New CPT® 2019 Codes From Biopsy to Breast MRI! Part 2

CPT® 2019 has so many additions coming, we couldn’t fit them all in one post. Here is the overview of the next bunch so you can start forming your update plans and not miss a beat when you start using the new codes.

Reminders: Part 1 covers FNA to cardiovascular surgery. This series of posts is about new five-digit Category I CPT® 2019 codes effective January 1, 2019. The posts don’t cover Cat. III or PLA code additions. Changes may occur before the code set is effective, so be sure you get a resource with official 2019 codes, descriptors, and guidelines in time for the new year of coding!

Bring Lymph Node Biopsy Coding Up to Date

You’ll be able to use new code 38531 to report open biopsy or excision of one or more inguinofemoral lymph nodes. The new code is in the same range as other open lymph node biopsy or excision codes.

Replace 43760 With New Gastrostomy Tube Codes

If you code percutaneous gastrostomy tube replacement, don’t miss new codes 43762 (not requiring gastrostomy tract revision) and 43763 (requiring gastrostomy tract revision). Both codes are specific to services without imaging or endoscopic guidance.

Expect gastrostomy tube change code 43760 to be deleted to make room for these new codes.

Watch for These New Urology Coding Options

Urology coders, you have a few code changes coming:

  • Codes 50436 and 50437 will allow you to report existing tract dilation for an endourologic procedure. The codes are for percutaneous services and include imaging guidance and RS&I. You’ll use 50437 for procedures involving new access into the renal collecting system. Because you’ll have these new codes, expect the CPT® 2019 code set to delete dilation code 50395.
  • You’ll use 53854 for transurethral destruction of prostate tissue using RF generated water vapor thermotherapy.

Focus on MR and US for Radiology Updates

For radiology coding, watch for updates to coding in these areas:

  • Elastography: You’ll have 76391 for MR elastography services. You’ll have a wider range of options for ultrasound elastography. You’ll use 76981 for parenchyma. Two new codes will be available for lesion studies. Code 76982 will apply to the first lesion, and you’ll report 76983 for each additional lesion. Current US elastography code 0346T will be deleted for 2019.
  • Microbubble US: More lesion imaging codes are coming in the form of 76978 and 76979. They apply to non-cardiac targeted dynamic microbubble sonographic contrast characterization. You’ll apply 76978 to the first lesion, and then apply 76979 for each additional lesion with separate injection.
  • Breast MRI: In place of 2018 breast MRI codes 77058 (unilateral) and 77059 (bilateral), expect to have four new codes that break down this way:
    • Without Contrast
      • Unilateral (77046)
      • Bilateral (77047)
    • Without and with contrast, including CAD when performed
      • Unilateral (77048)
      • Bilateral (77049).

What About You?

We still haven’t covered all of the additions, so keep your eye on the blog for more news. Are there any AMA CPT® 2019 updates you’re hoping to see, or are there any that you want to know more about?



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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