Advancedmd Eguide CPT HCPCS 2025
Advancedmd Eguide CPT HCPCS 2025
Codes 2025
Added | Revised | Deleted
1
ADDED/REVISED/DELETED CPT/HCPCS & ICD-10 CODES DISCLAIMER
ADVANCEDMD IS PROVIDING THIS CPT/HCPCS & ICD-10 LIST OF ADDED, REVISED AND DELETED
CODES FOR 2025 “AS IS” WITHOUT WARRANTY OF ANY KIND, INCLUDING BUT NOT LIMITED TO ANY
EXPRESSED OR IMPLIED WARRANTIES OR WARRANTIES FOR FITNESS FOR A PARTICULAR PURPOSE
OR MERCHANTABILITY. ADVANCEDMD DISCLAIMS RESPONSIBILITY FOR ANY ERRORS OR OMISSIONS
CONTAINED WITHIN THE ADDED, REVISED AND DELETED CPT/HCPCS & ICD-10 CODES LIST INCLUDING
IN CONJUNCTION WITH ITS USE WITH ANY SOFTWARE AND/OR HARDWARE SYSTEM. ADVANCEDMD
DISCLAIMS RESPONSIBILITY FOR ANY CONSEQUENCES OR LIABILITY WHICH MAY BE ATTRIBUTED TO
OR RELATED IN ANY WAY TO THE USE, NON-USE OR INTERPRETATION OF THE INFORMATION PROVIDED
OR NOT PROVIDED WITHIN THIS DOCUMENT. THE INFORMATION PROVIDED WITHIN THIS DOCUMENT IS
SOLELY AS A SERVICE TO ADVANCEDMD CLIENTS AND IS NOT A GUARANTEE OF ANY TYPE AS TO THE
ACCURACY OR COMPLETENESS OF THE INFORMATION. WE CANNOT GUARANTEE THE ACCURACY OF
THE INFORMATION PRINTED HEREIN AND ARE NOT RESPONSIBLE FOR CLAIMS OR LIABILITY THAT MAY
RESULT FROM THE USE OF THIS INFORMATION.
ADVANCEDMD NEITHER REPRESENTS NO GUARANTEES THAT ANY OF THE LIST OF CPT/HCPCS & ICD-10
CODES INFORMATION CONTAINED HEREIN IS COMPLETE, ACCURATE OR APPLICABLE TO ANY SPECIFIC
CLIENT OR THEIR PRACTICE OR PATIENT(S) AND ADVANCEDMD DISCLAIMS ALL LIABILITY FOR ANY
CONSEQUENCES WHICH MAY RESULT FROM RELIANCE ON THE INFORMATION CONTAINED WITHIN
THIS DOCUMENT. THIS INFORMATION IS NOT INTENDED TO BE NOR SHOULD BE CONSTRUED AS LEGAL
ADVICE OR GUIDANCE IN ANY MANNER OR CAPACITY, CLIENTS ARE RESPONSIBLE FOR DETERMINING
WHETHER THE INFORMATION CONTAINED WITHIN THIS DOCUMENT IS USEFUL OR APPLICABLE FOR
THEIR PURPOSES. THIS INFORMATION IS NOT INTENDED TO BE A FINAL OR EXHAUSTIVE LIST OF ADDED,
REVISED AND DELETED CODES FOR 2025, THE CPT/HCPCS CODES ARE FREQUENTLY REVISED AND
ADVANCEDMD DISCLAIMS ALL RESPONSIBILITY FOR ADDED, REVISED AND DELETED CODES WHICH ARE
LATER ADDED, REVISED, MODIFIED OR DELETED AT ANY TIME; NO INDEPENDENT VERIFICATION OF THE
DATA IS CLAIMED OR IMPLIED.
FURTHERMORE, PLEASE NOTE THAT ADVANCEDMD IS PROVIDING THIS INFORMATION WITHIN ITS
LIMITED LICENSE WITH THE AMERICAN MEDICAL ASSOCIATION (AMA) AND THAT ANY QUESTIONS
PERTAINING TO LICENSE OR USE OF THE CPT MUST BE ADDRESSED TO THE AMA AS THE SCOPE OF
ADVANCEDMD’S LICENSE IS DETERMINED BY THE AMA, THE COPYRIGHT HOLDER. CLIENTS DO NOT ACT
FOR OR ON BEHALF OF ADVANCEDMD AND ADVANCEDMD SPECIFICALLY DISCLAIMS REASONABILITY
FOR ANY LIABILITY ATTRIBUTABLE TO THE CLIENT’S USE OF THE CPT/HCPCS CODES. IN NO EVENT
SHALL ADVANCEDMD BE LIABLE FOR DIRECT, INDIRECT, SPECIAL, INCIDENTAL, OR CONSEQUENTIAL
DAMAGES ARISING OUT OF THE USE OF SUCH INFORMATION OR MATERIAL.
Helpful Tips
Here are some helpful articles to assist you in updating these codes in AdvancedMD.
You must be logged into your office key to access these articles below.
2
2025 CPT Codes
Below are the 2025 CPT code updates. This list includes new CPT codes, revised codes and deleted codes.
Category III
Category III 0901T Placement of bone marrow sampling port, including imaging guidance when performed
Category III 0902T QTc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ECG device
Category III 0903T Electrocardiogram, algorithmically generated 12-lead ECG from a reduced-lead ECG; with interpretation and report
Category III 0904T Electrocardiogram, algorithmically generated 12-lead ECG from a reduced-lead ECG; tracing only
Category III 0905T Electrocardiogram, algorithmically generated 12-lead ECG from a reduced-lead ECG; interpretation and report only
Concurrent optical and magnetic stimulation (COMS) therapy, wound assessment and dressing care; first application,
Category III 0906T
total wound(s) surface area less than or equal to 50 sq cm
Concurrent optical and magnetic stimulation (COMS) therapy, wound assessment and dressing care; each
Category III 0907T additional application, total wound(s) surface area less than or equal to 50 sq cm (List separately in addition to
code for primary procedure)
Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming,
Category III 0908T
when performed
Category III 0909T Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed
Category III 0910T Removal of integrated neurostimulation system, vagus nerve
Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or
Category III 0911T
other qualified health care professional
Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician
Category III 0912T
or other qualified health care professional
Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-
eluting), including mechanical dilation by nondrug-delivery balloon angioplasty, endoluminal imaging using intravascular
Category III 0913T
ultrasound (IVUS) or optical coherence tomography (OCT) when performed, imaging supervision, interpretation, and
report, single major coronary artery or branch
Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-
eluting) performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent
placement or coronary atherectomy, including mechanical dilation by nondrug-delivery balloon angioplasty, endoluminal
Category III 0914T
imaging using intravascular ultrasound (IVUS) or optical coherence tomography (OCT) when performed, imaging
supervision, interpretation, and report, single major coronary artery or branch (List separately in addition to code for
percutaneous coronary stent or atherectomy intervention)
3
Added CPT Codes for 2025
Speciality CPT Code Description
Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic
Category III 0915T guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual
transvenous electrodes/leads (pacing and defibrillation)
Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic
Category III 0916T
guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator only
Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic
Category III 0917T guidance, and evaluation and programming of sensing and therapeutic parameters; single transvenous lead (pacing or
defibrillation) only
Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic
Category III 0918T guidance, and evaluation and programming of sensing and therapeutic parameters; dual transvenous leads (pacing and
defibrillation) only
Category III 0919T Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only
Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing
Category III 0920T
lead only
Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous
Category III 0921T
defibrillation lead only
Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and
Category III 0922T
defibrillation) transvenous leads only
Category III 0923T Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only
Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s),
Category III 0924T
including fluoroscopic guidance and programming of sensing and therapeutic parameters
Category III 0925T Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator
Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of
Category III 0926T the device and select optimal permanent programmed values with analysis, including review and report, implantable
cardiac contractility modulation-defibrillation system
Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and
Category III 0927T
disconnection, per patient encounter, implantable cardiac contractility modulation-defibrillation system
Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim
Category III 0928T
analysis and report(s) by a physician or other qualified health care professional
Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote
Category III 0929T
data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results
Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold
Category III 0930T evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial
implantation or replacement with testing of cardiac contractility modulation-defibrillator pulse generator
Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold
Category III 0931T evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial
implantation or replacement with testing of cardiac contractility modulation-defibrillator pulse generator
Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated
Category III 0932T
preserved ejection fraction, with interpretation and report by a physician or other qualified health care professional
Transcatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including
Category III 0933T sensor calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological
supervision and interpretation
Remote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left
atrial pressure recordings, interpretation(s) and trend analysis, with adjustments to the diuretics plan, treatment paradigm
Category III 0934T
thresholds, medications or lifestyle modifications, when performed, and report(s) by a physician or other qualified health
care professional
Cystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach,
Category III 0935T including insertion of guide wire, selective placement of ureteral sheath(s) and multiple conformable electrodes, contrast
injection(s), and fluoroscopy, bilateral
Category III 0936T Photobiomodulation therapy of retina, single session
External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and
Category III 0937T storage; including recording, scanning analysis with report, review and interpretation by a physician or other qualified
health care professional
External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and
Category III 0938T
storage; recording (including connection and initial recording)
External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and
Category III 0939T
storage; scanning analysis with report
External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and
Category III 0940T
storage; review and interpretation by a physician or other qualified health care professional
Cystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated
Category III 0941T
cystoscopic visualization
Category III 0942T Cystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold
Category III 0943T Cystourethroscopy, flexible; with removal of prostatic urethral scaffold
4
Added CPT Codes for 2025
Speciality CPT Code Description
Category III 0944T 3D contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation
Intraoperative assessment for abnormal (tumor) tissue, in-vivo, following partial mastectomy (eg, lumpectomy) using
Category III 0945T
computer-aided fluorescence imaging (List separately in addition to code for primary procedure)
Orthopedic implant movement analysis using paired computed tomography (CT) examination of the target structure,
Category III 0946T including data acquisition, data preparation and transmission, interpretation and report (including CT scan of the joint or
extremity performed with paired views)
Magnetic resonance image guided low intensity focused ultrasound (MRgFUS), stereotactic blood-brain barrier
Category III 0947T disruption using microbubble resonators to increase the concentration of blood-based biomarkers of target, intracranial,
including stereotactic navigation and frame placement, when performed
Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation
Category III 0863T
and programming; transmitter component only
Category III 0864T Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy
Quantitative magnetic resonance image (MRI) analysis of the brain with comparison to prior magnetic resonance (MR)
study(ies), including lesion identification, characterization, and quantification, with brain volume(s) quantification and/
Category III 0865T
or severity score, when performed, data preparation and transmission, interpretation and report, obtained without
diagnostic MRI examination of the brain during the same session
Quantitative magnetic resonance image (MRI) analysis of the brain with comparison to prior magnetic resonance (MR)
study(ies), including lesion detection, characterization, and quantification, with brain volume(s) quantification and/or
Category III 0866T
severity score, when performed, data preparation and transmission, interpretation and report, obtained with diagnostic
MRI examination of the brain (List separately in addition to code for primary procedure)
Integumentary System
Integumentary System 15011 Harvest of skin for skin cell suspension autograft; first 25 sq cm or less
Harvest of skin for skin cell suspension autograft; each additional 25 sq cm or part thereof (List separately in addition to
Integumentary System 15012
code for primary procedure)
Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of
Integumentary System 15013
skin cells, and filtration; first 25 sq cm or less of harvested skin
Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of
Integumentary System 15014 skin cells, and filtration; each additional 25 sq cm of harvested skin or part thereof (List separately in addition to code for
primary procedure)
Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk,
Integumentary System 15015
arms, legs; first 480 sq cm or less
Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk,
Integumentary System 15016
arms, legs; each additional 480 sq cm or part thereof (List separately in addition to code for primary procedure)
Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face,
Integumentary System 15017
scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 480 sq cm or less
Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face,
Integumentary System 15018 scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 480 sq cm or part
thereof (List separately in addition to code for primary procedure)
Musculoskeletal System
Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with
Musculoskeletal System 25448
interposition, when performed
Cardiovascular System
Chimeric antigen receptor T-cell (CAR-T) therapy; harvesting of blood-derived T lymphocytes for development of
Cardiovascular System 38225
genetically modified autologous CAR-T cells, per day
Chimeric antigen receptor T-cell (CAR-T) therapy; preparation of blood-derived T lymphocytes for transportation (eg,
Cardiovascular System 38226
cryopreservation, storage)
Cardiovascular System 38227 Chimeric antigen receptor T-cell (CAR-T) therapy; receipt and preparation of CAR-T cells for administration
Cardiovascular System 38228 Chimeric antigen receptor T-cell (CAR-T) therapy; CAR-T cell administration, autologous
Digestive System
Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s)
Digestive System 49186
or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less
Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s)
Digestive System 49187
or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm
Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s)
Digestive System 49188
or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm
Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s)
Digestive System 49189
or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm
Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s)
Digestive System 49190
or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 30 cm
5
Added CPT Codes for 2025
Speciality CPT Code Description
Nervous System
Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging
Nervous System 60660
guidance, radiofrequency
Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (List
Nervous System 60661
separately in addition to code for primary procedure)
Magnetic resonance image guided high intensity focused ultrasound (MRgFUS), stereotactic ablation of target,
Nervous System 61715
intracranial, including stereotactic navigation and frame placement, when performed
Nervous System 64466 Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed
Nervous System 64467 Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed
Nervous System 64468 Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed
Nervous System 64469 Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed
Nervous System 64473 Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed
Nervous System 64474 Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed
Nervous System 66683 Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed
Radiology
MR safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of
implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device
Radiology 76014
vendors, review of prior imaging), analyzing current MR conditional status of individual components and systems, and
consulting published professional guidance with written report; initial 15 minutes
MR safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of
implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device
Radiology 76015 vendors, review of prior imaging), analyzing current MR conditional status of individual components and systems, and
consulting published professional guidance with written report; each additional 30 minutes (List separately in addition to
code for primary procedure)
MR safety determination by a physician or other qualified health care professional responsible for the safety of the MR
procedure, including review of implant MR conditions for indicated MR examination, analysis of risk vs clinical benefit
Radiology 76016
of performing MR examination, and determination of MR equipment, accessory equipment, and expertise required to
perform examination, with written report
MR safety medical physics examination customization, planning and performance monitoring by medical physicist or MR
safety expert, with review and analysis by physician or other qualified health care professional to prioritize and select
Radiology 76017
views and imaging sequences, to tailor MR acquisition specific to restrictive requirements or artifacts associated with MR
conditional implants or to mitigate risk of non-conditional implants or foreign bodies, with written report
MR safety implant electronics preparation under supervision of physician or other qualified health care professional,
including MR-specific programming of pulse generator and/or transmitter to verify device integrity, protection of device
Radiology 76018
internal circuitry from MR electromagnetic fields, and protection of patient from risks of unintended stimulation or
heating while in the MR room, with written report
MR safety implant positioning and/or immobilization under supervision of physician or other qualified health care
professional, including application of physical protections to secure implanted medical device from MR-induced
Radiology 76019
translational or vibrational forces, magnetically induced functional changes, and/or prevention of radiofrequency burns
from inadvertent tissue contact while in the MR room, with written report
Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic;
Radiology 76989
interpretation and report only
6
Added CPT Codes for 2025
Speciality CPT Code Description
Infectious disease, bacterial vaginosis and vaginitis, real-time PCR amplification of DNA markers for Atopobium vaginae,
Atopobium species, Megasphaera type 1, and Bacterial Vaginosis Associated Bacteria-2 (BVAB-2), utilizing vaginal-
Pathology and Laboratory 81515 fluid specimens, algorithm reported as positive or negative for high likelihood of bacterial vaginosis, includes separate
detection of Trichomonas vaginalis and Candida species (C. albicans, C. tropicalis, C. parapsilosis, C. dubliniensis),
Candida glabrata/Candida krusei, when reported
Transplantation medicine (allograft rejection, kidney), mRNA, gene expression profiling by quantitative polymerase
Pathology and Laboratory 81558 chain reaction (qPCR) of 139 genes, utilizing whole blood, algorithm reported as a binary categorization as transplant
excellence, which indicates immune quiescence, or not transplant excellence, indicating subclinical rejection
Pathology and Laboratory 82233 Beta-amyloid; 1-40 (Abeta 40)
Pathology and Laboratory 82234 Beta-amyloid; 1-42 (Abeta 42)
Pathology and Laboratory 83884 Neurofilament light chain (NfL)
Pathology and Laboratory 84393 Tau, phosphorylated (eg, pTau 181, pTau 217), each
Pathology and Laboratory 84394 Tau, total (tTau)
Pathology and Laboratory 86581 Streptococcus pneumoniae antibody (IgG), serotypes, multiplex immunoassay, quantitative
Infectious agent detection by nucleic acid (DNA or RNA); Helicobacter pylori (H. pylori), clarithromycin resistance,
Pathology and Laboratory 87513
amplified probe technique
Infectious agent detection by nucleic acid (DNA or RNA); Mycobacterium tuberculosis, rifampin resistance, amplified
Pathology and Laboratory 87564
probe technique
Pathology and Laboratory 87594 Infectious agent detection by nucleic acid (DNA or RNA); Pneumocystis jirovecii, amplified probe technique
Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), separately reported high-risk
Pathology and Laboratory 87626
types (eg, 16, 18, 31, 45, 51, 52) and high-risk pooled result(s)
7
Added CPT Codes for 2025
Speciality CPT Code Description
Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically
Medicine Services and Procedures 98009 appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion.
When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.
Synchronous audio-only visit for the evaluation and management of a new patient, which requires a
medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes
Medicine Services and Procedures 98010
of medical discussion. When using total time on the date of the encounter for code selection, 45 minutes must be
met or exceeded.
Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically
Medicine Services and Procedures 98011 appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion.
When using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.
Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically
Medicine Services and Procedures 98012 appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical
discussion. When using total time on the date of the encounter for code selection, 10 minutes must be exceeded.
Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically
Medicine Services and Procedures 98013 appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion.
When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.
Synchronous audio-only visit for the evaluation and management of an established patient, which requires a
medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes
Medicine Services and Procedures 98014
of medical discussion. When using total time on the date of the encounter for code selection, 30 minutes must be
met or exceeded.
Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically
Medicine Services and Procedures 98015 appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion.
When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.
Brief communication technology-based service (eg, virtual check-in) by a physician or other qualified health care
professional who can report evaluation and management services, provided to an established patient, not originating
Medicine Services and Procedures 98016 from a related evaluation and management service provided within the previous 7 days nor leading to an evaluation
and management service or procedure within the next 24 hours or soonest available appointment, 5-10 minutes of
medical discussion
8
Revised CPT Codes for 2025
CPT
Speciality 2025 Description 2024 Description
Code
Proprietary Laboratory Analyses
Eosinophilic esophagitis, 2 protein biomarkers (Eotaxin-3 [CCL26 Inflammation (eosinophilic esophagitis), ELISA analysis of
{C-C motif chemokine ligand 26}] and Major Basic Protein [PRG2 eotaxin-3 (CCL26 [C-C motif chemokine ligand 26]) and major
Proprietary {proteoglycan 2, pro eosinophil major basic protein}]), enzyme- basic protein (PRG2 [proteoglycan 2, pro eosinophil major
0095U
Laboratory Analyses linked immunosorbent assays (ELISA), specimen obtained by basic protein]), specimen obtained by swallowed nylon string,
esophageal string test device, algorithm reported as probability of algorithm reported as predictive probability index for active
active or inactive eosinophilic esophagitis eosinophilic esophagitis
Oncology (bladder), 10 protein biomarkers (A1AT, ANG,
Oncology (bladder), analysis of 10 protein biomarkers (A1AT,
APOE, CA9, IL8, MMP9, MMP10, PAI1, SDC1 and VEGFA), by
Proprietary ANG, APOE, CA9, IL8, MMP9, MMP10, PAI1, SDC1, and VEGFA)
0356U immunoassays, urine, diagnostic algorithm, including patient’s
Laboratory Analyses by immunoassays, urine, algorithm reported as a probability of
age, race and gender, reported as a probability of harboring
bladder cancer
urothelial cancer
Category III
Automated analysis of binocular eye movements without spatial
calibration, including disconjugacy, saccades, and pupillary Eye-movement analysis without spatial calibration, with
Category III 0615T
dynamics for the assessment of concussion, with interpretation interpretation and report
and report
Musculoskeletal System
Musculoskeletal System 21630 Radical resection of sternum Radical resection of sternum;
Arthroplasty, intercarpal or carpometacarpal joints; interposition
Musculoskeletal System 25447 Arthroplasty, interposition, intercarpal or carpometacarpal joints
(eg, tendon)
Respiratory System
Obliteration of aortopulmonary septal defect, with Obliteration of aortopulmonary septal defect; with
Respiratory System 25447
cardiopulmonary bypass cardiopulmonary bypass
Pathology
Hereditary breast cancer-related disorders (eg, hereditary Hereditary breast cancer-related disorders (eg, hereditary breast
breast cancer, hereditary ovarian cancer, hereditary endometrial cancer, hereditary ovarian cancer, hereditary endometrial cancer);
Pathology 81432 cancer, hereditary pancreatic cancer, hereditary prostate cancer), genomic sequence analysis panel, must include sequencing of
genomic sequence analysis panel, 5 or more genes, interrogation at least 10 genes, always including BRCA1, BRCA2, CDH1, MLH1,
for sequence variants and copy number variants MSH2, MSH6, PALB2, PTEN, STK11, and TP53
Hereditary colon cancer-related disorders (eg, Lynch syndrome, Hereditary colon cancer disorders (eg, Lynch syndrome, PTEN
PTEN hamartoma syndrome, Cowden syndrome, familial hamartoma syndrome, Cowden syndrome, familial adenomatosis
Pathology 81435 adenomatosis polyposis), genomic sequence analysis panel, 5 polyposis); genomic sequence analysis panel, must include
or more genes, interrogation for sequence variants and copy sequencing of at least 10 genes, including APC, BMPR1A, CDH1,
number variants MLH1, MSH2, MSH6, MUTYH, PTEN, SMAD4, and STK11
Hereditary neuroendocrine tumor-related disorders (eg, Hereditary neuroendocrine tumor disorders (eg, medullary
medullary thyroid carcinoma, parathyroid carcinoma, malignant thyroid carcinoma, parathyroid carcinoma, malignant
Pathology 81437 pheochromocytoma or paraganglioma), genomic sequence pheochromocytoma or paraganglioma); genomic sequence
analysis panel, 5 or more genes, interrogation for sequence analysis panel, must include sequencing of at least 6 genes,
variants and copy number variants including MAX, SDHB, SDHC, SDHD, TMEM127, and VHL
Infectious agent detection by nucleic acid (DNA or RNA); Human Infectious agent detection by nucleic acid (DNA or RNA); Human
Pathology 87624 Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45,
51, 52, 56, 58, 59, 68), pooled result 51, 52, 56, 58, 59, 68)
Macroscopic examination, dissection, and preparation of Macroscopic examination, dissection, and preparation of
tissue for non-microscopic analytical studies (eg, nucleic acid- tissue for non-microscopic analytical studies (eg, nucleic acid-
Pathology 88387
based molecular studies), each tissue preparation (eg, a single based molecular studies); each tissue preparation (eg, a single
lymph node) lymph node)
Medicine
Influenza virus vaccine, trivalent (ccIIV3), derived from cell Influenza virus vaccine, trivalent (ccIIV3), derived from cell
Medicine 90661 cultures, subunit, antibiotic free, 0.5 mL dosage, for cultures, subunit, preservative and antibiotic free, 0.5 mL dosage,
intramuscular use for intramuscular use
9
Revised CPT Codes for 2025
CPT
Speciality 2025 Description 2024 Description
Code
Computerized ophthalmic diagnostic imaging (eg, optical
Scanning computerized ophthalmic diagnostic imaging, anterior
Medicine 92132 coherence tomography [OCT]), anterior segment, with
segment, with interpretation and report, unilateral or bilateral
interpretation and report, unilateral or bilateral
Computerized ophthalmic diagnostic imaging (eg, optical Scanning computerized ophthalmic diagnostic imaging, posterior
Medicine 92133 coherence tomography [OCT]), posterior segment, with segment, with interpretation and report, unilateral or bilateral;
interpretation and report, unilateral or bilateral; optic nerve optic nerve
Computerized ophthalmic diagnostic imaging (eg, optical Scanning computerized ophthalmic diagnostic imaging,
Medicine 92134 coherence tomography [OCT]), posterior segment, with posterior segment, with interpretation and report, unilateral or
interpretation and report, unilateral or bilateral; retina bilateral; retina
Comprehensive electrophysiologic evaluation with transseptal Comprehensive electrophysiologic evaluation including
catheterizations, insertion and repositioning of multiple electrode transseptal catheterizations, insertion and repositioning of
catheters, induction or attempted induction of an arrhythmia multiple electrode catheters with intracardiac catheter ablation
including left or right atrial pacing/recording, and intracardiac of atrial fibrillation by pulmonary vein isolation, including
Medicine 93656 catheter ablation of atrial fibrillation by pulmonary vein isolation, intracardiac electrophysiologic 3-dimensional mapping,
including intracardiac electrophysiologic 3-dimensional mapping, intracardiac echocardiography including imaging supervision and
intracardiac echocardiography with imaging supervision and interpretation, induction or attempted induction of an arrhythmia
interpretation, right ventricular pacing/recording, and His bundle including left or right atrial pacing/recording, right ventricular
recording, when performed pacing/recording, and His bundle recording, when performed
Transcranial Doppler study of the intracranial arteries; venous- Transcranial Doppler study of the intracranial arteries; emboli
Medicine 93893
arterial shunt detection with intravenous microbubble injection detection with intravenous microbubble injection
Acupuncture, 1 or more needles; without electrical stimulation, Acupuncture, 1 or more needles; without electrical stimulation,
each additional 15 minutes of personal one-on-one contact with each additional 15 minutes of personal one-on-one contact
Medicine 97811
the patient, with insertion of needle(s) (List separately in addition with the patient, with re-insertion of needle(s) (List separately in
to code for primary procedure) addition to code for primary procedure)
Acupuncture, 1 or more needles; without electrical stimulation, Acupuncture, 1 or more needles; without electrical stimulation,
each additional 15 minutes of personal one-on-one contact with each additional 15 minutes of personal one-on-one contact
Medicine 97814
the patient, with insertion of needle(s) (List separately in addition with the patient, with re-insertion of needle(s) (List separately in
to code for primary procedure) addition to code for primary procedure)
Education and training for patient self-management by a Education and training for patient self-management by a
nonphysician qualified health care professional using a qualified, nonphysician health care professional using a
Medicine 98960
standardized curriculum, face-to-face with the patient (could standardized curriculum, face-to-face with the patient (could
include caregiver/family) each 30 minutes; individual patient include caregiver/family) each 30 minutes; individual patient
Education and training for patient self-management by a Education and training for patient self-management by a
nonphysician qualified health care professional using a qualified, nonphysician health care professional using a
Medicine 98961
standardized curriculum, face-to-face with the patient (could standardized curriculum, face-to-face with the patient (could
include caregiver/family) each 30 minutes; 2-4 patients include caregiver/family) each 30 minutes; 2-4 patients
Education and training for patient self-management by a nonphysician Education and training for patient self-management by a qualified,
qualified health care professional using a standardized curriculum, nonphysician health care professional using a standardized
Medicine 98962
face-to-face with the patient (could include caregiver/family) each 30 curriculum, face-to-face with the patient (could include caregiver/
minutes; 5-8 patients family) each 30 minutes; 5-8 patients
Telephone assessment and management service provided Telephone assessment and management service provided
by a nonphysician qualified health care professional to an by a qualified nonphysician health care professional to an
established patient, parent, or guardian not originating from a established patient, parent, or guardian not originating from a
Medicine 98966 related assessment and management service provided within the related assessment and management service provided within the
previous 7 days nor leading to an assessment and management previous 7 days nor leading to an assessment and management
service or procedure within the next 24 hours or soonest service or procedure within the next 24 hours or soonest
available appointment; 5-10 minutes of medical discussion available appointment; 5-10 minutes of medical discussion
Telephone assessment and management service provided Telephone assessment and management service provided
by a nonphysician qualified health care professional to an by a qualified nonphysician health care professional to an
established patient, parent, or guardian not originating from a established patient, parent, or guardian not originating from a
Medicine 98967 related assessment and management service provided within the related assessment and management service provided within the
previous 7 days nor leading to an assessment and management previous 7 days nor leading to an assessment and management
service or procedure within the next 24 hours or soonest service or procedure within the next 24 hours or soonest
available appointment; 11-20 minutes of medical discussion available appointment; 11-20 minutes of medical discussion
Telephone assessment and management service provided Telephone assessment and management service provided
by a nonphysician qualified health care professional to an by a qualified nonphysician health care professional to an
established patient, parent, or guardian not originating from a established patient, parent, or guardian not originating from a
Medicine 98968 related assessment and management service provided within the related assessment and management service provided within the
previous 7 days nor leading to an assessment and management previous 7 days nor leading to an assessment and management
service or procedure within the next 24 hours or soonest service or procedure within the next 24 hours or soonest
available appointment; 21-30 minutes of medical discussion available appointment; 21-30 minutes of medical discussion
Nonphysician qualified health care professional online digital Qualified nonphysician health care professional online digital
Medicine 98970 assessment and management, for an established patient, for up to assessment and management, for an established patient, for up
7 days, cumulative time during the 7 days; 5-10 minutes to 7 days, cumulative time during the 7 days; 5-10 minutes
Nonphysician qualified health care professional online digital Qualified nonphysician health care professional online digital
Medicine 98971 assessment and management, for an established patient, for up to 7 assessment and management, for an established patient, for up to 7
days, cumulative time during the 7 days; 11-20 minutes days, cumulative time during the 7 days; 11-20 minutes
Nonphysician qualified health care professional online digital Qualified nonphysician health care professional online digital
Medicine 98972 assessment and management, for an established patient, for up to assessment and management, for an established patient, for up
7 days, cumulative time during the 7 days; 21 or more minutes to 7 days, cumulative time during the 7 days; 21 or more minutes
10
Revised CPT Codes for 2025
CPT
Speciality 2025 Description 2024 Description
Code
Revision or removal of peripheral, sacral, or gastric
Revision or removal of peripheral or gastric neurostimulator pulse
Medicine 64595 neurostimulator pulse generator or receiver, with detachable
generator or receiver
connection to electrode array
Remote therapeutic monitoring (eg, therapy adherence, therapy Remote therapeutic monitoring (eg, therapy adherence, therapy
Medicine 98975 response, digital therapeutic intervention); initial set-up and response); initial set-up and patient education on use of
patient education on use of equipment equipment
Remote therapeutic monitoring (eg, therapy adherence, therapy Remote therapeutic monitoring (eg, therapy adherence, therapy
response, digital therapeutic intervention); device(s) supply response); device(s) supply with scheduled (eg, daily) recording(s)
Medicine 98976
for data access or data transmissions to support monitoring of and/or programmed alert(s) transmission to monitor respiratory
respiratory system, each 30 days system, each 30 days
Remote therapeutic monitoring (eg, therapy adherence, therapy Remote therapeutic monitoring (eg, therapy adherence,
response, digital therapeutic intervention); device(s) supply therapy response); device(s) supply with scheduled (eg, daily)
Medicine 98977
for data access or data transmissions to support monitoring of recording(s) and/or programmed alert(s) transmission to monitor
musculoskeletal system, each 30 days musculoskeletal system, each 30 days
Remote therapeutic monitoring (eg, therapy adherence, therapy Remote therapeutic monitoring (eg, therapy adherence, therapy
response, digital therapeutic intervention); device(s) supply response); device(s) supply with scheduled (eg, daily) recording(s)
Medicine 98978
for data access or data transmissions to support monitoring of and/or programmed alert(s) transmission to monitor cognitive
cognitive behavioral therapy, each 30 days behavioral therapy, each 30 days
11
Deleted CPT Codes for 2025
Speciality CPT Code Description
Proprietary Laboratory Analyses
Proprietary
Laboratory 0346U Beta Amyloid, Aß40 And Aß42 By Liquid Chromatography With Tandem Mass Spectrometry (Lc-Ms/Ms), Ratio, Plasma
Analyses
Infectious disease (bacterial vaginosis and vaginitis), multiplex amplified probe technique, for detection of bacterial vaginosis-
Proprietary
associated bacteria (BVAB-2, Atopobium vaginae, and Megasphera type 1), algorithm reported as detected or not detected and
Laboratory 0352U
separate detection of Candida species (C. albicans, C. tropicalis, C. parapsilosis, C. dubliniensis), Candida glabrata/Candida krusei,
Analyses
and trichomonas vaginalis, vaginal-fluid specimen, each result reported as detected or not detected
Proprietary
Drug Metabolism (Adverse Drug Reactions And Drug Response), Targeted Sequence Analysis, 20 Gene Variants And Cyp2D6
Laboratory 0380U
Deletion Or Duplication Analysis With Reported Genotype And Phenotype
Analyses
Proprietary Oncology (Breast), Targeted Hybrid-Capture Genomic Sequence Analysis Panel, Circulating Tumor Dna (Ctdna) Analysis Of 56
Laboratory 0428U Or More Genes, Interrogation For Sequence Variants, Gene Copy Number Amplifications, Gene Rearrangements, Microsatellite
Analyses Instability, And Tumor Mutation Burden
Proprietary Oncology (Lung And Colon Cancer), Dna, Qualitative, Next-Generation Sequencing Detection Of Single-Nucleotide Variants And
Laboratory 0448U Deletions In Egfr And Kras Genes, Formalin-Fixed Paraffin-Embedded (Ffpe) Solid Tumor Samples, Reported As Presence Or
Analyses Absence Of Targeted Mutation(S), With Recommended Therapeutic Options
Proprietary Autoimmune (Rheumatoid Arthritis), Next-Generation Sequencing (Ngs), Gene Expression Testing Of 19 Genes, Whole Blood, With
Laboratory 0456U Analysis Of Anti-Cyclic Citrullinated Peptides (Ccp) Levels, Combined With Sex, Patient Global Assessment, And Body Mass Index
Analyses (Bmi), Algorithm Reported As A Score That Predicts Nonresponse To Tumor Necrosis Factor Inhibitor (Tnfi) Therapy
Category III
Category III 0398T 30 minutes face-to-face with patient/family
Infectious agent detection by nucleic acid (DNA or RNA), Human Papillomavirus (HPV) for five or more separately reported high-risk
Category III 0500T
HPV types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) (ie, genotyping)
Chimeric antigen receptor T-cell (CAR-T) therapy; harvesting of blood-derived T lymphocytes for development of genetically
Category III 0537T
modified autologous CAR-T cells, per day
Chimeric antigen receptor T-cell (CAR-T) therapy; preparation of blood-derived T lymphocytes for transportation (eg,
Category III 0538T
cryopreservation, storage)
Category III 0539T Chimeric antigen receptor T-cell (CAR-T) therapy; receipt and preparation of CAR-T cells for administration
Category III 0540T Chimeric antigen receptor T-cell (CAR-T) therapy; CAR-T cell administration, autologous
Percutaneous transcatheter placement of iliac arteriovenous anastomosis implant, inclusive of all radiological supervision and
Category III 0553T
interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention
Oncology, chemotherapeutic drug cytotoxicity assay of cancer stem cells (CSCs), from cultured CSCs and primary tumor cells,
Category III 0564T
categorical drug response reported based on percent of cytotoxicity observed, a minimum of 14 drugs or drug combinations
Category III 0567T Permanent fallopian tube occlusion with degradable biopolymer implant, transcervical approach, including transvaginal ultrasound
Introduction of mixture of saline and air for sonosalpingography to confirm occlusion of fallopian tubes, transcervical approach,
Category III 0568T
including transvaginal ultrasound and pelvic ultrasound
Insertion of iris prosthesis, including suture fixation and repair or removal of iris, when performed; without removal of crystalline lens
Category III 0616T
or intraocular lens, without insertion of intraocular lens
Insertion of iris prosthesis, including suture fixation and repair or removal of iris, when performed; with removal of crystalline lens
Category III 0617T
and insertion of intraocular lens
Insertion of iris prosthesis, including suture fixation and repair or removal of iris, when performed; with secondary intraocular lens
Category III 0618T
placement or intraocular lens exchange
Musculoskeletal System
Musculoskeletal
15819 Cervicoplasty
System
Musculoskeletal
21632 Radical resection of sternum; with mediastinal lymphadenectomy
System
Cardiovascular System
Cardiovascular
33471 Valvotomy, pulmonary valve, closed heart, via pulmonary
System
Cardiovascular
33737 artery
System
Cardiovascular
33813 Obliteration of aortopulmonary septal defect; without cardiopulmonary bypass
System
12
Deleted CPT Codes for 2025
Speciality CPT Code Description
Digestive System
Digestive System 47802 U-tube hepaticoenterostomy
Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal
Digestive System 49203
primary or secondary tumors; largest tumor 5 cm diameter or less
Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal
Digestive System 49204
primary or secondary tumors; largest tumor 5.1-10.0 cm diameter
Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal
Digestive System 49205
primary or secondary tumors; largest tumor greater than 10.0 cm diameter
Pathology
Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer);
Pathology 81433
duplication/deletion analysis panel, must include analyses for BRCA1, BRCA2, MLH1, MSH2, and STK11
Hereditary colon cancer disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis
Pathology 81436 polyposis); duplication/deletion analysis panel, must include analysis of at least 5 genes, including MLH1, MSH2, EPCAM, SMAD4,
and STK11
Hereditary neuroendocrine tumor disorders (eg, medullary thyroid carcinoma, parathyroid carcinoma, malignant
Pathology 81438 pheochromocytoma or paraganglioma); duplication/deletion analysis panel, must include analyses for SDHB, SDHC, SDHD,
and VHL
Medicine
Medicine 90630 Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, for intradermal use
Medicine 90654 Influenza virus vaccine, trivalent (IIV3), split virus, preservative-free, for intradermal use
Medicine 93890 vasoreactivity study
Medicine 96003 Dynamic fine wire electromyography, during walking or other functional activities, 1 muscle
Medicine 96040 Medical genetics and genetic counseling services, each
E/M
Telephone evaluation and management service by a physician or other qualified health care professional who may report
evaluation and management services provided to an established patient, parent, or guardian not originating from a related E/M
E/M 99441
service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest
available appointment; 5-10 minutes of medical discussion
Telephone evaluation and management service by a physician or other qualified health care professional who may report
evaluation and management services provided to an established patient, parent, or guardian not originating from a related E/M
E/M 99442
service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest
available appointment; 11-20 minutes of medical discussion
Telephone evaluation and management service by a physician or other qualified health care professional who may report
evaluation and management services provided to an established patient, parent, or guardian not originating from a related E/M
E/M 99443
service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest
available appointment; 21-30 minutes of medical discussion
13
2025 HCPCS Codes
Below are the 2025 HCPCS code updates. This list includes new HCPCS codes, revised codes and deleted codes.
Durable Medical Equipment E1804 Dynamic adjustable elbow flexion only device, includes soft interface material
Durable Medical Equipment E1807 Dynamic adjustable wrist extension only device, includes soft interface material
Durable Medical Equipment E1808 Dynamic adjustable wrist flexion only device, includes soft interface material
Durable Medical Equipment E1813 Dynamic adjustable knee extension only device, includes soft interface material
Durable Medical Equipment E1814 Dynamic adjustable knee flexion only device, includes soft interface material
Durable Medical Equipment E1822 Dynamic adjustable ankle extension only device, includes soft interface material
Durable Medical Equipment E1823 Dynamic adjustable ankle flexion only device, includes soft interface material
Durable Medical Equipment E1826 Dynamic adjustable finger extension only device, includes soft interface material
Durable Medical Equipment E1827 Dynamic adjustable finger flexion only device, includes soft interface material
Durable Medical Equipment E1828 Dynamic adjustable toe extension only device, includes soft interface material
Durable Medical Equipment E1829 Dynamic adjustable toe flexion only device, includes soft interface material
Drugs, biologicals & medical equipment not identified as HCPCS level II codes
Drugs, biologicals & medical
equipment not identified as HCPCS Q0521 Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription
level II codes
Drugs, biologicals & medical
equipment not identified as HCPCS Q5139 Injection, eculizumab-aeeb (bkemv), biosimilar, 10 mg
level II codes
14
Added HCPCS Codes for 2025
Speciality HCPCS Code Description
Drugs, biologicals & medical
equipment not identified as HCPCS Q5140 Injection, adalimumab-fkjp, biosimilar, 1 mg
level II codes
Drugs, biologicals & medical
equipment not identified as HCPCS Q5141 Injection, adalimumab-aaty, biosimilar, 1 mg
level II codes
Drugs, biologicals & medical
equipment not identified as HCPCS Q5142 Injection, adalimumab-ryvk biosimilar, 1 mg
level II codes
Drugs, biologicals & medical
equipment not identified as HCPCS Q5143 Injection, adalimumab-adbm, biosimilar, 1 mg
level II codes
Drugs, biologicals & medical
equipment not identified as HCPCS Q5144 Injection, adalimumab-aacf (idacio), biosimilar, 1 mg
level II codes
Drugs, biologicals & medical
equipment not identified as HCPCS Q5145 Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg
level II codes
Drugs, biologicals & medical
equipment not identified as HCPCS Q5146 Injection, trastuzumab-strf (hercessi), biosimilar, 10 mg
level II codes
Drugs, biologicals & medical
equipment not identified as HCPCS Q9996 Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg
level II codes
Drugs, biologicals & medical
equipment not identified as HCPCS Q9997 Injection, ustekinumab-ttwe (pyzchiva), intravenous, 1 mg
level II codes
Drugs, biologicals & medical
equipment not identified as HCPCS Q9998 Injection, ustekinumab-aekn (selarsdi), 1 mg
level II codes
15
Revised HCPCS Codes for 2025
Speciality HCPCS Code Description
Tuberculosis Codes
Tuberculosis Codes TB Drug or biological acquired with 340b drug pricing program discount, reported for informational purposes
Durable Medical Equipment E1805 Dynamic adjustable wrist extension and flexion device, includes soft interface material
Durable Medical Equipment E1810 Dynamic adjustable knee extension and flexion device, includes soft interface material
Durable Medical Equipment E1815 Dynamic adjustable ankle extension and flexion device, includes soft interface material
Durable Medical Equipment E1825 Dynamic adjustable finger extension and flexion device, includes soft interface material
Durable Medical Equipment E1830 Dynamic adjustable toe extension and flexion device, includes soft interface material
Orthodics or Prothestics
Orthodics or Prothestics L8720 External lower extremity sensory prosthetic device, cutaneous stimulation of mechanoreceptors proximal to the ankle, per leg
16
Deleted HCPCS Codes for 2025
HCPCS
Speciality Description
Code
Non Oral Medications
Non Oral Medications JG Drug or biological acquired with 340b drug pricing program discount, reported for informational purposes
Non Oral Medications J0135 Injection, adalimumab, 20 mg
Non Oral Medications J0570 Buprenorphine implant, 74.2 mg
Non Oral Medications J2796 Injection, romiplostim, 10 micrograms
Non Oral Medications J2806 Injection, sincalide (maia), not therapeutically equivalent to j2805, 5 micrograms
Non Oral Medications J9058 Injection, bendamustine hydrochloride (apotex), 1 mg
Non Oral Medications J9059 Injection, bendamustine hydrochloride (baxter), 1 mg
Non Oral Medications J9259 Injection, paclitaxel protein-bound particles (american regent), not therapeutically equivalent to j9264, 1 mg
Drugs, biologicals & medical equipment not identified as HCPCS level II codes
Drugs, biologicals & medical
equipment not identified as HCPCS Q0516 Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription oral drug, per 30-days
level II codes
Drugs, biologicals & medical
equipment not identified as HCPCS Q0517 Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription oral drug, per 60-days
level II codes
Drugs, biologicals & medical
equipment not identified as HCPCS Q0518 Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription oral drug, per 90-days
level II codes
Drugs, biologicals & medical
equipment not identified as HCPCS Q0519 Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription injectable drug, per 30-days
level II codes
Drugs, biologicals & medical
equipment not identified as HCPCS Q0520 Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription injectable drug, per 60-days
level II codes
Drugs, biologicals & medical
equipment not identified as HCPCS Q5131 Injection, adalimumab-aacf (idacio), biosimilar, 20 mg
level II codes
Drugs, biologicals & medical
equipment not identified as HCPCS Q5132 Injection, adalimumab-afzb (abrilada), biosimilar, 10 mg
level II codes
17
BONUS: ICD-10 Codes for 2025
Below are the ICD-10 code updates. This list includes revised codes, new codes, and deleted codes.
18
New ICD-10 Codes for 2025
System ICD-10 Code Description
19
New ICD-10 Codes for 2025
System ICD-10 Code Description
Malignant neoplasms of lymphoid,
C84.9A Mature T/NK-cell lymphomas, unspecified, in remission
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C84.AA Cutaneous T-cell lymphoma, unspecified, in remission
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C84.ZA Other mature T/NK-cell lymphomas, in remission
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C85.1A Unspecified B-cell lymphoma, in remission
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C85.2A Mediastinal (thymic) large B-cell lymphoma, in remission
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C85.8A Other specified types of non-Hodgkin lymphoma, in remission
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C85.9A Non-Hodgkin lymphoma, unspecified, in remission
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C86.00 Extranodal NK/T-cell lymphoma, nasal type not having achieved remission
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C86.01 Extranodal NK/T-cell lymphoma, nasal type, in remission
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C86.10 Hepatosplenic T-cell lymphoma not having achieved remission
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C86.11 Hepatosplenic T-cell lymphoma, in remission
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C86.20 Enteropathy-type (intestinal) T-cell lymphoma not having achieved remission
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C86.21 Enteropathy-type (intestinal) T-cell lymphoma, in remission
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C86.30 Subcutaneous panniculitis-like T-cell lymphoma not having achieved remission
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C86.31 Subcutaneous panniculitis-like T-cell lymphoma, in remission
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C86.40 Blastic NK-cell lymphoma not having achieved remission
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C86.41 Blastic NK-cell lymphoma, in remission
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C86.50 Angioimmunoblastic T-cell lymphoma not having achieved remission
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C86.51 Angioimmunoblastic T-cell lymphoma, in remission
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C86.60 Primary cutaneous CD30-positive T-cell proliferations not having achieved remission
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C86.61 Primary cutaneous CD30-positive T-cell proliferations, in remission
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C88.00 Waldenstrom macroglobulinemia not having achieved remission
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C88.01 Waldenstrom macroglobulinemia, in remission
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C88.20 Heavy chain disease not having achieved remission
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C88.21 Heavy chain disease, in remission
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C88.30 Immunoproliferative small intestinal disease not having achieved remission
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C88.31 Immunoproliferative small intestinal disease, in remission
hematopoietic and related tissue
Malignant neoplasms of lymphoid, Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue [MALT-lymphoma]
C88.40
hematopoietic and related tissue not having achieved remission
Malignant neoplasms of lymphoid, Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue [MALT-lymphoma],
C88.41
hematopoietic and related tissue in remission
Malignant neoplasms of lymphoid,
C88.80 Other malignant immunoproliferative diseases not having achieved remission
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C88.81 Other malignant immunoproliferative diseases, in remission
hematopoietic and related tissue
20
New ICD-10 Codes for 2025
System ICD-10 Code Description
Malignant neoplasms of lymphoid,
C88.90 Malignant immunoproliferative disease, unspecified not having achieved remission
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C88.91 Malignant immunoproliferative disease, unspecified, in remission
hematopoietic and related tissue
Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
Diseases of the blood and blood-forming
organs and certain disorders involving the D61.03 Fanconi anemia
immune mechanism
22
New ICD-10 Codes for 2025
System ICD-10 Code Description
Diseases of the digestive system K60.329 Anal fistula, complex, unspecified
Diseases of the digestive system K60.40 Rectal fistula, unspecified
Diseases of the digestive system K60.411 Rectal fistula, simple, initial
Diseases of the digestive system K60.412 Rectal fistula, simple, persistent
Diseases of the digestive system K60.413 Rectal fistula, simple, recurrent
Diseases of the digestive system K60.419 Rectal fistula, simple, unspecified
Diseases of the digestive system K60.421 Rectal fistula, complex, initial
Diseases of the digestive system K60.422 Rectal fistula, complex, persistent
Diseases of the digestive system K60.423 Rectal fistula, complex, recurrent
Diseases of the digestive system K60.429 Rectal fistula, complex, unspecified
Diseases of the digestive system K60.50 Anorectal fistula, unspecified
Diseases of the digestive system K60.511 Anorectal fistula, simple, initial
Diseases of the digestive system K60.512 Anorectal fistula, simple, persistent
Diseases of the digestive system K60.513 Anorectal fistula, simple, recurrent
Diseases of the digestive system K60.519 Anorectal fistula, simple, unspecified
Diseases of the digestive system K60.521 Anorectal fistula, complex, initial
Diseases of the digestive system K60.522 Anorectal fistula, complex, persistent
Diseases of the digestive system K60.523 Anorectal fistula, complex, recurrent
Diseases of the digestive system K60.529 Anorectal fistula, complex, unspecified
23
New ICD-10 Codes for 2025
System ICD-10 Code Description
Diseases of the musculoskeletal system and
M65.919 Unspecified synovitis and tenosynovitis, unspecified shoulder
connective tissue
Diseases of the musculoskeletal system and
M65.921 Unspecified synovitis and tenosynovitis, right upper arm
connective tissue
Diseases of the musculoskeletal system and
M65.922 Unspecified synovitis and tenosynovitis, left upper arm
connective tissue
Diseases of the musculoskeletal system and
M65.929 Unspecified synovitis and tenosynovitis, unspecified upper arm
connective tissue
Diseases of the musculoskeletal system and
M65.931 Unspecified synovitis and tenosynovitis, right forearm
connective tissue
Diseases of the musculoskeletal system and
M65.932 Unspecified synovitis and tenosynovitis, left forearm
connective tissue
Diseases of the musculoskeletal system and
M65.939 Unspecified synovitis and tenosynovitis, unspecified forearm
connective tissue
Diseases of the musculoskeletal system and
M65.941 Unspecified synovitis and tenosynovitis, right hand
connective tissue
Diseases of the musculoskeletal system and
M65.942 Unspecified synovitis and tenosynovitis, left hand
connective tissue
Diseases of the musculoskeletal system and
M65.949 Unspecified synovitis and tenosynovitis, unspecified hand
connective tissue
Diseases of the musculoskeletal system and
M65.951 Unspecified synovitis and tenosynovitis, right thigh
connective tissue
Diseases of the musculoskeletal system and
M65.952 Unspecified synovitis and tenosynovitis, left thigh
connective tissue
Diseases of the musculoskeletal system and
M65.959 Unspecified synovitis and tenosynovitis, unspecified thigh
connective tissue
Diseases of the musculoskeletal system and
M65.961 Unspecified synovitis and tenosynovitis, right lower leg
connective tissue
Diseases of the musculoskeletal system and
M65.962 Unspecified synovitis and tenosynovitis, left lower leg
connective tissue
Diseases of the musculoskeletal system and
M65.969 Unspecified synovitis and tenosynovitis, unspecified lower leg
connective tissue
Diseases of the musculoskeletal system and
M65.971 Unspecified synovitis and tenosynovitis, right ankle and foot
connective tissue
Diseases of the musculoskeletal system and
M65.972 Unspecified synovitis and tenosynovitis, left ankle and foot
connective tissue
Diseases of the musculoskeletal system and
M65.979 Unspecified synovitis and tenosynovitis, unspecified ankle and foot
connective tissue
Diseases of the musculoskeletal system and
M65.98 Unspecified synovitis and tenosynovitis, other site
connective tissue
Diseases of the musculoskeletal system and
M65.99 Unspecified synovitis and tenosynovitis, multiple sites
connective tissue
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
Symptoms, signs and abnormal clinical and
R41.85 Anosognosia
laboratory findings, not elsewhere classified
24
New ICD-10 Codes for 2025
System ICD-10 Code Description
Injury, poisoning and certain other Poisoning by immune checkpoint inhibitors and immunostimulant drugs, accidental
T45.AX1S
consequences of external causes (unintentional), sequela
Injury, poisoning and certain other Poisoning by immune checkpoint inhibitors and immunostimulant drugs, intentional self-harm,
T45.AX2A
consequences of external causes initial encounter
Injury, poisoning and certain other Poisoning by immune checkpoint inhibitors and immunostimulant drugs, intentional self-harm,
T45.AX2D
consequences of external causes subsequent encounter
Injury, poisoning and certain other
T45.AX2S Poisoning by immune checkpoint inhibitors and immunostimulant drugs, intentional self-harm, sequela
consequences of external causes
Injury, poisoning and certain other
T45.AX3A Poisoning by immune checkpoint inhibitors and immunostimulant drugs, assault, initial encounter
consequences of external causes
Injury, poisoning and certain other
T45.AX3D Poisoning by immune checkpoint inhibitors and immunostimulant drugs, assault, subsequent encounter
consequences of external causes
Injury, poisoning and certain other
T45.AX3S Poisoning by immune checkpoint inhibitors and immunostimulant drugs, assault, sequela
consequences of external causes
Injury, poisoning and certain other Poisoning by immune checkpoint inhibitors and immunostimulant drugs, undetermined,
T45.AX4A
consequences of external causes initial encounter
Injury, poisoning and certain other Poisoning by immune checkpoint inhibitors and immunostimulant drugs, undetermined,
T45.AX4D
consequences of external causes subsequent encounter
Injury, poisoning and certain other
T45.AX4S Poisoning by immune checkpoint inhibitors and immunostimulant drugs, undetermined, sequela
consequences of external causes
Injury, poisoning and certain other
T45.AX5A Adverse effect of immune checkpoint inhibitors and immunostim ulant drugs, initial encounter
consequences of external causes
Injury, poisoning and certain other
T45.AX5D Adverse effect of immune checkpoint inhibitors and immunostim ulant drugs, subsequent encounter
consequences of external causes
Injury, poisoning and certain other
T45.AX5S Adverse effect of immune checkpoint inhibitors and immunostimulant drugs, sequela
consequences of external causes
Injury, poisoning and certain other
T45.AX6A Underdosing of immune checkpoint inhibitors and immunostimulant drugs, initial encounter
consequences of external causes
Injury, poisoning and certain other
T45.AX6D Underdosing of immune checkpoint inhibitors and immunostimulant drugs, subsequent encounter
consequences of external causes
Injury, poisoning and certain other
T45.AX6S Underdosing of immune checkpoint inhibitors and immunostimulant drugs, sequela
consequences of external causes
Injury, poisoning and certain other
T81.320A Disruption or dehiscence of gastrointestinal tract anastomosis, repair, or closure, initial encounter
consequences of external causes
Injury, poisoning and certain other
T81.320D Disruption or dehiscence of gastrointestinal tract anastomosis, repair, or closure, subsequent encounter
consequences of external causes
Injury, poisoning and certain other
T81.320S Disruption or dehiscence of gastrointestinal tract anastomosis, repair, or closure, sequela
consequences of external causes
Injury, poisoning and certain other Disruption or dehiscence of closure of internal operation (surgical) wound of abdominal wall muscle or
T81.321A
consequences of external causes fascia, initial encounter
Injury, poisoning and certain other Disruption or dehiscence of closure of internal operation (surgical) wound of abdominal wall muscle or
T81.321D
consequences of external causes fascia, subsequent encounter
Injury, poisoning and certain other Disruption or dehiscence of closure of internal operation (surgical) wound of abdominal wall muscle or
T81.321S
consequences of external causes fascia, sequela
Injury, poisoning and certain other Disruption or dehiscence of closure of other specified internal operation (surgical) wound,
T81.328A
consequences of external causes initial encounter
Injury, poisoning and certain other Disruption or dehiscence of closure of other specified internal operation (surgical) wound,
T81.328D
consequences of external causes subsequent encounter
Injury, poisoning and certain other
T81.328S Disruption or dehiscence of closure of other specified internal operation (surgical) wound, sequela
consequences of external causes
Injury, poisoning and certain other
T81.329A Deep disruption or dehiscence of operation wound, unspecified, initial encounter
consequences of external causes
Injury, poisoning and certain other
T81.329D Deep disruption or dehiscence of operation wound, unspecified, subsequent encounter
consequences of external causes
Injury, poisoning and certain other
T81.329S Deep disruption or dehiscence of operation wound, unspecified, sequela
consequences of external causes
25
New ICD-10 Codes for 2025
System ICD-10 Code Description
Factors influencing health status and contact
Z17.21 Progesterone receptor positive status
with health services
Factors influencing health status and contact
Z17.22 Progesterone receptor negative status
with health services
Factors influencing health status and contact
Z17.31 Human epidermal growth factor receptor 2 positive status
with health services
Factors influencing health status and contact
Z17.32 Human epidermal growth factor receptor 2 negative status
with health services
Factors influencing health status and contact
Z17.410 Hormone receptor positive with human epidermal growth factor receptor 2 positive status
with health services
Factors influencing health status and contact
Z17.411 Hormone receptor positive with human epidermal growth factor receptor 2 negative status
with health services
Factors influencing health status and contact
Z17.420 Hormone receptor negative with human epidermal growth factor receptor 2 positive status
with health services
Factors influencing health status and contact
Z17.421 Hormone receptor negative with human epidermal growth factor receptor 2 negative status
with health services
Factors influencing health status and contact
Z51.A Encounter for sepsis aftercare
with health services
Factors influencing health status and contact
Z59.71 Insufficient health insurance coverage
with health services
Factors influencing health status and contact
Z59.72 Insufficient welfare support
with health services
Factors influencing health status and contact
Z67.A1 Duffy null
with health services
Factors influencing health status and contact
Z67.A2 Duffy a positive
with health services
Factors influencing health status and contact
Z67.A3 Duffy b positive
with health services
Factors influencing health status and contact
Z67.A4 Duffy a and b positive
with health services
Factors influencing health status and contact Body mass index [BMI] pediatric, 120% of the 95th percentile for age to less than 140% of the 95th
Z68.55
with health services percentile for age
Factors influencing health status and contact
Z68.56 Body mass index [BMI] pediatric, greater than or equal to 140% of the 95th percentile for age
with health services
Factors influencing health status and contact
Z83.72 Family history of familial adenomatous polyposis
with health services
Factors influencing health status and contact
Z86.0100 Personal history of colon polyps, unspecified
with health services
Factors influencing health status and contact
Z86.0101 Personal history of adenomatous and serrated colon polyps
with health services
Factors influencing health status and contact
Z86.0102 Personal history of hyperplastic colon polyps
with health services
Factors influencing health status and contact
Z86.0109 Personal history of other colon polyps
with health services
Factors influencing health status and contact
Z92.26 Personal history of immune checkpoint inhibitor therapy
with health services
26
Deleted ICD-10 Codes for 2025
System ICD-10 Code Description
Malignant neoplasms of lymphoid, hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C83.39 Diffuse large B-cell lymphoma, extranodal and solid organ sites
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C86.0 Extranodal NK/T-cell lymphoma, nasal type
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C86.1 Hepatosplenic T-cell lymphoma
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C86.2 Enteropathy-type (intestinal) T-cell lymphoma
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C86.3 Subcutaneous panniculitis-like T-cell lymphoma
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C86.4 Blastic NK-cell lymphoma
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C86.5 Angioimmunoblastic T-cell lymphoma
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C86.6 Primary cutaneous CD30-positive T-cell proliferations
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C88.0 Waldenstrom macroglobulinemia
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C88.2 Heavy chain disease
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C88.3 Immunoproliferative small intestinal disease
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C88.4 Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue [MALT-lymphoma]
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C88.8 Other malignant immunoproliferative diseases
hematopoietic and related tissue
Malignant neoplasms of lymphoid,
C88.9 Malignant immunoproliferative disease, unspecified
hematopoietic and related tissue
27
Deleted ICD-10 Codes for 2025
System ICD-10 Code Description
Diseases of the musculoskeletal system and connective tissue
Diseases of the musculoskeletal system and
M51.36 Other intervertebral disc degeneration, lumbar region
connective tissue
Diseases of the musculoskeletal system and
M51.37 Other intervertebral disc degeneration, lumbosacral region
connective tissue
Diseases of the musculoskeletal system and
M65.9 Synovitis and tenosynovitis, unspecified
connective tissue
(800) 825-0224
advancedmd.com
© 2025 AdvancedMD, Inc. All rights reserved. 28