provider performs the procedurebilaterally.

36465 Injection of non-compounded foamsclerosant withultrasound compressionmaneuvers to guidedispersion of theinjectate, inclusive of allimaging guidance andmonitoring; singleincompetent extremitytruncal vein (eg, greatsaphenous vein,accessory saphenousvein)

Code 36465 and 36466 were added to report theinjection of noncompounded foam sclerosant (achemical solution that inflames a blood vessel'slining and makes the vessel walls adhere to eachother) for destruction of incompetent veins (a largervein in which the valves aren’t functioning, whichcauses it to stay filled with blood and appear blueand ropy) to treat venous insufficiency. In thisprocedure, ultrasound compression maneuvers areused to guide dispersion of the foam. This procedureincludes all imaging guidance and monitoringnecessary to carry out the procedure for multipleincompetent truncal veins. Report 36465 for injectionof noncompounded foam sclerosant to treat a singlevein and 36466 for the same procedure to treatmultiple veins.For injection of a sclerosant into a vein withoutcompression maneuvers to guide dispersion of theinjectate, see 36470 and 36471, and for endovenousablation therapy of incompetent vein[s] bytranscatheter delivery of a chemical adhesive, see36482 and 36483. For vascular embolization andocclusion procedures, see 37241-37244.

36466 Injection of non-compounded foamsclerosant withultrasound compressionmaneuvers to guidedispersion of theinjectate, inclusive of allimaging guidance and

Code 36465 and 36466 were added to report theinjection of noncompounded foam sclerosant (achemical solution that inflames a blood vessel'slining and makes the vessel walls adhere to eachother) for destruction of incompetent veins (a largervein in which the valves aren’t functioning, whichcauses it to stay filled with blood and appear blue

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monitoring; multipleincompetent truncalveins (eg, greatsaphenous vein,accessory saphenousvein), same leg

and ropy) to treat venous insufficiency. In thisprocedure, ultrasound compression maneuvers areused to guide dispersion of the foam. This procedureincludes all imaging guidance and monitoringnecessary to carry out the procedure for multipleincompetent truncal veins. Report 36465 for injectionof noncompounded foam sclerosant to treat a singlevein and 36466 for the same procedure to treatmultiple veins.For injection of a sclerosant into a vein withoutcompression maneuvers to guide dispersion of theinjectate, see 36470 and 36471, and for endovenousablation therapy of incompetent vein[s] bytranscatheter delivery of a chemical adhesive, see36482 and 36483. For vascular embolization andocclusion procedures, see 37241-37244.

36482 Endovenous ablationtherapy of incompetentvein, extremity, bytranscatheter delivery ofa chemical adhesive (eg,cyanoacrylate) remotefrom the access site,inclusive of all imagingguidance and monitoring,percutaneous; first veintreated

Code 36482 is one of the two new codes added toreport the use of endovenous ablation ofincompetent veins (a larger vein in which the valvesaren’t functioning, which causes it to stay filled withblood and appear blue and ropy) of the extremity byinstillation of a chemical adhesive such ascyanoacrylate for the treatment of venousinsufficiency. The procedure includes all imagingguidance and monitoring necessary to carry out theprocedure for the first vein in the extremity. This codeis for the first vein treated; for each subsequent veinin a single extremity but separate access points, seeadd-on code +36483.

36483 Endovenous ablationtherapy of incompetentvein, extremity, bytranscatheter delivery ofa chemical adhesive (eg,cyanoacrylate) remotefrom the access site,inclusive of all imagingguidance and monitoring,percutaneous;subsequent vein(s)treated in a singleextremity, each throughseparate access sites(List separately inaddition to code forprimary procedure)

Code +36483 is one of two new codes added toreport the endovenous ablation of incompetent veinof the extremity by application of chemical adhesivesuch as cyanoacrylate for the treatment of venousinsufficiency. Use this code in addition to the primarycode (36482) for each subsequent vein treated in asingle extremity through separate access site. Theprocedure includes all imaging guidance andmonitoring necessary to carry out the procedure.

55874 Transperineal placementof biodegradablematerial, peri-prostatic,single or multipleinjection(s), includingimage guidance, whenperformed

The 2018 code set adds 55874 to replace 0438T.This new code retains the description of the categoryIII code but clarifies the wording by replacing “vianeedle” with “injection(s)” after “single or multiple”and adding “when performed” to qualify imageguidance. Report 55874 for placement of one ormore pieces of absorbable material via injections

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through the perineum into the area surrounding theprostate under image guidance to separate theanterior rectal wall from the prostate and reduce theamount of radiation the rectum is exposed to duringradiotherapy for prostate cancer.

71045 Radiologic examination,chest; single view

The 2018 code set adds new codes 71045-71048 toreplace 71010-71035. CPT® has simplified thereporting of chest X-rays by adding a few new codesthat specify only the number of views, not the type ofview. Report 71045 for a single X-ray view of thechest, 71046 for 2 views, 71047 for 3 views, and71048 for 4 or more views.

71046 Radiologic examination,chest; 2 views


71047 Radiologic examination,chest; 3 views


71048 Radiologic examination,chest; 4 or more views


74018 Radiologic examination,abdomen; 1 view

The 2018 code set adds new codes 74018-74021 toreplace 74000-74020. CPT® has simplified thereporting of abdominal X-rays by adding a few newcodes that specify only the number of views, not thetype of view. Report 74018 for a single view of theabdomen, 74019 for 2 views, and 74021 for 3 ormore views.

74019 Radiologic examination,abdomen; 2 views


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74021 Radiologic examination,abdomen; 3 or moreviews


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Respiratory


0022U Targeted genomicsequence analysis panel,non-small cell lungneoplasia, DNA and RNAanalysis, 23 genes,interrogation for sequencevariants andrearrangements, reportedas presence/absence ofvariants and associatedtherapy(ies) to consider

CPT® adds 0022U for the proprietaryOncomine™ Dx Target Test from Thermo FisherScientific., a DNA and RNA genomic sequencinganalysis of paraffin-embedded tumor tissuesamples to detect the presence of 23 genes,markers for non-small cell lung cancer (NSCLC).This code became effective October 1, 2017, andwill appear for the first time in the 2019 CPT®manual.“U” codes are a new addition to the CPT® codeset and identify specific proprietary laboratoryanalyses (PLA) tests; use this code for only theOncomine™ Dx Target Test from Thermo FisherScientific.

0494T Surgical preparation andcannulation of marginal(extended) cadaver donorlung(s) to ex vivo organperfusion system, includingdecannulation, separationfrom the perfusion system,and cold preservation of theallograft prior toimplantation, whenperformed

The 2018 code set adds 0494T to report thesurgical preparation and preservation of cadaverdonor lung(s) including attaching the lung to anorgan perfusion system and its removal forimplantation. Donor organ perfusion technologyuses ventilation and perfusion of the donor lung toreproduce the in vivo (in the body) environment,increasing its viability for a longer period. Thesystem also assesses the function of marginallungs and expands the number of acceptabledonor lungs.See also 0495T and +0496T for monitoring ofdonor lung function after attachment to an organperfusion system by a qualified healthcareprofessional using various parameters.

0495T Initiation and monitoringmarginal (extended)cadaver donor lung(s)organ perfusion system byphysician or qualified healthcare professional, includingphysiological and laboratoryassessment (eg, pulmonaryartery flow, pulmonaryartery pressure, left atrialpressure, pulmonaryvascular resistance,mean/peak and plateauairway pressure, dynamiccompliance and perfusategas analysis), includingbronchoscopy and X raywhen performed; first twohours in sterile field

The 2018 code set add 0495T and 0496T toreport marginal donor lung monitoring by aqualified healthcare professional. Report 0495Tfor the first two hours of monitoring, using variousparameters, including visual physiologicassessment, various laboratory pulmonaryfunction studies, and even bronchoscopy and X-ray. For each additional hour of monitoring, report+0496T with 0495T. The code set also adds0494T to report the surgical preparation andpreservation of cadaver donor lung(s) includingattaching the lung to an organ perfusion systemand its removal for implantation. Donor organperfusion technology uses ventilation andperfusion of the donor lung to reproduce the in

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vivo (in the body) environment, increasing itsviability for a longer period. The system alsoassesses the function of marginal lungs andexpands the number of acceptable donor lungs.

0496T Initiation and monitoringmarginal (extended)cadaver donor lung(s)organ perfusion system byphysician or qualified healthcare professional, includingphysiological and laboratoryassessment (eg, pulmonaryartery flow, pulmonaryartery pressure, left atrialpressure, pulmonaryvascular resistance,mean/peak and plateauairway pressure, dynamiccompliance and perfusategas analysis), includingbronchoscopy and X raywhen performed; eachadditional hour (Listseparately in addition tocode for primary procedure)

The 2018 code set add 0495T and +0496T toreport marginal donor lung monitoring by aqualified healthcare professional. Report 0495Tfor the first two hours of monitoring, using variousparameters, including visual physiologicassessment, various laboratory pulmonaryfunction studies, and even bronchoscopy and X-ray. For each additional hour of monitoring, report+0496T with 0495T. The code set also adds0494T to report the surgical preparation andpreservation of cadaver donor lung(s) includingattaching the lung to an organ perfusion systemand its separation from the organ perfusionsystem for implantation. Donor organ perfusiontechnology uses ventilation and perfusion of thedonor lung to reproduce the in vivo (in the body)environment, increasing its viability for a longerperiod. The system also assesses the function ofmarginal lungs and expands the number ofacceptable donor lungs.

32994 Ablation therapy forreduction or eradication of 1or more pulmonary tumor(s)including pleura or chestwall when involved bytumor extension,percutaneous, includingimaging guidance whenperformed, unilateral;cryoablation

The 2018 code set adds 32994 to replace0340T. This new CPT® code specifies that thisprocedure is for either reduction or completedestruction of one or more pulmonary tumors. Theprovider makes a small incision through the skinand inserts a cryoprobe (a thin needle used tofreeze abnormal tissue) and extends it underimaging guidance to the site of the tumor(s) onone side of the lungs or chest wall. This codespecifies tumor destruction by cryoablation; see32998 for a similar procedure usingradiofrequency ablation (the use of heat producedby focused radio waves).This code represents a unilateral service,meaning performed on one side. Append modifier50 or RT/LT, depending on payer preference, ifthe provider performs the procedure bilaterally.

94617 Exercise test forbronchospasm, includingpre- and post-spirometry,electrocardiographicrecording(s), and pulseoximetry

The 2018 code set adds 94617 to report anexercise test to assess exercise-inducedbronchospasm and includes recording spirometrybefore and after vigorous exercise, recording ofpatient’s oxygen saturation, and continuouselectrocardiogram recording during the exerciseby placement of chest electrodes.See also new code 94618 for pulmonary stresstesting and revised code 94621 for extensive

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cardiopulmonary stress testing.

94618 Pulmonary stress testing(eg, 6-minute walk test),including measurement ofheart rate, oximetry, andoxygen titration, whenperformed

The 2018 code set adds 94618 to replace 94620.Report 94618 for pulmonary stress testing whenexercise, such as a 6-minute walk test, isperformed to assess pulmonary (lung) functionand includes heart rate and oxygen saturationmeasurement. If the patient is receiving oxygenduring the procedure and the amount of oxygenreceived is adjusted (titrated) to provide betteroxygen saturation during exercise, that, too, isincluded. Code 94618 is commonly used toassess lung function in patients with dyspnea. Formore extensive cardiopulmonary stress testingthat includes electrocardiographic recordings, seerevised code 94621.

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https://coder.aapc.com/cpt-code-changes-2018/code-category/Vascular 1/9


34701 Endovascular repair ofinfrarenal aorta bydeployment of an aorto-aortic tube endograftincluding pre-proceduresizing and deviceselection, allnonselectivecatheterization(s), allassociated radiologicalsupervision andinterpretation, allendograft extension(s)placed in the aorta fromthe level of the renalarteries to the aorticbifurcation, and allangioplasty/stentingperformed from the levelof the renal arteries tothe aortic bifurcation; forother than rupture (eg,for aneurysm,pseudoaneurysm,dissection, penetratingulcer)

The 2018 code set adds 34701 and 34702 to replace34800. The two new codes specify that theprocedure is repair of the infrarenal aorta andappend the indications at the end of the descriptor.Code 34702 is for rupture and 34701 for reasonsother than rupture. The new codes also specify thatthe procedure includes radiological supervision andinterpretation, device sizing and selection prior to theprocedure, any device extensions and anyangioplasty or stents required between the renalarteries and the aortic bifurcation where it dividesinto two branches. Code 34702 adds trauma to thelist of indications (aneurysm, pseudoaneurysm,dissection, penetrating ulcer) for repair of theintrarenal aorta.For similar procedures to repair the infrarenal aortaand/or iliac artery, see 34704-34706 and for similarprocedures to repair just the iliac artery, see 34707-34708.

34702 Endovascular repair ofinfrarenal aorta bydeployment of an aorto-aortic tube endograftincluding pre-proceduresizing and deviceselection, allnonselectivecatheterization(s), allassociated radiologicalsupervision andinterpretation, allendograft extension(s)placed in the aorta fromthe level of the renalarteries to the aorticbifurcation, and allangioplasty/stentingperformed from the levelof the renal arteries tothe aortic bifurcation; forrupture includingtemporary aortic and/oriliac balloon occlusion,when performed (eg, foraneurysm,pseudoaneurysm,dissection, penetratingulcer, traumaticdisruption)

The 2018 code set adds 34701 and 34702 to replace34800. The two new codes specify that theprocedure is to report repair of the infrarenal aortausing an aorto-aortic tube, see 34701 and 34702. Italso clarifies that the procedure is repair of theinfrarenal aorta and append the indications for therepair at the end of the descriptors. In these twoprocedures, the tube graft is placed only in the aorta;it does not go beyond the aortic bifurcation where itdivides into two branches (the iliac arteries). Code34702 is for rupture and 34701 for reasons otherthan rupture. The new codes also specify that theprocedure includes radiological supervision andinterpretation, device sizing and selection prior to theprocedure, any graft extensions and any angioplastyor stents required between the renal arteries and theaortic bifurcation. Code 34702 adds trauma to the listof indications (aneurysm, pseudoaneurysm,dissection, penetrating ulcer, trauma) for repair of theintrarenal aorta.For similar procedures to repair the infrarenal aortaand/or iliac artery, see 34704-34706 and for similarprocedures to repair just the iliac artery, see 34707-34708.

34703 Endovascular repair ofinfrarenal aorta and/or

The 2018 code set adds 34703 and 34704 to replace34802. The two new codes include repair of either

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https://coder.aapc.com/cpt-code-changes-2018/code-category/Vascular#



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iliac artery(ies) bydeployment of an aorto-uni-iliac endograftincluding pre-proceduresizing and deviceselection, allnonselectivecatheterization(s), allassociated radiologicalsupervision andinterpretation, allendograft extension(s)placed in the aorta fromthe level of the renalarteries to the iliacbifurcation, and allangioplasty/stentingperformed from the levelof the renal arteries tothe iliac bifurcation; forother than rupture (eg,for aneurysm,pseudoaneurysm,dissection, penetratingulcer)

the infrarenal aorta or iliac artery, or both, andappend the indications for the repair at the end of thedescriptors. The endograft in these two proceduresis placed in the aorta and down one iliac arterybeyond the aortic bifurcation. Code 34704 is forrupture and 34703 for reasons other than rupture.The new codes also specify that the proceduresinclude radiological supervision and interpretation,device sizing and selection prior to the procedure,any graft extensions and any angioplasty or stentsrequired down to where the iliac arteries branch(bifurcation). They also include temporary aorticand/or iliac balloon occlusion (clamping off thearteries to prevent blood flow), when performed.Code 34704 adds trauma to the list of indications(aneurysm, pseudoaneurysm, dissection, penetratingulcer, trauma). For the same procedures using anaorto-bi-iliac endograft, see 34705-34706, for similarprocedures to repair only the infrarenal artery, see34701-34702, and for procedures to repair only theiliac artery, see 34707-34708.

34704 Endovascular repair ofinfrarenal aorta and/oriliac artery(ies) bydeployment of an aorto-uni-iliac endograftincluding pre-proceduresizing and deviceselection, allnonselectivecatheterization(s), allassociated radiologicalsupervision andinterpretation, allendograft extension(s)placed in the aorta fromthe level of the renalarteries to the iliacbifurcation, and allangioplasty/stentingperformed from the levelof the renal arteries tothe iliac bifurcation; forrupture includingtemporary aortic and/oriliac balloon occlusion,when performed (eg, foraneurysm,pseudoaneurysm,dissection, penetratingulcer, traumaticdisruption)

The 2018 code set adds 34703 and 34704 to replace34802. The two new codes include repair of eitherthe infrarenal aorta or iliac artery, or both, andappend the indications for the repair at the end of thedescriptors. The endograft in these two proceduresis placed in the aorta and down one iliac arterybeyond the aortic bifurcation. Code 34704 is forrupture and 34703 for reasons other than rupture.The new codes also specify that the proceduresinclude radiological supervision and interpretation,device sizing and selection prior to the procedure,any graft extensions and any angioplasty or stentsrequired down to where the iliac arteries branch(bifurcation). They also include temporary aorticand/or iliac balloon occlusion (clamping off thearteries to prevent blood flow), when performed.Code 34704 adds trauma to the list of indications(aneurysm, pseudoaneurysm, dissection, penetratingulcer, trauma). For the same procedures using anaorto-bi-iliac endograft, see 34705-34706, for similarprocedures to repair only the infrarenal artery, see34701-34702, and for procedures to repair only theiliac artery, see 34707-34708.

34705 Endovascular repair ofinfrarenal aorta and/oriliac artery(ies) bydeployment of an aorto-bi-iliac endograftincluding pre-procedure

The 2018 code set adds 34705 and 34706 to replace34803. CPT® 34705 and 34706 is added to reportrepair of the infrarenal aorta and/or the iliac arteryusing an aorto-bi-iliac endograft. The two new codesinclude repair of either the infrarenal aorta or iliac

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sizing and deviceselection, allnonselectivecatheterization(s), allassociated radiologicalsupervision andinterpretation, allendograft extension(s)placed in the aorta fromthe level of the renalarteries to the iliacbifurcation, and allangioplasty/stentingperformed from the levelof the renal arteries tothe iliac bifurcation; forother than rupture (eg,for aneurysm,pseudoaneurysm,dissection, penetratingulcer)

artery, or both, and append the indications for therepair at the end of the descriptors. The endograft inthese two procedures is placed in the aorta anddown both iliac arteries beyond the aortic bifurcation.Code 34706 is for rupture and 34705 for reasonsother than rupture. The new codes also specify thatthe procedures include radiological supervision andinterpretation, device sizing and selection prior to theprocedure, any graft extensions and any angioplastyor stents required down to where the iliac arteriesbranch (bifurcation). They also include temporaryaortic and/or iliac balloon occlusion (clamping off thearteries to prevent blood flow), when performed.Code 34706 adds trauma to the list of indications(aneurysm, pseudoaneurysm, dissection, penetratingulcer, trauma). For the same procedures using anaorto-uni-iliac endograft, see 34703-34704 and forsimilar procedures to repair only the infrarenal artery,see 34701-34702, and for procedure to repair onlythe iliac artery, see 34707-34708.

34706 Endovascular repair ofinfrarenal aorta and/oriliac artery(ies) bydeployment of an aorto-bi-iliac endograftincluding pre-proceduresizing and deviceselection, allnonselectivecatheterization(s), allassociated radiologicalsupervision andinterpretation, allendograft extension(s)placed in the aorta fromthe level of the renalarteries to the iliacbifurcation, and allangioplasty/stentingperformed from the levelof the renal arteries tothe iliac bifurcation; forrupture includingtemporary aortic and/oriliac balloon occlusion,when performed (eg, foraneurysm,pseudoaneurysm,dissection, penetratingulcer, traumaticdisruption)

The 2018 code set adds 34705 and 34706 to replace34803. CPT® 34705 and 34706 are added to reportrepair of the infrarenal aorta and/or the iliac arteryusing an aorto-bi-iliac endograft. The two new codesinclude repair of either the infrarenal aorta or iliacartery, or both, and append the indications for therepair at the end of the descriptors. The endograft inthese two procedures is placed in the aorta anddown both iliac arteries beyond the aortic bifurcation.Code 34706 is for rupture and 34705 for reasonsother than rupture. The new codes also specify thatthe procedures include radiological supervision andinterpretation, device sizing and selection prior to theprocedure, any graft extensions and any angioplastyor stents required down to where the iliac arteriesbranch (bifurcation). They also include temporaryaortic and/or iliac balloon occlusion (closing off thearteries to prevent blood flow), when performed.Code 34706 adds trauma to the list of indications(aneurysm, pseudoaneurysm, dissection, penetratingulcer, trauma). For the same procedures using anaorto-uni-iliac endograft, see 34703-34704 and forsimilar procedures to repair only the infrarenal artery,see 34701-34702, and for procedures to repair onlythe iliac artery, see 34707-34708.

34707 Endovascular repair ofiliac artery bydeployment of an ilio-iliactube endograft includingpre-procedure sizing anddevice selection, allnonselective

The 2018 code set adds 34707 and 34708 to replace34804, 34805, and 34806. Use 34707 and 34708 toreport repair of an iliac artery using a tube endograftplaced only in the iliac artery. The new codes appendthe indications for the repair at the end of the

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catheterization(s), allassociated radiologicalsupervision andinterpretation, and allendograft extension(s)proximally to the aorticbifurcation and distally tothe iliac bifurcation, andtreatment zoneangioplasty/stenting,when performed,unilateral; for other thanrupture (eg, foraneurysm,pseudoaneurysm,dissection, arteriovenousmalformation)

descriptors and specify the placement of the tubegrafts (endografts). The codes that end in an evennumber are for rupture and add trauma to the list ofindications, and those ending in an odd number arefor reasons other than rupture and do not includetrauma in the indications. The new codes alsospecify that the procedure includes radiologicalsupervision and interpretation, device sizing andselection prior to the procedure, any graftextensions, and any angioplasty or stents required.A few other new codes (34701-34708) have beenadded to report repair of the infrarenal aorta or theiliac arteries, or both. See 34701 and 34702 forinfrarenal aorta repair using an aorto-aortic tubeendograft that does not extend beyond the aorticbifurcation into the iliac arteries. See 34703 and34704 for repair of the infrarenal aorta and/or iliacartery(ies) using an aorto-uni-iliac endograft thatextends into one branch below the bifurcation and34705 and 34706 when the provider places an aorto-bi-iliac endograft that extends into both branchesbelow the bifurcation. Codes 34705-34708 includetemporary aortic and/or iliac balloon occlusion(clamping off the arteries to prevent blood flow),when performed.

34708 Endovascular repair ofiliac artery bydeployment of an ilio-iliactube endograft includingpre-procedure sizing anddevice selection, allnonselectivecatheterization(s), allassociated radiologicalsupervision andinterpretation, and allendograft extension(s)proximally to the aorticbifurcation and distally tothe iliac bifurcation, andtreatment zoneangioplasty/stenting,when performed,unilateral; for ruptureincluding temporaryaortic and/or iliac balloonocclusion, whenperformed (eg, foraneurysm,pseudoaneurysm,dissection, arteriovenousmalformation, traumaticdisruption)

The 2018 code set adds 34707 and 34708 to replace34804, 34805, and 34806. Use 34707 and 34708 toreport repair of an iliac artery using a tube endograftplaced only in the iliac artery. The new codes appendthe indications for the repair at the end of thedescriptors and specify the placement of the tubegrafts (endografts). The codes that end in an evennumber are for rupture and add trauma to the list ofindications, and those ending in an odd number arefor reasons other than rupture and do not includetrauma in the indications. The new codes alsospecify that the procedure includes radiologicalsupervision and interpretation, device sizing andselection prior to the procedure, any graftextensions, and any angioplasty or stents required.A few other new codes (34701-34708) have beenadded to report repair of the infrarenal aorta or theiliac arteries, or both. See 34701 and 34702 forinfrarenal aorta repair using an aorto-aortic tubeendograft that does not extend beyond the aorticbifurcation into the iliac arteries. See 34703 and34704 for repair of the infrarenal aorta and/or iliacartery(ies) using an aorto-uni-iliac endograft thatextends into one branch below the bifurcation and34705 and 34706 when the provider places an aorto-bi-iliac endograft that extends into both branches

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below the bifurcation. Codes 34705-34708 includetemporary aortic and/or iliac balloon occlusion(clamping off the arteries to prevent blood flow),when performed.

34709 Placement of extensionprosthesis(es) distal tothe common iliacartery(ies) or proximal tothe renal artery(ies) forendovascular repair ofinfrarenal abdominalaortic or iliac aneurysm,false aneurysm,dissection, penetratingulcer, including pre-procedure sizing anddevice selection, allnonselectivecatheterization(s), allassociated radiologicalsupervision andinterpretation, andtreatment zoneangioplasty/stenting,when performed, pervessel treated (Listseparately in addition tocode for primaryprocedure)

The 2018 code set adds +34709, 34710, +34711 toreplace 34825 and 34826. These new CPT® codesspecify placement of extension prosthesis(es) distalto the common iliac artery(ies) or proximal to therenal artery(ies); the code includes radiologicalsupervision and interpretation, device sizing andselection, and angioplasty or stenting, whenperformed, in the treatment zone. Report +34709 foreach vessel treated during a primary procedure andlist separately in addition to the code for the primaryprocedure. Report 34710 for delayed placement(rather than placement during a primary procedure)for the first vessel treated, and +34711 with 34710for each additional vessel treated.

34710 Delayed placement ofdistal or proximalextension prosthesis forendovascular repair ofinfrarenal abdominalaortic or iliac aneurysm,false aneurysm,dissection, endoleak, orendograft migration,including pre-proceduresizing and deviceselection, allnonselectivecatheterization(s), allassociated radiologicalsupervision andinterpretation, andtreatment zoneangioplasty/stenting,when performed; initialvessel treated


34711 Delayed placement ofdistal or proximalextension prosthesis forendovascular repair ofinfrarenal abdominalaortic or iliac aneurysm,false aneurysm,dissection, endoleak, orendograft migration,including pre-proceduresizing and deviceselection, all

The 2018 code set adds +34709, 34710, +34711 toreplace 34825 and 34826. These new CPT® codesspecify placement of extension prosthesis(es) distalto the common iliac artery(ies) or proximal to therenal artery(ies); the code includes radiologicalsupervision and interpretation, device sizing andselection, and angioplasty or stenting, whenperformed, in the treatment zone. Report 34710 fordelayed placement (rather than placement during a

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nonselectivecatheterization(s), allassociated radiologicalsupervision andinterpretation, andtreatment zoneangioplasty/stenting,when performed; eachadditional vessel treated(List separately inaddition to code forprimary procedure)

primary procedure) for the first vessel treated, and+34711 for each additional vessel treated. Report+34709 for each vessel treated during a primaryprocedure and list separately in addition to the codefor the primary procedure.

34712 Transcatheter delivery ofenhanced fixationdevice(s) to theendograft (eg, anchor,screw, tack) and allassociated radiologicalsupervision andinterpretation

CPT® 2018 adds 34712 to report a new type offixation device delivered through the lumen of acatheter (transcatheter) to secure placement of anendograft (a tube introduced through endoscopicmethods) for endovascular repair of an artery. Thisprocedure also includes radiological supervision andinterpretation.

34713 Percutaneous accessand closure of femoralartery for delivery ofendograft through a largesheath (12 French orlarger), includingultrasound guidance,when performed,unilateral (List separatelyin addition to code forprimary procedure)

CPT® 2018 adds new add-on code +34713, one ofseveral new codes for adjunctive procedures forendovascular repair of an artery, to report accessand closure of the femoral artery percutaneously, aminimally invasive procedure performed through asmall incision in the skin. This procedure is used todeliver an endograft via a 12F or larger sheath toimprove or restore blood flow in an artery. Thisprocedure also includes ultrasound guidance whenperformed.Append modifier 50 or RT/LT, depending on payerpreference, if the provider performs the procedurebilaterally.

34714 Open femoral arteryexposure with creation ofconduit for delivery ofendovascular prosthesisor for establishment ofcardiopulmonary bypass,by groin incision,unilateral (List separatelyin addition to code forprimary procedure)

CPT® 2018 adds three new add-on codes (+34714to +34716) to the plethora of endovascularprocedure codes for placement of a prosthesis (e.g.,a tube) or conduit (an anastomosis or connectionbetween two vessels) to improve or restore bloodflow in an artery. This procedure is sometimesnecessary when a provider is performing anothercardiovascular procedure and finds a narrowed orblocked artery. Report +34714 for femoral arteryexposure and creation of a conduit for placement ofa tube prosthesis or for cardiopulmonary bypass;+34715 for axillary or subclavian artery exposure viaan infra- or supraclavicular incision for placement ofa tube prosthesis, and +34716 for the sameexposure with creation of a conduit for placement ofa tube prosthesis or for cardiopulmonary bypass.Report all three of these procedures in addition tothe primary procedure code.All three procedures are unilateral, meaningperformed on one side. Append modifier 50 or RT/LT,

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depending on payer preference, if the providerperforms the procedure bilaterally.

34715 Open axillary/subclavianartery exposure fordelivery of endovascularprosthesis byinfraclavicular orsupraclavicular incision,unilateral (List separatelyin addition to code forprimary procedure)

CPT® 2018 adds three new add-on codes (+34714to +34716) to the plethora of endovascularprocedure codes for placement of a prosthesis (e.g.,a tube) or conduit (an anastomosis or connectionbetween two vessels) to improve or restore bloodflow in an artery. This procedure is sometimesnecessary when a provider is performing anothercardiovascular procedure and finds a narrowed orblocked artery. Report +34714 for femoral arteryexposure and creation of a conduit for placement ofa tube prosthesis or for cardiopulmonary bypass;+34715 for axillary or subclavian artery exposure viaan infra- or supraclavicular incision for placement ofa tube prosthesis, and +34716 for the sameexposure with creation of a conduit for placement ofa tube prosthesis or for cardiopulmonary bypass.Report all three of these procedures in addition tothe primary procedure code.All three procedures are unilateral, meaningperformed on one side. Append modifier 50 or RT/LT,depending on payer preference, if the providerperforms the procedure bilaterally.

34716 Open axillary/subclavianartery exposure withcreation of conduit fordelivery of endovascularprosthesis or forestablishment ofcardiopulmonary bypass,by infraclavicular orsupraclavicular incision,unilateral (List separatelyin addition to code forprimary procedure)

CPT® 2018 adds three new add-on codes (+34714to +34716) to the plethora of endovascularprocedure codes for placement of a prosthesis (e.g.,a tube) or conduit (an anastomosis or connectionbetween two vessels) to improve or restore bloodflow in an artery. This procedure is sometimesnecessary when a provider is performing anothercardiovascular procedure and finds a narrowed orblocked artery. Report +34714 for femoral arteryexposure and creation of a conduit for placement ofa tube prosthesis or for cardiopulmonary bypass;+34715 for axillary or subclavian artery exposure viaan infra- or supraclavicular incision for placement ofa tube prosthesis, and +34716 for the sameexposure with creation of a conduit for placement ofa tube prosthesis or for cardiopulmonary bypass.Report all three of these procedures in addition tothe primary procedure code.All three procedures are unilateral, meaningperformed on one side. Append modifier 50 or RT/LT,depending on payer preference, if the providerperforms the procedure bilaterally.

36465 Injection of non-compounded foamsclerosant withultrasound compressionmaneuvers to guide

Code 36465 and 36466 were added to report theinjection of noncompounded foam sclerosant (achemical solution that inflames a blood vessel'slining and makes the vessel walls adhere to each

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dispersion of theinjectate, inclusive of allimaging guidance andmonitoring; singleincompetent extremitytruncal vein (eg, greatsaphenous vein,accessory saphenousvein)

other) for destruction of incompetent veins (a largervein in which the valves aren’t functioning, whichcauses it to stay filled with blood and appear blueand ropy) to treat venous insufficiency. In thisprocedure, ultrasound compression maneuvers areused to guide dispersion of the foam. This procedureincludes all imaging guidance and monitoringnecessary to carry out the procedure for multipleincompetent truncal veins. Report 36465 for injectionof noncompounded foam sclerosant to treat a singlevein and 36466 for the same procedure to treatmultiple veins.For injection of a sclerosant into a vein withoutcompression maneuvers to guide dispersion of theinjectate, see 36470 and 36471, and for endovenousablation therapy of incompetent vein[s] bytranscatheter delivery of a chemical adhesive, see36482 and 36483. For vascular embolization andocclusion procedures, see 37241-37244.

36466 Injection of non-compounded foamsclerosant withultrasound compressionmaneuvers to guidedispersion of theinjectate, inclusive of allimaging guidance andmonitoring; multipleincompetent truncalveins (eg, greatsaphenous vein,accessory saphenousvein), same leg

Code 36465 and 36466 were added to report theinjection of noncompounded foam sclerosant (achemical solution that inflames a blood vessel'slining and makes the vessel walls adhere to eachother) for destruction of incompetent veins (a largervein in which the valves aren’t functioning, whichcauses it to stay filled with blood and appear blueand ropy) to treat venous insufficiency. In thisprocedure, ultrasound compression maneuvers areused to guide dispersion of the foam. This procedureincludes all imaging guidance and monitoringnecessary to carry out the procedure for multipleincompetent truncal veins. Report 36465 for injectionof noncompounded foam sclerosant to treat a singlevein and 36466 for the same procedure to treatmultiple veins.For injection of a sclerosant into a vein withoutcompression maneuvers to guide dispersion of theinjectate, see 36470 and 36471, and for endovenousablation therapy of incompetent vein[s] bytranscatheter delivery of a chemical adhesive, see36482 and 36483. For vascular embolization andocclusion procedures, see 37241-37244.

36482 Endovenous ablationtherapy of incompetentvein, extremity, bytranscatheter delivery ofa chemical adhesive (eg,cyanoacrylate) remotefrom the access site,inclusive of all imagingguidance and monitoring,

Code 36482 is one of the two new codes added toreport the use of endovenous ablation ofincompetent veins (a larger vein in which the valvesaren’t functioning, which causes it to stay filled withblood and appear blue and ropy) of the extremity byinstillation of a chemical adhesive such ascyanoacrylate for the treatment of venousinsufficiency. The procedure includes all imaging

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percutaneous; first veintreated

guidance and monitoring necessary to carry out theprocedure for the first vein in the extremity. This codeis for the first vein treated; for each subsequent veinin a single extremity but separate access points, seeadd-on code +36483.

36483 Endovenous ablationtherapy of incompetentvein, extremity, bytranscatheter delivery ofa chemical adhesive (eg,cyanoacrylate) remotefrom the access site,inclusive of all imagingguidance and monitoring,percutaneous;subsequent vein(s)treated in a singleextremity, each throughseparate access sites(List separately inaddition to code forprimary procedure)

Code +36483 is one of two new codes added toreport the endovenous ablation of incompetent veinof the extremity by application of chemical adhesivesuch as cyanoacrylate for the treatment of venousinsufficiency. Use this code in addition to the primarycode (36482) for each subsequent vein treated in asingle extremity through separate access site. Theprocedure includes all imaging guidance andmonitoring necessary to carry out the procedure.

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