ARTICLE SUMMARY:
Medtech makes progress at recent CPT coding meeting. Excerpted from Pathways’ Picks October 23: Tarver on Top, Action at EU and UK Parliaments, CPT Wins, and More.
The CPT Editorial Panel approved 16 conversions from Category III to Category I billing codes during a meeting last month, marking the advancement of technologies for heart failure, cancer treatment, and spine procedures, among others, from “experimental” status to more accepted practice. The American Medical Association group met September 19-21 in New Mexico and published a summary of outcomes from the closely watched deliberations October 16. Among the device systems that made the III-to-I jump are CVRx’s Barostim baroflex activation heart failure therapy and AngioDynamics’ NanoKnife Irreversible Electroporation ablation technology for prostate and liver lesions. The upgraded CPT codes, which won’t take effect until January 2026, offer a path to expanded adoption and, in particular, more consistent reimbursement for the impacted devices. Overall, the CPT panel approved 89 new Category I codes, including 46 codes that can be used to bill more precisely for vascular procedures performed in different regions of the lower extremities, and another six (plus revisions) to allow more flexible billing of remote monitoring devices and services. Finally, the panel approved 27 new Category III codes for services including AI analysis of cardiac dysfunction, benign prostate ablation with high-intensity focused ultrasound (HIFU), and multi-spectral imaging of burn wounds.