2025 CPT® Coding Updates

B R E N D A E D WA R D S , C P C , C D E O , C P B , C P M A , C P C - I , C E M C , C R C , C P M S , C M R S , C M C S , C E M A , C PA - R A

D I R E C TO R O F A U D I T I N G , C R O S S R O A D S H E A LT H R E S O U R C E S

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The speaker has no financial relationship to any products or services
referenced in this program. The program is intended to be informational
only. The speaker is not an authoritative source by law. Attendees are
advised to reference payor specific provider manuals, on-line or otherwise,
for verification prior to making changes to their coding, documentation
and/or billing practices.

2
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 17 EM (telehealth)
33 Surgery
420 Total Changes 270 6 Radiology
new 13 Laboratory
codes 101 “U” codes
PLA are 37% of new codes
3 E/M
18 Medicine
13 Surgery
112 81 Category III
6 Laboratory deleted 30% of new codes
8 “U” codes codes
1 MAAA
69 Medicine
13 Category III 5 Surgery
38 5 Laboratory
revised 4 “U” codes
codes 22 Medicine
2 Category III

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This Just In…

https://www.dea.gov/sites/default/files/2024-11/HHS-DEA.pdf

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 https://www.terryfletcher.net/2024/12/02/telehealth-2025-the-final-rule/

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 Evaluation and Management
DELETED
99441 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 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
99442 11-20 minutes of medical discussion
99443 21-30 minutes of medical discussion

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New Section - Telemedicine Services
Located after 99202-99215 Office or other outpatient visit codes

Synchronous Audio-Video E/M 98000-98007

Synchronous Audio-only E/M 98008-98015
Brief Synchronous Communication Technology Service (Virtual Check-In) 98016

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New! Telemedicine Section
• Read the introductory section for guidance on new codes (this is the condensed version), page 17, 2025 CPT® ebook.
• Service is based on MDM or time (98000 – 98015) on the date of the encounter.
• Service time must exceed 10 minutes of medical discussion for audio-only codes (98008-98015).
98000-98007 - Telemedicine services (audio AND video) may be used for a patient requiring re-assessment for response or complications related to the
treatment plan of a previous visit.
•Codes do not require a specific time interval from last in-person or telemedicine visit.
•Can be used on new or established patient encounters.
•May be initiated by a physician or other QHP as well as by a patient and/or family/caregiver.
•Telemedicine services must be performed on a separate calendar date from another E/M service.
•When performed on the same date as another E/M service, the elements and time of these services are summed and reported in aggregate, ensuring that any
overlapping time is only counted once.
•If the minimum time for reporting a telemedicine service has not been achieved, time spent with the patient may still count toward the total time on the date of the
encounter of an in-person E/M service.

98008 – 98015 Audio-only telemedicine services are for established patients with 5 to 10 minutes of medical discussion.

•Video technology is not required for audio-only visits.

98016 - Brief communication technology service (eg, virtual check-in) online digital E/M.

•Only used for established patient encounters for 5 – 10 minutes of medical discussion (not MDM)
•Patient-initiated and intended to evaluate whether a more extensive visit type is required (eg, an office or other outpatient E/M service).
•When the patient-initiated check-in leads to an E/M service on the same calendar date, and when time is used to select the level of that E/M service, the time from
98016 may be added to the time of the E/M service for the total time on the date of the encounter.

99421 – 99423 Asynchronous (ie, not live in real-time) are reported using Online Digital Evaluation and Management Services.

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The Do Not’s
• Do not report telemedicine services for oversight of clinical staff (eg, chronic care management [CCM]).
• Do not count the time performing telemedicine services toward time performing CCM (99437, 99491)
or principal care management services (99424, 99425).
• Do not count time for establishing the connection or arranging the appointment, even when performed
by the physician or other QHP.
• Services of less than five minutes are not reported.

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Audio-Video
ADDED
Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history
and/or examination
Straightforward medical decision making.
98000 Total time on the date of the encounter, 15 minutes must be met or exceeded.
Low medical decision making.
98001 Total time on the date of the encounter, 30 minutes must be met or exceeded.
Moderate medical decision making.
98002 Total time on the date of the encounter, 45 minutes must be met or exceeded.
High medical decision making. When using total time on the date of the encounter for code selection, 60 minutes must be met or
98003 exceeded.
Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate
history and/or examination
Straightforward medical decision making.
98004 Total time on the date of the encounter, 10 minutes must be met or exceeded.
Low medical decision making.
98005 Total time on the date of the encounter, 20 minutes must be met or exceeded.
Moderate medical decision making.
98006 Total time on the date of the encounter, 30 minutes must be met or exceeded.
High medical decision making.
98007 Total time on the date of the encounter, 40 minutes must be met or exceeded.
• May be reported for new or established patients.
• Synchronous audio and video telecommunication is required.
• Services may be reported based on total time on the date of the encounter or MDM

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 Audio-Only
ADDED
Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or
examination
98008
Straightforward medical decision making, and more than 10 minutes of medical discussion.
Total time on the date of the encounter, 15 minutes must be met or exceeded.
Low medical decision making, and more than 10 minutes of medical discussion.
98009
Total time on the date of the encounter, 30 minutes must be met or exceeded.
Moderate medical decision making, and more than 10 minutes of medical discussion.
98010
Total time on the date of the encounter, 45 minutes must be met or exceeded.
High medical decision making, and more than 10 minutes of medical discussion.
98011
Total time on the date of the encounter, 60 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
98012
Straightforward medical decision making, and more than 10 minutes of medical discussion.
Total time on the date of the encounter, 10 minutes must be exceeded.
Low medical decision making, and more than 10 minutes of medical discussion.
98013
Total time on the date of the encounter, 20 minutes must be met or exceeded.
Moderate medical decision making, and more than 10 minutes of medical discussion.
98014
Total time on the date of the encounter, 30 minutes must be met or exceeded.
High medical decision making, and more than 10 minutes of medical discussion.
98015
Total time on the date of the encounter, 40 minutes must be met or exceeded.
Do not report 98012-980155:
• for home and outpatient INR monitoring when reporting 93792, 93793)
• when using 99374, 99375, 99377, 99378, 99379, 99380 for the same call[s]
• during the same month with 99487, 99489
• when performed during the service time of 99495, 99496
For services 55 minutes or longer, use prolonged services code 99417

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Virtual Check-In

ADDED
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 from a related evaluation and
98016
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

Do not report 98016 in conjunction with 98000-98015

Do not report for services of less than 5 minutes of medical discussion

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 Code(s) Service New / Established Synchronous Level/Unit Reported Service Reported Other Notations

MDM or total time on DOS; no Per single

Do not report w/same
98000-98007 Synchronous audio-video Both minimum time required unless calendar date
Yes day in-person E/M
using time

MDM or total time; must be Per single

Do not report w/same
98008-98015 Synchronous audio-only Both Yes more than 10 minutes or calendar date
day in-person E/M
medical discussion

Not related to E/M in

Single 5-10 minute medical Per single
98016 Virtual check-in Established Yes prior 7 days or leading
discussion calendar date
to E/M in next 24 hours

Not related to E/M in

Established Minutes during 7-day period
99421-99423 Online digital E/M No Per 7 days prior 7 days or leading
to E/M in next 24 hours

Interprofessional No in-person
Not required
99446-99451 phone/internet/EHR consultation Both Minutes during a 7-day day Per 7 days encounter within 14
(5 minutes or more) days

Interprofessional No in-person
Not required Minutes during a single day Per 14 days
99452 phone/internet/EHR referral Both encounter within 14
service days
99424, 99425, MD or QHP time
Care management and remote Per calendar
99437, 99484, Established Not required Minutes excluded on date of
treatment management month
99491 other E/M
All above listed codes Same time is not counted twice

2025 AMA CPT® Professional Edition, p. 18 (ebook)

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Integumentary – Skin Cell Suspension Autograft

ADDED
15011 Harvest of skin for skin cell suspension autograft; first 25 sq cm or less
each additional 25 sq cm or part thereof (List separately in addition to code for primary procedure)
+15012
Use with 15011
Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and
15013 filtration;
first 25 sq cm or less of harvested skin
each additional 25 sq cm of harvested skin or part thereof (List separately in addition to code for primary procedure)
+15014
Use with 15013
Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs;
15015
first 480 sq cm or less
each additional 480 sq cm or part thereof (List separately in addition to code for primary procedure)
+15016
Use with 15015
Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp,
15017
eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 480 sq cm or less
each additional 480 sq cm or part thereof (List separately in addition to code for primary procedure)
+15018
Use with 15017

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Integumentary – Other Procedures
DELETED
15819 Cervicoplasty

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Musculoskeletal
REVISED
21630 Radical resection of sternum;

DELETED
21632 Radical resection of sternum; with mediastinal lymphadenectomy

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Musculoskeletal
REVISED
From: Arthroplasty, interposition, intercarpal or carpometacarpal joints
25447
To: Arthroplasty, intercarpal or metacarpal joints; interposition (eg, tendon)

ADDED
Arthroplasty, intercarpal or metacarpal joints;
25448
suspension, including transfer or transplant of tendon, with interposition, when performed

Do not report 25447 and 25448 together

Do not report 25447/25448 in conjunction with 25310, 26480, when performed for intercarpal or
carpometacarpal joint arthroplasty

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Cardiovascular
DELETED
33471 Valvotomy, pulmonary valve, closed heart, via pulmonary artery

33737 Atrial septectomy or septostomy; open heart with inflow occlusion

33813 Obliteration of aortopulmonary septal defect; without cardiopulmonary bypass

REVISED
From: Obliteration of aortopulmonary septal defect; with cardiopulmonary bypass
33814
To: Obliteration of aortopulmonary septal defect, with cardiopulmonary bypass

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Lymph
ADDED
38225 Chimeric antigen receptor T-cell (CAR-T) therapy; harvesting of blood-derived T lymphocytes for
development of genetically modified autologous CAR-T cells, per day
38226 preparation of blood-derived T lymphocytes for transportation (eg, cryopreservation, storage)

38227 receipt and preparation of CAR-T cells for administration

38228 CAR-T cell administration, autologous

# - All are out of sequence

Formerly reported with Category III codes

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GI
DELETED
47802 U-tube hepaticoenterostomy

ADDED
49186 Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary
tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s);
5 cm or less
49187 5.1 to 10 cm
49188 10.1 to 20 cm
49189 20.1 to 30 cm
49190 greater than 30 cm

• Do not report 49186, 49187, 49188, 49189, 49190 in conjunction with 49000, 49010, 49215, 58943, 58950, 58951, 58952,
58953, 58954, 58956, 58958, 58960.
• For excision of perinephric cyst, use 50290.
• 49203, 49204, 49205 have been deleted. For open excision or destruction of intra-abdominal [ie, peritoneal, mesenteric,
retroperitoneal] primary or secondary tumor[s] or cyst[s], see 49186, 49187, 49188, 49189, 49190.
• For excision or destruction of endometriomas, open method, use 58999.

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Genitourinary
DELETED
50135 Pyelotomy; complicated (eg, secondary operation, congenital kidney abnormality)

51030 Cystotomy or cystostomy; with cryosurgical destruction of intravesical lesion

REVISED
From: Cystotomy or cystostomy; with fulguration and/or insertion of radioactive material
51020
To: Cystotomy or cystostomy, with fulguration and/or insertion of radioactive material

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 Male
DELETED
54438 Replantation, penis, complete amputation including urethral repair

ADDED
51721 Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement
during the same session and placement of an endorectal cooling device, when performed
Do not report 51721 in conjunction with 51701, 51702, 55881, 55882, 72195, 72196, 72197, 77022
For insertion of transurethral ultrasound transducer and ablation of prostate tissue using thermal ultrasound transducer performed by the same physician, use 55882
Urodynamics
53865 Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate
For insertion of a permanent urethral stent, use 52282
For insertion of a temporary prostatic urethral stent without cystourethroscopy, including urethral measurement, use 53855
For catheterization with removal of temporary device for ischemic remodeling of bladder neck and prostate, use 53866
53866 Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate
For cystourethroscopy with removal of temporary device for ischemic remodeling of bladder neck and prostate, use 52310
For insertion of temporary device for ischemic remodeling of bladder neck and prostate, use 53865
55881 Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue
ablation;
Do not report 55881 in conjunction with 55882
For insertion of transurethral ultrasound transducer and ablation of prostate tissue using thermal ultrasound transducer performed by the same physician, use 55882
55882 with insertion of transurethral ultrasound transducer for delivery of thermal ultrasound, including suprapubic tube placement and placement
of an endorectal cooling device, when performed
Do not report 55882 in conjunction with 55881
Do not report 55881, 55882 in conjunction with 51701, 51702, 51721, 72195, 72196, 72197, 77022)

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Female
DELETED
58957 Resection (tumor debulking) of recurrent ovarian, tubal, primary peritoneal, uterine malignancy
(intra-abdominal, retroperitoneal tumors), with omentectomy, if performed

REVISED
From: Resection (tumor debulking) of recurrent ovarian, tubal, primary peritoneal, uterine malignancy (intra-
abdominal, retroperitoneal tumors), with omentectomy, if performed; with pelvic lymphadenectomy and
limited para-aortic lymphadenectomy
58958
To: Resection (tumor debulking) of recurrent ovarian, tubal, primary peritoneal, uterine malignancy (intra-
abdominal, retroperitoneal tumors), with omentectomy, if performed, with pelvic lymphadenectomy and
limited para-aortic lymphadenectomy
Do not report with 38770, 38780, 44005, 49000, 49186, 49187, 49188, 49189, 49190, 49215, 49255, 58900-58960

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Endocrine System
ADDED
60660 Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance,
radiofrequency
60661 additional lobe, percutaneous, including imaging guidance, radiofrequency (List separately in addition to code
for primary procedure)

• Do not report 60660, 60661 in conjunction with 76940, 76942, 77013, 77022
• For laser ablation of benign thyroid nodule[s], use 0673T

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 Nervous System
ADDED
61715 Magnetic resonance image guided high intensity focused ultrasound (MRgFUS), stereotactic ablation of target, intracranial, including
stereotactic navigation and frame placement, when performed
Do not report 61715 in conjunction with 61781, 61800
Do not report 61715 in conjunction with 70540, 70542, 70543, 70544, 70545, 70546, 70551, 70552, 70553, when performed in the same session

64466 Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed
64467 Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed
64468 Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed
64469 Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed
64473 Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed
64474 Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed

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Eye and Ocular Adnexa
Added

66683 Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed

• Use 66683 in conjunction with 66825, 66830, 66840, 66850, 66852, 66920, 66930, 66940, 66982, 66983, 66984, 66985, 66986, 66987,
66988, 66989, 66991, for lens or intraocular lens surgery[ies] performed concurrently
• Do not report 66683 in conjunction with 65800, 65810, 65815, 65865, 65870, 65875, 66020, 66030, 66500, 66505, 66600, 66625,
66630, 66635, 66680, 66682, 66770, 67500, 67515, 69990, for the same eye, same surgeon, or same operative session
• For severing adhesions of anterior segment, incisional technique, without concurrent iris prosthesis implantation, see 65865, 65870,
65875, 65880
• For removal of iris tissue without concurrent iris prosthesis implantation, see 66600, 66605, 66625, 66630, 66635
• For repair of iris without concurrent iris prosthesis implantation, see 66680, 66682

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Radiology - Magnetic Resonance Safety
Implant/Foreign Body Procedures
ADDED
76014 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 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
76015
each additional 30 minutes (List separately in addition to code for primary procedure)
76016 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 of performing MR examination, and
determination of MR equipment, accessory equipment, and expertise required to perform examination, with written report
76017 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 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
76018 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 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
76019 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 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

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 Path & Lab
DELETED
81433 Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary
endometrial cancer); duplication/deletion analysis panel, must include analyses for BRCA1, BRCA2, MLH1, MSH2, and
STK11
81436 Hereditary colon cancer disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial
adenomatosis polyposis); duplication/deletion analysis panel, must include analysis of at least 5 genes, including MLH1,
MSH2, EPCAM, SMAD4, and STK11
81438 Hereditary neuroendocrine tumor disorders (eg, medullary thyroid carcinoma, parathyroid carcinoma, malignant
pheochromocytoma or paraganglioma); duplication/deletion analysis panel, must include analyses for SDHB, SDHC, SDHD,
and VHL
86327 Immunoelecgtrophoresis; crossed (2-dimensional assay)
86490 Skin test; coccidioidomycosis
83888 Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-
based molecular studies); in conjunction with a touch imprint, intraoperative consultation, or frozen section, each tissue
preparation (eg, a single lymph node) (List separately in addition to code for primary procedure)

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 REVISED

From: Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer); genomic sequence analysis
panel, must include sequencing of at least 10 genes, always including BRCA1, BRCA2, CDH1, MLH1, MSH2, MSH6, PALB2, PTEN, STK11, and TP53
81432
To: Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer, hereditary pancreatic cancer,
hereditary prostate cancer), genomic sequence analysis panel, 5 or more genes, interrogation for sequence variants and copy number variants
From: Hereditary colon cancer disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis); genomic sequence
analysis panel, must include sequencing of at least 10 genes, including APC, BMPR1A, CDH1, MLH1, MSH2, MSH6, MUTYH, PTEN, SMAD4, and STK11
81435
To: Hereditary colon cancer-related disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis), genomic
sequence analysis panel, 5 or more genes, interrogation for sequence variants and copy number variants
From: Hereditary neuroendocrine tumor disorders (eg, medullary thyroid carcinoma, parathyroid carcinoma, malignant pheochromocytoma or paraganglioma); genomic
sequence analysis panel, must include sequencing of at least 6 genes, including MAX, SDHB, SDHC, SDHD, TMEM127, and VHL
81437
To: Hereditary neuroendocrine tumor-related disorders (eg, medullary thyroid carcinoma, parathyroid carcinoma, malignant pheochromocytoma or paraganglioma),
genomic sequence analysis panel, 5 or more genes, interrogation for sequence variants and copy number variants
From: Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68)
87624
To: Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68), pooled
result
From: Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies); each tissue
preparation (eg, a single lymph node)
88387
To: Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue
preparation (eg, a single lymph node)

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 ADDED
81195 Cytogenomic (genome-wide) analysis, hematologic malignancy, structural variants and copy number variants, optical genome mapping (OGM)
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-fluid specimens, algorithm reported as positive
81515
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 chain reaction (qPCR) of
81558 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

82233 Beta-amyloid; 1-40 (Abeta 40)

82234 Beta-amyloid; 1-42 (Abeta 42)

83884 Neurofilament light chain (NfL)

84393 Tau, phosphorylated (eg, pTau 181, pTau 217), each

84394 Tau, total (tTau)

86581 Streptococcus pneumoniae antibody (IgG), serotypes, multiplex immunoassay, quantitative

87513 Infectious agent detection by nucleic acid (DNA or RNA); Helicobacter pylori (H. pylori), clarithromycin resistance, amplified probe technique
Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), separately reported high-risk types (eg, 16, 18, 31, 45,
87626 51, 52) and high-risk pooled result(s)

87564 Infectious agent detection by nucleic acid (DNA or RNA); Mycobacterium tuberculosis, rifampin resistance, amplified probe technique

87594 Infectious agent detection by nucleic acid (DNA or RNA); Pneumocystis jirovecii, amplified probe technique

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Proprietary Lab Analyses (PLA)
DELETED
Pain management (opioid-use disorder) genotyping panel, 16 common variants (ie, ABCB1, COMT, DAT1, DBH, DOR, DRD1, DRD2, DRD4,
0078U GABA, GAL, HTR2A, HTTLPR, MTHFR, MUOR, OPRK1, OPRM1), buccal swab or other germline tissue sample, algorithm reported as positive
or negative risk of opioid-use disorder
0167U Gonadotropin, chorionic (hCG), immunoassay with direct optical observation, blood
Oncology (thyroid), mRNA, gene expression analysis of 593 genes (including BRAF, RAS, RET, PAX8, and NTRK) for sequence variants and
0204U
rearrangements, utilizing fine needle aspirate, reported as detected or not detected
Infectious disease (bacterial vaginosis and vaginitis), multiplex amplified probe technique, for detection of bacterial vaginosis–associated
bacteria (BVAB-2, Atopobium vaginae, and Megasphera type 1), algorithm reported as detected or not detected and separate detection of
0352U
Candida species (C. albicans, C. tropicalis, C. parapsilosis, C. dubliniensis), Candida glabrata/Candida krusei, and trichomonas vaginalis,
vaginal-fluid specimen, each result reported as detected or not detected
Infectious agent detection by nucleic acid (DNA), Chlamydia trachomatis and Neisseria gonorrhoeae, multiplex amplified probe technique,
0353U
urine, vaginal, pharyngeal, or rectal, each pathogen reported as detected or not detected
Human papilloma virus (HPV), high-risk types (ie, 16, 18, 31, 33, 45, 52 and 58) qualitative mRNA expression of E6/E7 by quantitative
0354U
polymerase chain reaction (qPCR)
Obstetrics (pre-implantation genetic testing), evaluation of 300000 DNA single-nucleotide polymorphisms (SNPs) by microarray, embryonic
0396U
tissue, algorithm reported as a probability for single-gene germline conditions
Infectious agent detection by nucleic acid (DNA), genitourinary pathogens, identification of 20 bacterial and fungal organisms, including
0416U identification of 20 associated antibiotic-resistance genes, if performed, multiplex amplified probe technique, urine

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 REVISED
From: Oncology (brain), spheroid cell culture in a 3D microenvironment, 12 drug panel, tumor-response prediction for each drug

0248U To: Oncology, spheroid cell culture in 3D microenvironment, 12-drug panel, brain- or brain metastasis-response prediction for each drug
From: Infectious disease (bacterial or viral), biochemical assays, tumor necrosis factor-related apoptosis-inducing ligand (TRAIL), interferon
gamma-induced protein-10 (IP-10), and C-reactive protein, serum, algorithm reported as likelihood of bacterial infection

To: Infectious disease (bacterial or viral), biochemical assays, tumor necrosis factor-related apoptosis-inducing ligand (TRAIL), interferon
gamma-induced protein-10 (IP-10), and C-reactive protein, serum, or venous whole blood, algorithm reported as likelihood of bacterial
0351U infection
From: Oncology (oropharyngeal), evaluation of 17 DNA biomarkers using droplet digital PCR (ddPCR), cell-free DNA, algorithm reported as
a prognostic risk score for cancer recurrence

To: Oncology (oropharyngeal or anal), evaluation of 17 DNA biomarkers using droplet digital PCR (ddPCR), cell-free DNA, algorithm
0356U reported as a prognostic risk score for cancer recurrence
From: Oncology (prostate), mRNA, gene expression profiling of 18 genes, first-catch post-digital rectal examination urine (or processed
first-catch urine), algorithm reported as percentage of likelihood of detecting clinically significant prostate cancer

To: Oncology (prostate), mRNA, gene expression profiling of 18 genes, first-catch urine, algorithm reported as percentage of likelihood of
0403U detecting clinically significant prostate cancer

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 ADDED
Oncology (urothelial), mRNA expression profiling by real-time quantitative PCR of MDK, HOXA13, CDC2, IGFBP5, and CXCR2 in combination with droplet digital PCR
0420U (ddPCR) analysis of 6 single-nucleotide polymorphisms (SNPs) of genes TERT and FGFR3, urine, algorithm reported as a risk score for urothelial carcinoma
Oncology (colorectal) screening, quantitative real-time target and signal amplification of 8 RNA markers (GAPDH, SMAD4, ACY1, AREG, CDH1, KRAS, TNFRSF10B, EGLN2)
0421U and fecal hemoglobin, algorithm reported as a positive or negative for colorectal cancer risk
Oncology (pan-solid tumor), analysis of DNA biomarker response to anti-cancer therapy using cell-free circulating DNA, biomarker comparison to a previous baseline pre-
treatment cell-free circulating DNA analysis using next-generation sequencing, algorithm reported as a quantitative change from baseline, including specific alterations, if
0422U appropriate
Psychiatry (eg, depression, anxiety), genomic analysis panel, including variant analysis of 26 genes, buccal swab, report including metabolizer status and risk of drug
0423U toxicity by condition
Oncology (prostate), exosome-based analysis of 53 small noncoding RNAs (sncRNAs) by quantitative reverse transcription polymerase chain reaction (RT-qPCR), urine,
0424U reported as no molecular evidence, low-, moderate-, or elevated-risk of prostate cancer

0425U Genome (eg, unexplained constitutional or heritable disorder or syndrome), rapid sequence analysis, each comparator genome (eg, parents, siblings)

0426U Genome (eg, unexplained constitutional or heritable disorder or syndrome), ultra-rapid sequence analysis

0427U Monocyte distribution width, whole blood (List separately in addition to code for primary procedure)
Oncology (breast), targeted hybrid-capture genomic sequence analysis panel, circulating tumor DNA (ctDNA) analysis of 56 or more genes, interrogation for sequence
0428U variants, gene copy number amplifications, gene rearrangements, microsatellite instability, and tumor mutation burden

0429U Human papillomavirus (HPV), oropharyngeal swab, 14 high-risk types (ie, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68)

0430U Gastroenterology, malabsorption evaluation of alpha-1-antitrypsin, calprotectin, pancreatic elastase and reducing substances, feces, quantitative

0431U Glycine receptor alpha1 IgG, serum or cerebrospinal fluid (CSF), live cell-binding assay (LCBA), qualitative

0432U Kelch-like protein 11 (KLHL11) antibody, serum or cerebrospinal fluid (CSF), cell-binding assay, qualitative

0433U Oncology (prostate), 5 DNA regulatory markers by quantitative PCR, whole blood, algorithm, including prostate-specific antigen, reported as likelihood of cancer

0434U Drug metabolism (adverse drug reactions and drug response), genomic analysis panel, variant analysis of 25 genes with reported phenotypes

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 ADDED
Oncology, chemotherapeutic drug cytotoxicity assay of cancer stem cells (CSCs), from cultured CSCs and primary tumor cells, categorical drug response reported based on
0435U cytotoxicity percentage observed, minimum of 14 drugs or drug combinations
Oncology (lung), plasma analysis of 388 proteins, using aptamer-based proteomics technology, predictive algorithm reported as clinical benefit from immune checkpoint
0436U inhibitor therapy

0437U Psychiatry (anxiety disorders), mRNA, gene expression profiling by RNA sequencing of 15 biomarkers, whole blood, algorithm reported as predictive risk score
Drug metabolism (adverse drug reactions and drug response), buccal specimen, gene-drug interactions, variant analysis of 33 genes, including deletion/duplication analysis
0438U of CYP2D6, including reported phenotypes and impacted gene-drug interactions
Cardiology (coronary heart disease [CHD]), DNA, analysis of 5 single-nucleotide polymorphisms (SNPs) (rs11716050 [LOC105376934], rs6560711 [WDR37], rs3735222
[SCIN/LOC107986769], rs6820447 [intergenic], and rs9638144 [ESYT2]) and 3 DNA methylation markers (cg00300879 [transcription start site {TSS200} of CNKSR1],
cg09552548 [intergenic], and cg14789911 [body of SPATC1L]), qPCR and digital PCR, whole blood, algorithm reported as a 4-tiered risk score for a 3-year risk of symptomatic
0439U CHD
Cardiology (coronary heart disease [CHD]), DNA, analysis of 10 single-nucleotide polymorphisms (SNPs) (rs710987 [LINC010019], rs1333048 [CDKN2B-AS1], rs12129789
[KCND3], rs942317 [KTN1-AS1], rs1441433 [PPP3CA], rs2869675 [PREX1], rs4639796 [ZBTB41], rs4376434 [LINC00972], rs12714414 [TMEM18], and rs7585056 [TMEM18])
and 6 DNA methylation markers (cg03725309 [SARS1], cg12586707 [CXCL1], cg04988978 [MPO], cg17901584 [DHCR24-DT], cg21161138 [AHRR], and cg12655112 [EHD4]),
0440U qPCR and digital PCR, whole blood, algorithm reported as detected or not detected for CHD
Infectious disease (bacterial, fungal, or viral infection), semiquantitative biomechanical assessment (via deformability cytometry), whole blood, with algorithmic analysis and
0441U result reported as an index
Infectious disease (respiratory infection), Myxovirus resistance protein A (MxA) and C-reactive protein (CRP), fingerstick whole blood specimen, each biomarker reported as
0442U present or absent

0443U Neurofilament light chain (NfL), ultra-sensitive immunoassay, serum or cerebrospinal fluid
Oncology (solid organ neoplasia), targeted genomic sequence analysis panel of 361 genes, interrogation for gene fusions, translocations, or other rearrangements, using
0444U DNA from formalin-fixed paraffin-embedded (FFPE) tumor tissue, report of clinically significant variant(s)
β-amyloid (Abeta42) and phospho tau (181P) (pTau181), electrochemiluminescent immunoassay (ECLIA), cerebral spinal fluid, ratio reported as positive or negative for
0445U amyloid pathology
Autoimmune diseases (systemic lupus erythematosus [SLE]), analysis of 10 cytokine soluble mediator biomarkers by immunoassay, plasma, individual components reported
0446U with an algorithmic risk score for current disease activity
Autoimmune diseases (systemic lupus erythematosus [SLE]), analysis of 11 cytokine soluble mediator biomarkers by immunoassay, plasma, individual components reported
0447U with an algorithmic prognostic risk score for developing a clinical flare
Oncology (lung and colon cancer), DNA, qualitative, next-generation sequencing detection of single-nucleotide variants and deletions in EGFR and KRAS genes, formalin-fixed
0448U paraffin-embedded (FFPE) solid tumor samples, reported as presence or absence of targeted mutation(s), with recommended therapeutic options
Carrier screening for severe inherited conditions (eg, cystic fibrosis, spinal muscular atrophy, beta hemoglobinopathies [including sickle cell disease], alpha thalassemia),
0449U regardless of race or self-identified ancestry, genomic sequence analysis panel, must include analysis of 5 genes (CFTR, SMN1, HBB, HBA1, HBA2)

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 ADDED
Oncology, chemotherapeutic drug cytotoxicity assay of cancer stem cells (CSCs), from cultured CSCs and primary tumor cells, categorical drug response reported based on cytotoxicity
0435U percentage observed, minimum of 14 drugs or drug combinations

Oncology (lung), plasma analysis of 388 proteins, using aptamer-based proteomics technology, predictive algorithm reported as clinical benefit from immune checkpoint inhibitor
0436U therapy

0437U Psychiatry (anxiety disorders), mRNA, gene expression profiling by RNA sequencing of 15 biomarkers, whole blood, algorithm reported as predictive risk score
Drug metabolism (adverse drug reactions and drug response), buccal specimen, gene-drug interactions, variant analysis of 33 genes, including deletion/duplication analysis of CYP2D6,
0438U including reported phenotypes and impacted gene-drug interactions

Cardiology (coronary heart disease [CHD]), DNA, analysis of 5 single-nucleotide polymorphisms (SNPs) (rs11716050 [LOC105376934], rs6560711 [WDR37], rs3735222
[SCIN/LOC107986769], rs6820447 [intergenic], and rs9638144 [ESYT2]) and 3 DNA methylation markers (cg00300879 [transcription start site {TSS200} of CNKSR1], cg09552548
0439U [intergenic], and cg14789911 [body of SPATC1L]), qPCR and digital PCR, whole blood, algorithm reported as a 4-tiered risk score for a 3-year risk of symptomatic CHD
Cardiology (coronary heart disease [CHD]), DNA, analysis of 10 single-nucleotide polymorphisms (SNPs) (rs710987 [LINC010019], rs1333048 [CDKN2B-AS1], rs12129789 [KCND3],
rs942317 [KTN1-AS1], rs1441433 [PPP3CA], rs2869675 [PREX1], rs4639796 [ZBTB41], rs4376434 [LINC00972], rs12714414 [TMEM18], and rs7585056 [TMEM18]) and 6 DNA
methylation markers (cg03725309 [SARS1], cg12586707 [CXCL1], cg04988978 [MPO], cg17901584 [DHCR24-DT], cg21161138 [AHRR], and cg12655112 [EHD4]), qPCR and digital PCR,
0440U whole blood, algorithm reported as detected or not detected for CHD
Infectious disease (bacterial, fungal, or viral infection), semiquantitative biomechanical assessment (via deformability cytometry), whole blood, with algorithmic analysis and result
0441U reported as an index
Infectious disease (respiratory infection), Myxovirus resistance protein A (MxA) and C-reactive protein (CRP), fingerstick whole blood specimen, each biomarker reported as present or
0442U absent

0443U Neurofilament light chain (NfL), ultra-sensitive immunoassay, serum or cerebrospinal fluid
Oncology (solid organ neoplasia), targeted genomic sequence analysis panel of 361 genes, interrogation for gene fusions, translocations, or other rearrangements, using DNA from
0444U formalin-fixed paraffin-embedded (FFPE) tumor tissue, report of clinically significant variant(s)
β-amyloid (Abeta42) and phospho tau (181P) (pTau181), electrochemiluminescent immunoassay (ECLIA), cerebral spinal fluid, ratio reported as positive or negative for amyloid
0445U pathology
Autoimmune diseases (systemic lupus erythematosus [SLE]), analysis of 10 cytokine soluble mediator biomarkers by immunoassay, plasma, individual components reported with an
0446U algorithmic risk score for current disease activity
Autoimmune diseases (systemic lupus erythematosus [SLE]), analysis of 11 cytokine soluble mediator biomarkers by immunoassay, plasma, individual components reported with an
0447U algorithmic prognostic risk score for developing a clinical flare
Oncology (lung and colon cancer), DNA, qualitative, next-generation sequencing detection of single-nucleotide variants and deletions in EGFR and KRAS genes, formalin-fixed paraffin-
0448U embedded (FFPE) solid tumor samples, reported as presence or absence of targeted mutation(s), with recommended therapeutic options
Carrier screening for severe inherited conditions (eg, cystic fibrosis, spinal muscular atrophy, beta hemoglobinopathies [including sickle cell disease], alpha thalassemia), regardless of
0449U race or self-identified ancestry, genomic sequence analysis panel, must include analysis of 5 genes (CFTR, SMN1, HBB, HBA1, HBA2)

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 ADDED
Oncology (multiple myeloma), liquid chromatography with tandem mass spectrometry (LC-MS/MS), monoclonal paraprotein sequencing analysis, serum, results reported as baseline presence
0450U or absence of detectable clonotypic peptides

0451U Oncology (multiple myeloma), LC-MS/MS, peptide ion quantification, serum, results compared with baseline to determine monoclonal paraprotein abundance

0452U Oncology (bladder), methylated PENK DNA detection by linear target enrichment-quantitative methylation-specific real-time PCR (LTE-qMSP), urine, reported as likelihood of bladder cancer
Oncology (colorectal cancer), cell-free DNA (cfDNA), methylation-based quantitative PCR assay (SEPTIN9, IKZF1, BCAT1, Septin9-2, VAV3, BCAN), plasma, reported as presence or absence of
0453U circulating tumor DNA (ctDNA)

0454U Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping
Infectious agents (sexually transmitted infection), Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis, multiplex amplified probe technique, vaginal, endocervical,
0455U gynecological specimens, oropharyngeal swabs, rectal swabs, female or male urine, each pathogen reported as detected or not detected
Autoimmune (rheumatoid arthritis), next-generation sequencing (NGS), gene expression testing of 19 genes, whole blood, with analysis of anti-cyclic citrullinated peptides (CCP) levels,
0456U combined with sex, patient global assessment, and body mass index (BMI), algorithm reported as a score that predicts nonresponse to tumor necrosis factor inhibitor (TNFi) therapy

0457U Perfluoroalkyl substances (PFAS) (eg, perfluorooctanoic acid, perfluorooctane sulfonic acid), 9 PFAS compounds by LC-MS/MS, plasma or serum, quantitative

0458U Oncology (breast cancer), S100A8 and S100A9, by enzyme-linked immunosorbent assay (ELISA), tear fluid with age, algorithm reported as a risk score

0459U β-amyloid (Abeta42) and total tau (tTau), electrochemiluminescent immunoassay (ECLIA), cerebral spinal fluid, ratio reported as positive or negative for amyloid pathology

0460U Oncology, whole blood or buccal, DNA single-nucleotide polymorphism (SNP) genotyping by real-time PCR of 24 genes, with variant analysis and reported phenotypes
Oncology, pharmacogenomic analysis of single-nucleotide polymorphism (SNP) genotyping by real-time PCR of 24 genes, whole blood or buccal swab, with variant analysis, including impacted
0461U gene-drug interactions and reported phenotypes

0462U Melatonin levels test, sleep study, 7 or 9 sample melatonin profile (cortisol optional), enzyme-linked immunosorbent assay (ELISA), saliva, screening/preliminary
Oncology (cervix), mRNA gene expression profiling of 14 biomarkers (E6 and E7 of the highest-risk human papillomavirus [HPV] types 16, 18, 31, 33, 45, 52, 58), by real-time nucleic acid
0463U sequence-based amplification (NASBA), exo- or endocervical epithelial cells, algorithm reported as positive or negative for increased risk of cervical dysplasia or cancer for each biomarker
Oncology (colorectal) screening, quantitative real-time target and signal amplification, methylated DNA markers, including LASS4, LRRC4 and PPP2R5C, a reference marker ZDHHC1, and a
0464U protein marker (fecal hemoglobin), utilizing stool, algorithm reported as a positive or negative result

0465U Oncology (urothelial carcinoma), DNA, quantitative methylation-specific PCR of 2 genes (ONECUT2, VIM), algorithmic analysis reported as positive or negative
Cardiology (coronary artery disease [CAD]), DNA, genome-wide association studies (564856 single-nucleotide polymorphisms [SNPs], targeted variant genotyping), patient lifestyle and clinical
0466U data, buccal swab, algorithm reported as polygenic risk to acquired heart disease
Oncology (bladder), DNA, next-generation sequencing (NGS) of 60 genes and whole genome aneuploidy, urine, algorithms reported as minimal residual disease (MRD) status positive or
0467U negative and quantitative disease burden

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 ADDED

0468U Hepatology (nonalcoholic steatohepatitis [NASH]), miR-34a-5p, alpha 2-macroglobulin, YKL40, HbA1c, serum and whole blood, algorithm reported as a single score for NASH activity and fibrosis
Rare diseases (constitutional/heritable disorders), whole genome sequence analysis for chromosomal abnormalities, copy number variants, duplications/deletions, inversions, unbalanced
translocations, regions of homozygosity (ROH), inheritance pattern that indicate uniparental disomy (UPD), and aneuploidy, fetal sample (amniotic fluid, chorionic villus sample, or products of
conception), identification and categorization of genetic variants, diagnostic report of fetal results based on phenotype with maternal sample and paternal sample, if performed, as comparators
0469U and/or maternal cell contamination
0470U Oncology (oropharyngeal), detection of minimal residual disease by next-generation sequencing (NGS) based quantitative evaluation of 8 DNA targets, cell-free HPV 16 and 18 DNA from plasma
Oncology (colorectal cancer), qualitative real-time PCR of 35 variants of KRAS and NRAS genes (exons 2, 3, 4), formalin-fixed paraffin-embedded (FFPE), predictive, identification of detected
0471U mutations
Carbonic anhydrase VI (CA VI), parotid specific/secretory protein (PSP) and salivary protein (SP1) IgG, IgM, and IgA antibodies, enzyme-linked immunosorbent assay (ELISA), semiqualitative, blood,
0472U reported as predictive evidence of early Sjögren's syndrome
Oncology (solid tumor), next-generation sequencing (NGS) of DNA from formalin-fixed paraffin-embedded (FFPE) tissue with comparative sequence analysis from a matched normal specimen
0473U (blood or saliva), 648 genes, interrogation for sequence variants, insertion and deletion alterations, copy number variants, rearrangements, microsatellite instability, and tumor-mutation burden
Hereditary pan-cancer (eg, hereditary sarcomas, hereditary endocrine tumors, hereditary neuroendocrine tumors, hereditary cutaneous melanoma), genomic sequence analysis panel of 88 genes
0474U with 20 duplications/deletions using next-generation sequencing (NGS), Sanger sequencing, blood or saliva, reported as positive or negative for germline variants, each gene
Hereditary prostate cancer-related disorders, genomic sequence analysis panel using next-generation sequencing (NGS), Sanger sequencing, multiplex ligation-dependent probe amplification
(MLPA), and array comparative genomic hybridization (CGH), evaluation of 23 genes and duplications/deletions when indicated, pathologic mutations reported with a genetic risk score for prostate
0475U cancer
Drug metabolism, psychiatry (eg, major depressive disorder, general anxiety disorder, attention deficit hyperactivity disorder [ADHD], schizophrenia), whole blood, buccal swab, and
0476U pharmacogenomic genotyping of 14 genes and CYP2D6 copy number variant analysis and reported phenotypes
Drug metabolism, psychiatry (eg, major depressive disorder, general anxiety disorder, attention deficit hyperactivity disorder [ADHD], schizophrenia), whole blood, buccal swab, and
0477U pharmacogenomic genotyping of 14 genes and CYP2D6 copy number variant analysis, including impacted gene-drug interactions and reported phenotypes
Oncology (non-small cell lung cancer), DNA and RNA, digital PCR analysis of 9 genes (EGFR, KRAS, BRAF, ALK, ROS1, RET, NTRK 1/2/3, ERBB2, and MET) in formalin-fixed paraffin-embedded (FFPE)
0478U tissue, interrogation for single-nucleotide variants, insertions/deletions, gene rearrangements, and reported as actionable detected variants for therapy selection
0479U Tau, phosphorylated, pTau217
Infectious disease (bacteria, viruses, fungi, and parasites), cerebrospinal fluid (CSF), metagenomic next-generation sequencing (DNA and RNA), bioinformatic analysis, with positive pathogen
0480U identification
IDH1 (isocitrate dehydrogenase 1 [NADP+]), IDH2 (isocitrate dehydrogenase 2 [NADP+]), and TERT (telomerase reverse transcriptase) promoter (eg, central nervous system [CNS] tumors), next-
0481U generation sequencing (single-nucleotide variants [SNV], deletions, and insertions)
Obstetrics (preeclampsia), biochemical assay of soluble fms-like tyrosine kinase 1 (sFlt-1) and placental growth factor (PlGF), serum, ratio reported for sFlt-1/PlGF, with risk of progression for
0482U preeclampsia with severe features within 2 weeks
Infectious disease (Neisseria gonorrhoeae), sensitivity, ciprofloxacin resistance (gyrA S91F point mutation), oral, rectal, or vaginal swab, algorithm reported as probability of fluoroquinolone
0483U resistance
0484U Infectious disease (Mycoplasma genitalium), macrolide sensitivity (23S rRNA point mutation), oral, rectal, or vaginal swab, algorithm reported as probability of macrolide resistance
Oncology (solid tumor), cell-free DNA and RNA by next-generation sequencing, interpretative report for germline mutations, clonal hematopoiesis of indeterminate potential, and tumor-derived
0485U single-nucleotide variants, small insertions/deletions, copy number alterations, fusions, microsatellite instability, and tumor mutational burden

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 ADDED
Oncology (pan-solid tumor), next-generation sequencing analysis of tumor methylation markers present in cell-free circulating tumor DNA, algorithm reported as
0486U quantitative measurement of methylation as a correlate of tumor fraction
Oncology (solid tumor), cell-free circulating DNA, targeted genomic sequence analysis panel of 84 genes, interrogation for sequence variants, aneuploidy-corrected
0487U gene copy number amplifications and losses, gene rearrangements, and microsatellite instability

Obstetrics (fetal antigen noninvasive prenatal test), cell-free DNA sequence analysis for detection of fetal presence or absence of 1 or more of the Rh, C, c, D, E, Duffy
0488U (Fya), or Kell (K) antigen in alloimmunized pregnancies, reported as selected antigen(s) detected or not detected
Obstetrics (single-gene noninvasive prenatal test), cell-free DNA sequence analysis of 1 or more targets (eg, CFTR, SMN1, HBB, HBA1, HBA2) to identify paternally
inherited pathogenic variants, and relative mutation-dosage analysis based on molecular counts to determine fetal inheritance of maternal mutation, algorithm
0489U reported as a fetal risk score for the condition (eg, cystic fibrosis, spinal muscular atrophy, beta hemoglobinopathies [including sickle cell disease], alpha thalassemia)
Oncology (cutaneous or uveal melanoma), circulating tumor cell selection, morphological characterization and enumeration based on differential CD146, high
0490U molecular-weight melanoma-associated antigen, CD34 and CD45 protein biomarkers, peripheral blood

Oncology (solid tumor), circulating tumor cell selection, morphological characterization and enumeration based on differential epithelial cell adhesion molecule
0491U (EpCAM), cytokeratins 8, 18, and 19, CD45 protein biomarkers, and quantification of estrogen receptor (ER) protein biomarker-expressing cells, peripheral blood

Oncology (solid tumor), circulating tumor cell selection, morphological characterization and enumeration based on differential epithelial cell adhesion molecule
0492U (EpCAM), cytokeratins 8, 18, and 19, CD45 protein biomarkers, and quantification of PD-L1 protein biomarker-expressing cells, peripheral blood
Transplantation medicine, quantification of donor-derived cell-free DNA (cfDNA) using next-generation sequencing, plasma, reported as percentage of donor-derived
0493U cell-free DNA
Red blood cell antigen (fetal RhD gene analysis), next-generation sequencing of circulating cell-free DNA (cfDNA) of blood in pregnant individuals known to be RhD
0494U negative, reported as positive or negative

Oncology (prostate), analysis of circulating plasma proteins (tPSA, fPSA, KLK2, PSP94, and GDF15), germline polygenic risk score (60 variants), clinical information (age,
0495U family history of prostate cancer, prior negative prostate biopsy), algorithm reported as risk of likelihood of detecting clinically significant prostate cancer
Oncology (colorectal), cell-free DNA, 8 genes for mutations, 7 genes for methylation by real-time RT-PCR, and 4 proteins by enzyme-linked immunosorbent assay,
0496U blood, reported positive or negative for colorectal cancer or advanced adenoma risk
Oncology (prostate), mRNA gene-expression profiling by real-time RT-PCR of 6 genes (FOXM1, MCM3, MTUS1, TTC21B, ALAS1, and PPP2CA), utilizing formalin-fixed
0497U paraffin-embedded (FFPE) tissue, algorithm reported as a risk score for prostate cancer
Oncology (colorectal), next-generation sequencing for mutation detection in 43 genes and methylation pattern in 45 genes, blood, and formalin-fixed paraffin-
0498U embedded (FFPE) tissue, report of variants and methylation pattern with interpretation
Oncology (colorectal and lung), DNA from formalin-fixed paraffin-embedded (FFPE) tissue, next-generation sequencing of 8 genes (NRAS, EGFR, CTNNB1, PIK3CA,
0499U APC, BRAF, KRAS, and TP53), mutation detection

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 ADDED
0500U Autoinflammatory disease (VEXAS syndrome), DNA, UBA1 gene mutations, targeted variant analysis (M41T, M41V, M41L, c.118-2A>C, c.118-1G>C, c.118-9_118-2del, S56F, S621C)
0501U Oncology (colorectal), blood, quantitative measurement of cell-free DNA (cfDNA)
Human papillomavirus (HPV), E6/E7 markers for high-risk types (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68), cervical cells, branched-chain capture hybridization, reported as
0502U negative or positive for high risk for HPV
Neurology (Alzheimer disease), beta amyloid (Aβ40, Aβ42, Aβ42/40 ratio) and tau-protein (ptau217, np-tau217, ptau217/np-tau217 ratio), blood, immunoprecipitation with quantitation by
0503U liquid chromatography with tandem mass spectrometry (LC-MS/MS), algorithm score reported as likelihood of positive or negative for amyloid plaques
0504U Infectious disease (urinary tract infection), identification of 17 pathologic organisms, urine, real-time PCR, reported as positive or negative for each organism
0505U Infectious disease (vaginal infection), identification of 32 pathogenic organisms, swab, real-time PCR, reported as positive or negative for each organism
Gastroenterology (Barrett's esophagus), esophageal cells, DNA methylation analysis by next-generation sequencing of at least 89 differentially methylated genomic regions, algorithm reported
0506U as likelihood for Barrett's esophagus
0507U Oncology (ovarian), DNA, whole-genome sequencing with 5-hydroxymethylcytosine (5hmC) enrichment, using whole blood or plasma, algorithm reported as cancer detected or not detected
Transplantation medicine, quantification of donor-derived cell-free DNA using 40 single-nucleotide polymorphisms (SNPs), plasma, and urine, initial evaluation reported as percentage of donor-
0508U derived cell-free DNA with risk for active rejection
Transplantation medicine, quantification of donor-derived cell-free DNA using up to 12 single-nucleotide polymorphisms (SNPs) previously identified, plasma, reported as percentage of donor-
0509U derived cell-free DNA with risk for active rejection
0510U Oncology (pancreatic cancer), augmentative algorithmic analysis of 16 genes from previously sequenced RNA whole-transcriptome data, reported as probability of predicted molecular subtype
0511U Oncology (solid tumor), tumor cell culture in 3D microenvironment, 36 or more drug panel, reported as tumor-response prediction for each drug
Oncology (prostate), augmentative algorithmic analysis of digitized whole-slide imaging of histologic features for microsatellite instability (MSI) status, formalin-fixed paraffin-embedded (FFPE)
0512U tissue, reported as increased or decreased probability of MSI-high (MSI-H)
Oncology (prostate), augmentative algorithmic analysis of digitized whole-slide imaging of histologic features for microsatellite instability (MSI) and homologous recombination deficiency (HRD)
0513U status, formalin-fixed paraffin-embedded (FFPE) tissue, reported as increased or decreased probability of each biomarker
Gastroenterology (irritable bowel disease [IBD]), immunoassay for quantitative determination of adalimumab (ADL) levels in venous serum in patients undergoing adalimumab therapy, results
0514U reported as a numerical value as micrograms per milliliter (µg/mL)
Gastroenterology (irritable bowel disease [IBD]), immunoassay for quantitative determination of infliximab (IFX) levels in venous serum in patients undergoing infliximab therapy, results
0515U reported as a numerical value as micrograms per milliliter (µg/mL)
0516U Drug metabolism, whole blood, pharmacogenomic genotyping of 40 genes and CYP2D6 copy number variant analysis, reported as metabolizer status
Therapeutic drug monitoring, 80 or more psychoactive drugs or substances, LC-MS/MS, plasma, qualitative and quantitative therapeutic minimally and maximally effective dose of prescribed
0517U and non-prescribed medications
Therapeutic drug monitoring, 90 or more pain and mental health drugs or substances, LC-MS/MS, plasma, qualitative and quantitative therapeutic minimally effective range of prescribed and
0518U non-prescribed medications
Therapeutic drug monitoring, medications specific to pain, depression, and anxiety, LC-MS/MS, plasma, 110 or more drugs or substances, qualitative and quantitative therapeutic minimally
0519U effective range of prescribed, non-prescribed, and illicit medications in circulation
Therapeutic drug monitoring, 200 or more drugs or substances, LC-MS/MS, plasma, qualitative and quantitative therapeutic minimally effective range of prescribed and non-prescribed
0520U medications

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Medicine - Vaccine
All previously listed administration codes for COVID-19 vaccines have been
deleted.
90480 is only reported code
◦ This change actually occurred after the 2024 book was printed.

ADDED
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2
90480 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, single dose

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 Medicine – Vaccines – All Deleted
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein,
0001A preservative free, 30 mcg/0.3 mL dosage, diluent reconstituted; first dose
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein,
0002A preservative free, 30 mcg/0.3 mL dosage, diluent reconstituted; second dose
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein,
0003A preservative free, 30 mcg/0.3 mL dosage, diluent reconstituted; third dose
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein,
0004A preservative free, 30 mcg/0.3 mL dosage, diluent reconstituted; booster dose
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein,
0051A preservative free, 30 mcg/0.3 mL dosage, tris-sucrose formulation; first dose
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein,
0052A preservative free, 30 mcg/0.3 mL dosage, tris-sucrose formulation; second dose
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein,
0053A preservative free, 30 mcg/0.3 mL dosage, tris-sucrose formulation; third dose
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein,
0054A preservative free, 30 mcg/0.3 mL dosage, tris-sucrose formulation; booster dose
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, bivalent spike protein,
0121A preservative free, 30 mcg/0.3 mL dosage, tris-sucrose formulation; single dose
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, bivalent spike protein,
0124A preservative free, 30 mcg/0.3 mL dosage, tris-sucrose formulation; additional dose
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein,
0071A preservative free, 10 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation; first dose
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein,
0072A preservative free, 10 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation; second dose
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein,
0073A preservative free, 10 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation; third dose
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein,
0074A preservative free, 10 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation; booster dose
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, bivalent spike protein,
0151A preservative free, 10 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation; single dose
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, bivalent spike protein,
0154A preservative free, 10 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation; additional dose

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 All Deleted
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike
0081A protein, preservative free, 3 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation; first dose
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike
0082A protein, preservative free, 3 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation; second dose
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike
0083A protein, preservative free, 3 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation; third dose
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP,
0171A bivalent spike protein, preservative free, 3 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation; first dose
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP,
0172A bivalent spike protein, preservative free, 3 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation; second dose
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP,
0173A bivalent spike protein, preservative free, 3 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation; third dose
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP,
0174A bivalent spike protein, preservative free, 3 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation; additional dose
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike
0011A protein, preservative free, 100 mcg/0.5 mL dosage; first dose
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike
0012A protein, preservative free, 100 mcg/0.5 mL dosage; second dose
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein,
0013A preservative free, 100 mcg/0.5 mL dosage; third dose
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein,
0064A preservative free, 50 mcg/0.25 mL dosage, booster dose
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein,
0134A bivalent, preservative free, 50 mcg/0.5 mL dosage, additional dose
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein,
0141A bivalent, preservative free, 25 mcg/0.25 mL dosage; first dose
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein,
0142A bivalent, preservative free, 25 mcg/0.25 mL dosage; second dose
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein,
0144A bivalent, preservative free, 25 mcg/0.25 mL dosage; additional dose

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 All Deleted
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein,
0091A preservative free, 50 mcg/0.5 mL dosage; first dose, when administered to individuals 6 through 11 years
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein,
0092A preservative free, 50 mcg/0.5 mL dosage; second dose, when administered to individuals 6 through 11 years
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein,
0093A preservative free, 50 mcg/0.5 mL dosage; third dose, when administered to individuals 6 through 11 years
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein,
0094A preservative free, 50 mcg/0.5 mL dosage; booster dose, when administered to individuals 18 years and older
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, DNA, spike protein, chimpanzee
0021A adenovirus Oxford 1 (ChAdOx1) vector, preservative free, 5x1010 viral particles/0.5 mL dosage; first dose
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, DNA, spike protein, chimpanzee
0022A adenovirus Oxford 1 (ChAdOx1) vector, preservative free, 5x1010 viral particles/0.5 mL dosage; second dose
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, DNA, spike protein, adenovirus type
0031A 26 (Ad26) vector, preservative free, 5x1010 viral particles/0.5 mL dosage; single dose
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, DNA, spike protein, adenovirus type
0034A 26 (Ad26) vector, preservative free, 5x1010 viral particles/0.5 mL dosage; booster dose
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, recombinant spike protein
0041A nanoparticle, saponin-based adjuvant, preservative free, 5 mcg/0.5 mL dosage; first dose
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, recombinant spike protein
0042A nanoparticle, saponin-based adjuvant, preservative free, 5 mcg/0.5 mL dosage; second dose
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, recombinant spike protein
0044A nanoparticle, saponin-based adjuvant, preservative free, 5 mcg/0.5 mL dosage; booster dose
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, monovalent, preservative free, 5
0104A mcg/0.5 mL dosage, adjuvant AS03 emulsion, booster dose
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein,
0111A preservative free, 25 mcg/0.25 mL dosage; first dose
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein,
0112A preservative free, 25 mcg/0.25 mL dosage; second dose
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein,
0113A preservative free, 25 mcg/0.25 mL dosage; third dose
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, bivalent,
0164A preservative free, 10 mcg/0.2 mL dosage, additional dose

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 All Deleted
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, bivalent spike protein, preservative free, 3 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose
91317 formulation, for intramuscular use

91301 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 100 mcg/0.5 mL dosage, for intramuscular use

91306 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 50 mcg/0.25 mL dosage, for intramuscular use

91313 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, bivalent, preservative free, 50 mcg/0.5 mL dosage, for intramuscular use

91314 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, bivalent, preservative free, 25 mcg/0.25 mL dosage, for intramuscular use

91311 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 25 mcg/0.25 mL dosage, for intramuscular use

91316 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, bivalent, preservative free, 10 mcg/0.2 mL dosage, for intramuscular use

91309 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 50 mcg/0.5 mL dosage, for intramuscular use
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, DNA, spike protein, chimpanzee adenovirus Oxford 1 (ChAdOx1) vector, preservative free, 5x1010 viral particles/0.5
91302 mL dosage, for intramuscular use
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, DNA, spike protein, adenovirus type 26 (Ad26) vector, preservative free, 5x1010 viral particles/0.5 mL dosage, for
91303 intramuscular use
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, preservative free, 5 mcg/0.5 mL dosage, for
91304 intramuscular use

91310 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, monovalent, preservative free, 5 mcg/0.5 mL dosage, adjuvant AS03 emulsion, for intramuscular use

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 Medicine - Vaccine
DELETED
90654 Influenza virus vaccine, trivalent (IIV3), split virus, preservative-free, for intradermal use
90630 Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, for intradermal use

REVISED

From: Influenza virus vaccine, trivalent (ccIIV3), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 mL dosage, for intramuscular use
90661
To: Influenza virus vaccine, trivalent (ccIIV3), derived from cell cultures, subunit, antibiotic free, 0.5 mL dosage, for intramuscular use

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 Medicine - Vaccine
ADDED
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, 3 mcg/0.3
91318 mL dosage, tris-sucrose formulation, for intramuscular use
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, 10 mcg/0.3
91319 mL dosage, tris-sucrose formulation, for intramuscular
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, 30 mcg/0.3
91320 mL dosage, tris-sucrose formulation, for intramuscular use
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, 25 mcg/0.25 mL dosage,
91321 for intramuscular use
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, 50 mcg/0.5 mL dosage, for
91322 intramuscular use

90695 Influenza virus vaccine, H5N8, derived from cell cultures, adjuvanted, for intramuscular use

90684 Pneumococcal conjugate vaccine, 21 valent (PCV21), for intramuscular use

90637 Influenza virus vaccine, quadrivalent (qIRV), mRNA; 30 mcg/0.5 mL dosage, for intramuscular use

90638 Influenza virus vaccine, quadrivalent (qIRV), mRNA; 60 mcg/0.5 mL dosage, for intramuscular use
Meningococcal pentavalent vaccine, Men B-4C recombinant proteins and outer membrane vesicle and conjugated Men A, C, W, Y-diphtheria
90624 toxoid carrier, for intramuscular use

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Where are the Ages?

2025 AMA CPT® Professional Edition, p. 759 (ebook)

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 https://www.cdc.gov/iis/code-sets/fall-season-respiratory-codes.html

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 National
CPT Code or
CPT or HCPCS Short Descriptor Labeler Name Vaccine/Procedure Name Payment Effective Dates
HCPCS code
Allowance
90653 IIV ADJUVANT VACCINE IM Seqirus Fluad Trivalent (2024/2025) Preservative Free $83.490 08/01/2024-07/31/2025
Seqirus Afluria Trivalent (2024/2025) Preservative Free 08/01/2024-07/31/2025
Sanofi Pasteur Fluzone Trivalent (2024/2025) Preservative Free 08/01/2024-07/31/2025
90656 IIV3 VACC NO PRSV 0.5 ML IM Fluvarix Trivalent (2024/2025) Preservative Free $22.350 08/01/2024-07/31/2025
GlaxoSmithKline
FluLaval Trivalent (2024/2025) Preservative Free 08/01/2024-07/31/2025
Afluria Trivalent (2024/2025)
Seqirus 08/01/2024-07/31/2025
Pediatric Dose
90657 IIV3 VACCINE SPLT 0.25 ML IM $10.929
Fluzone Trivalent (2024/2025)
Sanofi Pasteur 08/01/2024-07/31/2025
Pediatric Dose
Seqirus Afluria Trivalent (2024/2025) 08/01/2024-07/31/2025
90658 IIV3 VACCINE SPLT 0.5 ML IM $21.858
Sanofi Pasteur Fluzone Trivalent (2024/2025) 08/01/2024-07/31/2025
90660 LAIV3 VACCINE INTRANASAL MedImmune FluMist Trivalent (2024/2025) $28.871 08/06/2024-07/31/2025
Flucelvax Trivalent (2024/2025) Preservative Free 08/01/2024-07/31/2025
90661 CCIIV3 VAC ABX FR 0.5 ML IM Seqirus $36.849
Flucelvax Trivalent (2024/2025) 08/01/2024-07/31/2025
Fluzone High-Dose Trivalent (2024/2025) Preservative
90662 IIV NO PRSV INCREASED AG IM Sanofi Pasteur $83.492 08/01/2024-07/31/2025
Free
Flublok Trivalent (2024/2025)
90673 RIV3 VACCINE NO PRESERV IM Sanofi Pasteur $83.492 08/01/2024-07/31/2025
Preservative Free
INFLUENZA VIRUS VACCINE, NOT
Q2039 N/A N/A N/A 08/01/2024-07/31/2025
OTHERWISE SPECIFIED
Please see links below for
G0008 ADMIN OF FLU VACCINE N/A Administration of influenza virus vaccine
Locality-Adjusted Payment Rates
Administration of influenza vaccine inside a patient's
home; reported only once per individual home per Please see links below for
M0201 FLU VACCINE HOME ADMIN N/A
date of service when such vaccine administration(s) Locality-Adjusted Payment Rates
are performed at the patient's home
https://www.cms.gov/medicare/payment/part-b-drugs/vaccine-pricing

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Ophthalmic
REVISED
92132 From: Scanning computerized ophthalmic diagnostic imaging, anterior segment, with interpretation and report,
unilateral or bilateral
To: Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [OCT]), anterior segment,
with interpretation and report, unilateral or bilateral
92133 From: Scanning computerized ophthalmic diagnostic imaging, posterior segment, with interpretation and
report, unilateral or bilateral; optic nerve
To: Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [OCT]), posterior segment,
with interpretation and report, unilateral or bilateral; optic nerve
92134 From: Scanning computerized ophthalmic diagnostic imaging, posterior segment, with interpretation and report,
unilateral or bilateral; retina
To: Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [OCT]), posterior segment,
with interpretation and report, unilateral or bilateral; retina

ADDED
92137 Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [OCT]), posterior segment,
with interpretation and report, unilateral or bilateral; retina, including OCT angiography

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 Cardiovascular
DELETED
93890 Transcranial Doppler study of the intracranial arteries; vasoreactivity study

96003 Dynamic fine wire electromyography, during walking or other functional activities, 1 muscle

REVISED
From: Comprehensive electrophysiologic evaluation including transseptal catheterizations, insertion and repositioning of
multiple electrode catheters with intracardiac catheter ablation of atrial fibrillation by pulmonary vein isolation, including
intracardiac electrophysiologic 3-dimensional mapping, intracardiac echocardiography including imaging supervision and
interpretation, induction or attempted induction of an arrhythmia including left or right atrial pacing/recording, right
ventricular pacing/recording, and His bundle recording, when performed
93656
To: Comprehensive electrophysiologic evaluation with transseptal catheterizations, insertion and repositioning of multiple
electrode catheters, induction or attempted induction of an arrhythmia including left or right atrial pacing/recording, and
intracardiac catheter ablation of atrial fibrillation by pulmonary vein isolation, including intracardiac electrophysiologic 3-
dimensional mapping, intracardiac echocardiography with imaging supervision and interpretation, right ventricular
pacing/recording, and His bundle recording, when performed
From: Transcranial Doppler study of the intracranial arteries; emboli detection with intravenous microbubble injection
93893
To: Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble
injection

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 Cardiovascular
ADDED
93896 Vasoreactivity study performed with transcranial Doppler study of intracranial arteries, complete (List
separately in addition to code for primary procedure)
93897 Emboli detection without intravenous microbubble injection performed with transcranial Doppler study of
intracranial arteries, complete (List separately in addition to code for primary procedure)
93898 Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial Doppler
study of intracranial arteries, complete (List separately in addition to code for primary procedure)

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Medical Genetics and Counseling
DELETED
96040 Medical genetics and genetic counseling services, each 30 minutes face-to-face with
patient/family

ADDED
96041 Medical genetics and genetic counseling services, each 30 minutes of total time provided by the
genetic counselor on the date of the encounter

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Administration Codes
ADDED
96380 Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with
counseling by physician or other qualified health care professional
96381 Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection

• Report 96380, 96381 for administration of respiratory syncytial virus, monoclonal antibody,
seasonal dose [90380, 90381]

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Acupuncture
REVISED
97811 From: Acupuncture, 1 or more needles; without electrical stimulation, each additional 15 minutes of personal one-on-
one contact with the patient, with re-insertion of needle(s) (List separately in addition to code for primary procedure)

To: Acupuncture, 1 or more needles; without electrical stimulation, each additional 15 minutes of personal one-on-one
contact with the patient, with insertion of needle(s) (List separately in addition to code for primary procedure)
97814 From: Acupuncture, 1 or more needles; with electrical stimulation, each additional 15 minutes of personal one-on-one
contact with the patient, with re-insertion of needle(s) (List separately in addition to code for primary procedure)

To: Acupuncture, 1 or more needles; with electrical stimulation, each additional 15 minutes of personal one-on-one
contact with the patient, with insertion of needle(s) (List separately in addition to code for primary procedure)

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 Self-Management Training
REVISED

From: Education and training for patient self-management by a qualified, nonphysician health care professional using a standardized
curriculum, face-to-face with the patient (could include caregiver/family) each 30 minutes; individual patient
98960
To: Education and training for patient self-management by a nonphysician qualified health care professional using a standardized
curriculum, face-to-face with the patient (could include caregiver/family) each 30 minutes; individual patient
From: Education and training for patient self-management by a qualified, nonphysician health care professional using a standardized
curriculum, face-to-face with the patient (could include caregiver/family) each 30 minutes; 2-4 patients
98961
To: Education and training for patient self-management by a nonphysician qualified health care professional using a standardized
curriculum, face-to-face with the patient (could include caregiver/family) each 30 minutes; 2-4 patients
From: Education and training for patient self-management by a qualified, nonphysician health care professional using a standardized
curriculum, face-to-face with the patient (could include caregiver/family) each 30 minutes; 5-8 patients
98962
To: Education and training for patient self-management by a nonphysician qualified health care professional using a standardized
curriculum, face-to-face with the patient (could include caregiver/family) each 30 minutes; 5-8 patients

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 Telephone Assessment/Management
REVISED

From: Telephone assessment and management service provided by a qualified nonphysician health care professional to an established patient, parent, or guardian not
originating from a related assessment and management service provided within the previous 7 days nor leading to an assessment and management service or procedure
98966 within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion

To: Telephone assessment and management service provided by a nonphysician qualified health care professional to an established patient, parent, or guardian not
originating from a related assessment and management service provided within the previous 7 days nor leading to an assessment and management service or procedure
within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion

From: Telephone assessment and management service provided by a qualified nonphysician health care professional to an established patient, parent, or guardian not
originating from a related assessment and management service provided within the previous 7 days nor leading to an assessment and management service or procedure
within the next 24 hours or soonest available appointment; 11-20 minutes of medical discussion
98967
To: Telephone assessment and management service provided by a nonphysician qualified health care professional to an established patient, parent, or guardian not
originating from a related assessment and management service provided within the previous 7 days nor leading to an assessment and management service or procedure
within the next 24 hours or soonest available appointment; 11-20 minutes of medical discussion

From: Telephone assessment and management service provided by a qualified nonphysician health care professional to an established patient, parent, or guardian not
originating from a related assessment and management service provided within the previous 7 days nor leading to an assessment and management service or procedure
within the next 24 hours or soonest available appointment; 21-30 minutes of medical discussion
98968
To: Telephone assessment and management service provided by a nonphysician qualified health care professional to an established patient, parent, or guardian not
originating from a related assessment and management service provided within the previous 7 days nor leading to an assessment and management service or procedure
within the next 24 hours or soonest available appointment; 21-30 minutes of medical discussion

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 Online Digital Assessment
REVISED
From: Qualified nonphysician health care professional online digital assessment and management, for an established patient, for up to 7
days, cumulative time during the 7 days; 5-10 minutes
98970
To: Nonphysician qualified health care professional online digital assessment and management, for an established patient, for up to 7 days,
cumulative time during the 7 days; 5-10 minutes
From: Qualified nonphysician health care professional online digital assessment and management, for an established patient, for up to 7
days, cumulative time during the 7 days; 11-20 minutes
98971
To: Nonphysician qualified health care professional online digital assessment and management, for an established patient, for up to 7 days,
cumulative time during the 7 days; 11-20 minutes

From: Qualified nonphysician health care professional online digital assessment and management, for an established patient, for up to 7
98972 days, cumulative time during the 7 days; 21 or more minutes
To: Nonphysician qualified health care professional online digital assessment and management, for an established patient, for up to 7 days,
cumulative time during the 7 days; 21 or more minutes

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 Remote Therapeutic Monitoring

REVISED
From: Remote therapeutic monitoring (eg, therapy adherence, therapy response); initial set-up and patient education on use of equipment
98975 To: Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention);
initial set-up and patient education on use of equipment
From: device(s) supply with scheduled (eg, daily) recording(s) and/or programmed alert(s) transmission to monitor respiratory system, each
98976 30 days
To: device(s) supply for data access or data transmissions to support monitoring of respiratory system, each 30 days
From: device(s) supply with scheduled (eg, daily) recording(s) and/or programmed alert(s) transmission to monitor musculoskeletal system,
98977 each 30 days
To: device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, each 30 days

From: Remote therapeutic monitoring (eg, therapy adherence, therapy response); device(s) supply with scheduled (eg, daily) recording(s)
98978
and/or programmed alert(s) transmission to monitor cognitive behavioral therapy, each 30 days
To: device(s) supply for data access or data transmissions to support monitoring of cognitive behavioral therapy, each 30 days

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 Category III
DELETED
0398T Magnetic resonance image guided high intensity focused ultrasound (MRgFUS), stereotactic ablation lesion, intracranial for movement disorder
including stereotactic navigation and frame placement when performed
0500T Infectious agent detection by nucleic acid (DNA or RNA), Human Papillomavirus (HPV) for five or more separately reported high-risk HPV types (eg,
16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) (ie, genotyping)
0537T Chimeric antigen receptor T-cell (CAR-T) therapy; harvesting of blood-derived T lymphocytes for development of genetically modified autologous
CAR-T cells, per day
0538T Chimeric antigen receptor T-cell (CAR-T) therapy; preparation of blood-derived T lymphocytes for transportation (eg, cryopreservation, storage)
0539T Chimeric antigen receptor T-cell (CAR-T) therapy; receipt and preparation of CAR-T cells for administration
0540T Chimeric antigen receptor T-cell (CAR-T) therapy; CAR-T cell administration, autologous
0553T Percutaneous transcatheter placement of iliac arteriovenous anastomosis implant, inclusive of all radiological supervision and interpretation,
intraprocedural roadmapping, and imaging guidance necessary to complete the intervention
0564T Oncology, chemotherapeutic drug cytotoxicity assay of cancer stem cells (CSCs), from cultured CSCs and primary tumor cells, categorical drug
response reported based on percent of cytotoxicity observed, a minimum of 14 drugs or drug combinations
0567T Permanent fallopian tube occlusion with degradable biopolymer implant, transcervical approach, including transvaginal ultrasound
0568T Introduction of mixture of saline and air for sonosalpingography to confirm occlusion of fallopian tubes, transcervical approach, including
transvaginal ultrasound and pelvic ultrasound
0616T Insertion of iris prosthesis, including suture fixation and repair or removal of iris, when performed; without removal of crystalline lens or
intraocular lens, without insertion of intraocular lens
0617T Insertion of iris prosthesis, including suture fixation and repair or removal of iris, when performed; with removal of crystalline lens and insertion of
intraocular lens
0618T Insertion of iris prosthesis, including suture fixation and repair or removal of iris, when performed; with secondary intraocular lens placement or
intraocular lens exchange

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 REVISED
0714T From: Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance
To: Transperineal laser ablation of benign prostatic hyperplasia; including imaging guidance
0615T From: Eye-movement analysis without spatial calibration, with interpretation and report
To: Automated analysis of binocular eye movements without spatial calibration, including disconjugacy,
saccades, and pupillary dynamics for the assessment of concussion, with interpretation and report

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Crosswalk for Category III to Category I

2024 Deleted Code Use in 2025

0398T 61715
0500T 87624-87624
0537T-0540T 38225-38228
0553T 37799
0564T 89240
0567T, 0568T 58999
0616T, 0618T 66683

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 Category III
ADDED
0901T Placement of bone marrow sampling port, including imaging guidance when performed
0867T Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 mL

0868T High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling, with interpretation and report

0869T Injection(s), bone-substitute material for bone and/or soft tissue hardware fixation augmentation, including intraoperative imaging
guidance, when performed
0870T Implantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled
indwelling bladder and peritoneal catheters with pump connections, including all imaging and initial programming, when performed

0871T Replacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal
catheters, including initial programming and imaging, when performed
0872T Replacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted
peritoneal ascites pump, including imaging and programming, when performed
0873T Revision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter,
associated bladder catheter), including imaging and programming, when performed
0874T Removal of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal
catheters
0875T Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional

0876T Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)

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0877T Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of
interstitial lung disease; obtained without concurrent CT examination of any structure contained in previously acquired diagnostic imaging
0878T Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of
interstitial lung disease; obtained with concurrent CT examination of the same structure
0879T Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of
interstitial lung disease; radiological data preparation and transmission
0880T Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of
interstitial lung disease; physician or other qualified health care professional interpretation and report
0881T Cryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of
patient tolerance to treatment, and removal of the oral device
0882T Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and
removal, upper extremity, minimum of 10 minutes; initial nerve (List separately in addition to code for primary procedure)
0883T Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and
removal, upper extremity, minimum of 10 minutes; each additional nerve (List separately in addition to code for primary procedure)
0884T Esophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic
drug delivery by drug-coated balloon catheter for esophageal stricture, including fluoroscopic guidance, when performed
0885T Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery
by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed
0886T Sigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug
delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed

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0887T End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (List separately in addition to code for primary
procedure)
0888T Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance

Personalized target development for accelerated, repetitive high-dose functional connectivity MRI-guided theta-burst stimulation derived from a
structural and resting-state functional MRI, including data preparation and transmission, generation of the target, motor threshold-starting
0889T location, neuronavigation files and target report, review and interpretation
Accelerated, repetitive high-dose functional connectivity MRI-guided theta-burst stimulation, including target assessment, initial motor threshold
0890T determination, neuronavigation, delivery and management, initial treatment day
Accelerated, repetitive high-dose functional connectivity MRI-guided theta-burst stimulation, including neuronavigation, delivery and
0891T management, subsequent treatment day
Accelerated, repetitive high-dose functional connectivity MRI-guided theta-burst stimulation, including neuronavigation, delivery and
0892T management, subsequent motor threshold redetermination with delivery and management, per treatment day
Noninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care
0893T professional interpretation and report
Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft
0894T following normothermic perfusion
Connection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly
physiological and laboratory assessments (eg, perfusate temperature, perfusate pH, hemodynamic parameters, bile production, bile pH, bile
0895T glucose, biliary bicarbonate, lactate levels, macroscopic assessment)
Connection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and
laboratory assessments (eg, perfusate temperature, perfusate pH, hemodynamic parameters, bile production, bile pH, bile glucose, biliary
0896T bicarbonate, lactate levels, macroscopic assessment) (List separately in addition to code for primary procedure)

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 Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected
intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation
0897T and report
Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and pathology, including
0898T visualization of margin volume and location, with margin determination and physician interpretation and report
Noninvasive determination of absolute quantitation of myocardial blood flow (AQMBF), derived from augmentative algorithmic analysis of the
dataset acquired via contrast cardiac magnetic resonance (CMR), pharmacologic stress, with interpretation and report by a physician or other
0899T qualified health care professional (List separately in addition to code for primary procedure)
Noninvasive estimate of absolute quantitation of myocardial blood flow (AQMBF), derived from assistive algorithmic analysis of the dataset
acquired via contrast cardiac magnetic resonance (CMR), pharmacologic stress, with interpretation and report by a physician or other qualified
0900T health care professional (List separately in addition to code for primary procedure)

0902T QTc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ECG device

0903T Electrocardiogram, algorithmically generated 12-lead ECG from a reduced-lead ECG; with interpretation and report

0904T Electrocardiogram, algorithmically generated 12-lead ECG from a reduced-lead ECG; tracing only

0905T Electrocardiogram, algorithmically generated 12-lead ECG from a reduced-lead ECG; interpretation and report only

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 Concurrent optical and magnetic stimulation (COMS) therapy, wound assessment and dressing care; first application, total wound(s) surface
0906T area less than or equal to 50 sq cm
Concurrent optical and magnetic stimulation (COMS) therapy, wound assessment and dressing care; each additional application, total
0907T wound(s) surface area less than or equal to 50 sq cm (List separately in addition to code for primary procedure)

0908T Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed

0909T Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed

0910T Removal of integrated neurostimulation system, vagus nerve

Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or other qualified health
0911T care professional
Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician or other qualified
0912T 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 ultrasound (IVUS) or optical coherence
0913T 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 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
0914T addition to code for percutaneous coronary stent or atherectomy intervention)

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 Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and
0915T 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 guidance, and evaluation and
0916T programming of sensing and therapeutic parameters; pulse generator only
Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and
0917T 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 guidance, and evaluation and
0918T programming of sensing and therapeutic parameters; dual transvenous leads (pacing and defibrillation) only
0919T Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only
0920T Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only
0921T Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only

0922T Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only
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), including fluoroscopic guidance
0924T and programming of sensing and therapeutic parameters
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 the device and select optimal
0926T permanent programmed values with analysis, including review and report, implantable cardiac contractility modulation-defibrillation system

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 Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection,
0927T per patient encounter, implantable cardiac contractility modulation-defibrillation system
Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim analysis
0928T 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 data
0929T acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results
Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation
(induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial implantation or
0930T replacement with testing of cardiac contractility modulation-defibrillator pulse generator
Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation
(induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial implantation or
0931T replacement with testing of cardiac contractility modulation-defibrillator pulse generator
Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved
0932T 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 sensor
calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological supervision and
0933T 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 thresholds,
0934T 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, including
insertion of guide wire, selective placement of ureteral sheath(s) and multiple conformable electrodes, contrast injection(s), and
0935T fluoroscopy, bilateral

0936T Photobiomodulation therapy of retina, single session

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 External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage;
including recording, scanning analysis with report, review and interpretation by a physician or other qualified health care
0937T professional
External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage;
0938T recording (including connection and initial recording)
External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage;
0939T scanning analysis with report
External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; review
0940T and interpretation by a physician or other qualified health care professional

0941T Cystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated cystoscopic visualization

0942T Cystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold

0943T Cystourethroscopy, flexible; with removal of prostatic urethral scaffold

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 computer-
0945T 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, including data
acquisition, data preparation and transmission, interpretation and report (including CT scan of the joint or extremity performed
0946T with paired views)
Magnetic resonance image guided low intensity focused ultrasound (MRgFUS), stereotactic blood-brain barrier disruption using
microbubble resonators to increase the concentration of blood-based biomarkers of target, intracranial, including stereotactic
0947T navigation and frame placement, when performed

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Multianalyte Assays
ADDED
0020M Oncology (central nervous system), analysis of 30000 DNA methylation loci by
methylation array, utilizing DNA extracted from tumor tissue, diagnostic algorithm reported
as probability of matching a reference tumor subclass

Proprietary Name/Clinical Laboratory/Manufacturer:

◦ Epignostix CNS Tumor Methylation Classifier, Heidelberg Epignostix GmbH

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2024 Physician Final Rule

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Where to Find Information:

https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2025-
https://public-inspection.federalregister.gov/2024-25382.pdf medicare-physician-fee-schedule-final-rule

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Or Find a Reputable Organization!
• Coding Intel https://codingintel.com/final-rule-webinar/
• AAPC Understanding the 2025 Physician Fee Schedule Final Rule
• Inbox health https://www.inboxhealth.com/event/navigating-medicares-
2025-final-rule-revenue-cycle-and-financial-implications/

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 MPFS Conversion Factor (CF)
• $32.35 for CY 2025, a 2.83 percent decrease from the current CF of $33.29
• Anesthesia CF $20.32, 2.2% decrease from 2024 $22.77

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 Finalized
• Hospital Inpatient or Observation (I/O) Evaluation and Management (E/M) add-on for
infectious diseases
• Expanding the definition of "Telecommunications System" to include audio-only services
• Establishing an APP Plus quality measure set
• Maintaining the performance threshold at 75 points for the CY 2025 performance period
• Maintaining the 75 percent data completeness threshold at 75 percent through the 2028
performance period
• Adding six new Merit-Based Incentive Payment System MIPS Value Pathways (MVPs)
related to ophthalmology, dermatology, gastroenterology, pulmonology, urology and
surgical care
• Modifying currently finalized MVPs, including the consolidation of two currently finalized
neurology-focused MVPs into a singular neurological MVP dea.gov

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 Questions?
BRENDA EDWARDS
[email protected]

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