Ah, the world of CPT codes – when you thought you had them all memorized, the AMA hits you with a brand-new batch. If you’re like most medical professionals, you probably have a love-hate relationship with CPT codes. Well, buckle up because the 2025 CPT codes are rolling in, complete with 420 updates! That’s right—270 new codes, 112 deletions, and 38 revised ones have joined the 11,000+ codes already in circulation.
In this quick guide, we’ll break down the key updates and what they mean for you, your practice, and your billing team. Ready? Let’s dive into the new CPT codes for 2025!
New CPT Codes for 2025: What’s Changing?
The CPT codes for 2025 bring some interesting updates, especially with the advent of new technologies and treatments. Below are some of the most important changes you’ll want to keep an eye on;
1. General Surgery
- Advanced Wound Care (Codes 15011–15018)
Previous Codes: Limited and less specific skin graft techniques.
New Codes: Introduced to cover innovative skin graft methods.
Usage: Use these codes when performing advanced skin graft procedures, documenting the specific technique utilized.
2. Tumor Removal (Codes 49186–49190)
Previous Codes: Generic coding that did not accurately reflect tumor surgery complexity.
New Codes: Provide detailed options for abdominal tumor removal, recognizing various techniques.
Usage: Apply these codes when performing abdominal tumor resections, ensuring documentation reflects the procedure’s specifics.
3. Telemedicine Office Visits
Previous System
Previously, telemedicine services required the use of modifier 95 for real-time audio-video consultations, using a limited set of codes that often did not capture the variety of telemedicine interactions adequately.
Changes Introduced
Starting in 2025, a dedicated E/M subsection for telemedicine will introduce 17 new CPT codes that categorize services based on technology type (audio-video vs. audio-only) and patient status (new or established).
New Telemedicine Codes
- 98000–98007: For real-time audio-video consultations.
- 98008–98015: For audio-only consultations, replace previous telephone visit codes.
- 98016: For brief virtual check-ins with established patients (5–10 minutes).
When to Use the Codes?
- Use 98000–98007 for comprehensive E/M services via video.
- Use 98008–98015 for audio-only consultations when video isn’t feasible.
- Use 98016 for short check-ins with established patients.
These changes aim to streamline billing and enhance access to telemedicine services.
4. Radiology
In radiology, new CPT codes have been introduced to enhance MRI safety evaluations for patients with implants or foreign bodies. Here’s a brief overview;
Previous Situation
Historically, there were no specific CPT codes dedicated to the safety assessment of patients with implants before MRIs, leading to ambiguity in documentation and coding.
New CPT Codes
The six new codes specifically address aspects of MRI safety procedures;
- 76014: Initial 15-minute assessment of implants or foreign bodies.
- 76015: Each additional 30-minute evaluation after the initial assessment.
- 76016: The MRI safety determination process by healthcare professionals.
- 76017: Customization of medical physics examinations for safety.
- 76018: Preparation of implant electronics, such as pacemaker programming.
- 76019: Positioning or immobilization of implants during the MRI.
Usage
- Pre-MRI Evaluation: Use 76014 for initial assessments and 76015 for longer evaluations.
- Comprehensive Safety Assessments: Use 76016 for detailed safety determination.
- Customization: Use 76017 for tailored safety protocols.
- Device Preparation: Use 76018 for adjusting settings on electronics.
- Positioning: Use 76019 for ensuring proper positioning of implants during the scan.
5. Anesthesia
What was It Before?
Prior to the introduction of these new CPT codes, fascial plane blocks for regional anesthesia were categorized under more general codes. Anesthesiologists typically used broader codes to report these procedures, which lacked specificity and could lead to ambiguity in billing and reimbursement. Commonly used codes may not have captured the unique aspects of these newer techniques, leading to inefficiencies in tracking outcomes and utilization for appropriate billing practices.
Changes Introduced
The recent updates include six specific CPT codes that enhance clarity and specificity for practitioners and payers alike. Here’s a breakdown of each new code and its purpose;
- 64466 – Injection-based thoracic fascial plane block (unilateral): This code is used when a single-sided thoracic fascial block is performed with injection, including imaging guidance when applicable.
- 64467 – Continuous infusion-based thoracic fascial plane block (unilateral): This code is designated for cases where a continuous infusion of anesthetic is utilized on one side of the thorax, again including imaging guidance if performed.
- 64468 – Injection-based thoracic fascial plane block (bilateral): This code applies to bilateral injections for a thoracic fascial block, with the option for imaging guidance.
- 64469 – Continuous infusion-based thoracic fascial plane block (bilateral): Similar to 64467, this code covers continuous infusion on both sides of the thorax, with the additional note on imaging guidance.
- 64473 – Injection-based lower extremity fascial plane block (unilateral): This is specific to unilateral lower extremity fascial blocks performed via injection, also accounting for imaging guidance.
- 64474 – Continuous infusion-based lower extremity fascial plane block (unilateral): This code is intended for cases involving continuous infusion in a single lower extremity, including imaging when applicable.
When to Use Them?
The introduction of these CPT codes enables better categorization of fascial plane blocks. Here’s when to use each;
- Use 64466 and 64467 when performing thoracic fascial plane blocks on one side, especially when utilizing imaging to guide the procedure.
- Use 64468 and 64469 for bilateral procedures, ensuring to document the type of administration (injection vs. continuous infusion) clearly.
- Use 64473 and 64474 for unilateral blocks in the lower extremities, again noting whether the procedure was performed with immediate placement of anesthetic or through continuous administration.
- These changes not only streamline the billing process but also more accurately reflect the complexity and variability of fascial plane blocks in modern anesthesia practices, promoting better patient care and clinical outcomes.
6. Deleted and No Longer Reported Codes
- 99441–99443: Telephone-based E/M services have been removed.
- 99202–99205, 99212–99215: No longer used for office and outpatient E/M visits.
- Medicare Update: Medicare will only reimburse 98016 while excluding other telemedicine-related codes. However, some behavioral and mental health services will remain eligible for telehealth reimbursement.
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