Dive Deeper Into CPT® 2019 Updates With a Focus on Revised Descriptors

Dive in to CPT® 2019 coding updates

You learned about CPT® 2019 additions in our overview series with Part 1, Part 2, and Part 3. But what about revisions? We covered some of those in relation to additions, but here are some more updates that may affect you when the changes are effective Jan. 1, 2019. (These are highlights, not a complete list, so be sure you use the updated AMA CPT® code set and guidelines for 2019 dates of service!)

Swap Out ‘Family’ for ‘Territory’ for +61641, +61642

The descriptors for +61641 and +61642 for intracranial vasospasm balloon dilation will revise their terminology from referencing “same vascular family” to “same vascular territory.” Consider the changes before you report these “each additional vessel” codes in 2019.

Remove Nephrostomy From 74485 Descriptor

RS&I code 74485 will apply to dilation of ureter(s) or urethra in 2019, removing the term nephrostomy.

Keep in mind: CPT® 2019 will delete 50395 (guide intro with dilation for nephrostomy tract). Instead, you’ll have 50436 and 50437 for dilation of existing tract, including RS&I.

Work ‘Leadless Pacemaker’ Into Multiple Cat. I Codes

Expect CPT® 2019 to delete Category III codes 0387T-0391T, which apply to leadless pacemaker services. To replace these codes, watch for “leadless pacemaker system” to be added to these codes:

  • Programming device evaluation code 93279, which will apply to “single lead pacemaker system or leadless pacemaker system in one cardiac chamber”
  • Peri-procedural device evaluation code 93286 and interrogation device evaluation code 93288, which will apply to “single, dual, or multiple lead pacemaker system, or leadless pacemaker system”
  • Physician/qualified professional remote interrogation device eval code 93294, which will apply to “single, dual, or multiple lead pacemaker system, or leadless pacemaker system”
  • Technician remote interrogation device eval code 93296, which will apply to “single, dual, or multiple lead pacemaker system, leadless pacemaker system, or implantable defibrillator system.”

Update Language for These Codes

Some of the descriptor changes offer clarity. Check out these wording revisions:

  • Codes 77021 and 77027 will add the term “imaging” so their descriptors begin with “magnetic resonance imaging.
  • Code 77387’s descriptor removes a word so it will reference “radiation treatment” rather than “radiation treatment delivery.”
  • Get used to seeing “subcutaneous cardiac rhythm monitor system” instead of “implantable loop recorder system” in code descriptors. CPT® 2019 will make this change in codes 93285, 93291, 93298, and 93299.
  • Descriptors for interrogation codes 93290, 93297, and 93299 will add the term physiologic to “implantable cardiovascular physiologic monitor system” to better identify the type of device and data involved.

Watch New Age Range for Car Seat Codes

Codes 94780 and +94781 apply to car seat/bed testing for airway integrity. In 2018, the code descriptors refer to testing of a neonate with continual nursing observation.

In 2019, the code descriptors refer to testing for infants through 12 months of age with continual clinical staff observation.

Add EHR to 99446-99449

The 2018 code descriptors for 99446-99449 all begin with “Interprofessional telephone/Internet assessment and management service provided by a consultative physician.”

In 2019, the descriptors will also refer to EHRs, with the new language “Interprofessional telephone/Internet/electronic health record assessment and management service provided by a consultative physician.”

What About You?

Do you expect any of these revisions to change the way you code in 2019? How do you learn changes to existing codes to break old habits?


Deborah works on a wide range of TCI SuperCoder projects, researching and writing about coding, as well as assisting with data updates and tool development for our online coding solutions. Since joining TCI in 2004, she’s covered the ins and outs of coding for radiology, cardiology, oncology and hematology, orthopedics, audiology, and more.

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