The 2012 CPT code changes bundle several procedures into combination codes, including CT angiography of the abdomen and pelvis, hepatobiliary imaging, pulmonary imaging codes, and various interventional radiology codes. New codes have been introduced for abdominal paracentesis, peritoneal lavage, placement and removal of vena cava filters, and renal angiography that now include all catheter placement and imaging guidance. Approximately 15-20 current CPT codes also have text or description revisions to improve clarity.

1. 2012 CPT Coding Changes
The 2012 CPT code changes have been released! There are quite a few addi<ons, dele<ons, and
revisions that will affect Radiology. As with last year, the new codes con<nue to bundle mul<ple
procedures into one combina<on code on procedures performed together greater than 75% of the <me,
as well as including the guidance and supervision & interpreta<on codes into vascular and non‐vascular
interven<on codes. Below I have outlined the codes that appear to have the biggest impact/change for
the HIS clients. As soon as fee schedule and RVU informa<on becomes available, I will pass this
informa<on on to everyone in order to gain a beQer understanding of what the impact of these changes
will be for each prac<ce.
CT
CTA of the abdomen and pelvis will now be combined into a single code assuming both studies are
performed at the same imaging session. If a CTA of the abdomen OR pelvis is performed independently,
the exis<ng CTA codes would s<ll be reported.
New 2012 CPT Code Descrip<on:
 74174‐Computed Tomographic Angiography, abdomen and pelvis, with contrast material(s),
including noncontrast images, if performed, and image postprocessing
o Replaces codes 74175 (CTA Abdomen) and 72191 (CTA Pelvis) if both studies were
performed at the same imaging session
NUCLEAR MEDICINE
Hepatobiliary imaging code 78223 has been deleted and replaced by two new codes defining the proper
code assignment when pharmacologic interven<on is used.
New 2012 CPT Code Descrip<on:
 78226‐Hepatobiliary system imaging, including gallbladder when present;
 78227‐Hepatobiliary system imaging, including gallbladder when present; with pharmacologic
interven<on, including quan<ta<ve measurement(s) when performed
o Replaces code 78223‐Hepatobiliary system imaging, with or without pharmacologic
interven<on, with or without quan<ta<ve measurement of gallbladder func<on
The nine exis<ng pulmonary imaging codes have been combined into four new codes. In 2011, the
exis<ng codes were very specific in their descrip<on of what needed to be performed to determine
correct code choice (e.g., aerosol or gas, rebreathing and washout, etc.). In 2012, they have combined
the techniques.
New 2012 CPT Code Descrip<on:
 78579‐Pulmonary ven<la<on imaging (e.g., aerosol or gas)
 78582‐Pulmonary ven<la<on (e.g., aerosol or gas) and perfusion imaging
Tgalan 1 2012 Coding Changes
HIS – Radiology Division November 2, 2011

2.  78597‐Quan<ta<ve differen<al pulmonary perfusion, including imaging when performed
 78598‐Quan<ta<ve differen<al pulmonary perfusion and ven<la<on (e.g., aerosol or gas),
including imaging when performed
o Replaces nine codes from the range of 78584 through 78596
NON‐VASCULAR INTERVENTIONAL RADIOLOGY
The exis<ng codes for ini<al and subsequent paracentesis interven<ons have been replaced by 2 new
codes that will no longer allow separate repor<ng for the imaging guidance. In 2012, peritoneal lavage
has been issued its own CPT code which was previously included in the 2011 code choices.
New 2012 CPT Code Descrip<on:
 49082‐Abdominal paracentesis (diagnos<c or therapeu<c); without imaging guidance
 49083‐Abdominal paracentesis (diagnos<c or therapeu<c); with imaging guidance
 49084‐Peritoneal lavage, including imaging guidance, when performed
o Replaces codes 49080 and 49081‐Peritoneocentesis, abdominal paracentesis, or
peritoneal lavage; ini<al or subsequent. These new codes no longer permit repor<ng US
or CT guidance separately.
VASCULAR INTERVENTIONAL RADIOLOGY
IVC filter placement, reposi<oning, and retrieval codes have been replaced by new codes which include
all catheter placement and imaging.
New 2012 CPT Code Descrip<on:
 37191‐Inser<on of intravascular vena cava filter, endovascular approach including vascular
access, vessel selec<on, and radiological supervision and interpreta<on, intraprocedural
roadmapping, and imaging guidance (ultrasound and fluoroscopy), when performed
o Combines the filter placement and guidance codes (37620 and 75940)
 37192‐Reposi<oning of intravascular vena cava filter, endovascular approach including vascular
access, vessel selec<on, and radiological supervision and interpreta<on, intraprocedural
roadmapping, and imaging guidance (ultrasound and fluoroscopy), when performed
o No specific code existed for IVC reposi<oning prior to 2012
 37193‐Retrieval (removal) of intravascular vena cava filter, endovascular approach including
vascular access, vessel selec<on, and radiological supervision and interpreta<on, intraprocedural
roadmapping, and imaging guidance (ultrasound and fluoroscopy), when performed
o Combines the foreign body retrieval codes 37203 and 75961 that were previously
reported to beQer depict IVC filter removal
Tgalan 2 2012 Coding Changes
HIS – Radiology Division November 2, 2011

3. The exis<ng codes and rules for coding renal angiography have been revised and/or deleted and new
codes which include all catheter placement and imaging have been introduced.
New 2012 CPT Code Descrip<on:
 36251‐Selec<ve catheter placement (first‐order), main renal artery and any accessory renal
artery(s) for renal angiography, including arterial puncture and catheter placement(s),
fluoroscopy, contrast injec<on(s), image postprocessing, permanent recording of images, and
radiological supervision and interpreta<on, including pressure gradient measurements when
performed, and flush aortogram when performed; unilateral
 36252‐Selec<ve catheter placement (first‐order), main renal artery and any accessory renal
artery(s) for renal angiography, including arterial puncture and catheter placement(s),
fluoroscopy, contrast injec<on(s), image postprocessing, permanent recording of images, and
radiological supervision and interpreta<on, including pressure gradient measurements when
performed, and flush aortogram when performed; bilateral
 36253‐Superselec<ve catheter placement (one or more second order or higher renal artery
branches) renal artery and any accessory renal artery(s) for renal angiography, including arterial
puncture, catheteriza<on, fluoroscopy, contrast injec<on(s), image postprocessing, permanent
recording of images, and radiological supervision and interpreta<on, including pressure gradient
measurements when performed, and flush aortogram when performed; unilateral
 36254‐Superselec<ve catheter placement (one or more second order or higher renal artery
branches) renal artery and any accessory renal artery(s) for renal angiography, including arterial
puncture, catheteriza<on, fluoroscopy, contrast injec<on(s), image postprocessing, permanent
recording of images, and radiological supervision and interpreta<on, including pressure gradient
measurements when performed, and flush aortogram when performed; bilateral
o These new codes now include the codes for catheter placement(s) (36245 through
36248, depending upon vascular branch selec<vity) as well as the radiological
supervision and interpreta<on codes (75722 and 75724).
REVISIONS
There will also be approximately 15‐20 revisions in the text and descrip<on of current CPT codes that
pertain to the radiology book of business. These revisions are made to beQer clarify what is included in
a specific code. These revisions do not typically alter reimbursement but are meant to beQer clarify the
study requirements.
Tgalan 3 2012 Coding Changes
HIS – Radiology Division November 2, 2011