2025 CPT Changes, Deletions, and Revisions for Radiology

The 2025 CPT updates for radiology introduce new codes, revisions, and deletions aimed at modernizing and streamlining radiology practices. These updates address advancements in imaging technology, emphasize bundled coding for efficiency, and introduce new procedural descriptors to improve documentation accuracy.
This comprehensive guide outlines the 2025 changes for radiology, focusing on:

1. New CPT Codes: For emerging imaging modalities and procedures.
2. Revised CPT Codes: Enhancements to descriptors and inclusion of bundled services.
3. Deleted CPT Codes: Removal of redundant or outdated codes.
4. Impact on Payer Policies: Documentation and billing strategies for reimbursement.
5. Implementation Strategies for Radiology Practices.

1. Overview of the 2025 CPT Updates for Radiology
Radiology remains one of the most rapidly evolving medical fields, with continuous innovations in imaging technology and techniques. The 2025 CPT updates reflect:

• The adoption of artificial intelligence (AI) tools in radiology workflows.
• Expansion of interventional radiology codes, including image-guided biopsies and ablations.
• Refinement of nuclear medicine and PET imaging codes.
• A focus on bundling services, including preparation, imaging, and interpretation.

2025 CPT Changes, Deletions, and Revisions for Radiology

2. New CPT Codes for 20252.1
Advanced Imaging Technologies
NEW CODE: 0739T

• Description: AI-assisted analysis of diagnostic imaging data, including automated lesion detection, quantification, and reporting.
• Clinical Applications:
  • Used in oncology imaging for tumor volume measurement and tracking.
  • Enhances diagnostic accuracy in cardiovascular imaging, such as plaque characterization in coronary CT angiography.
• Payer Guidelines:
  • Experimental Classification: Some payers consider AI-assisted imaging tools investigational.
  • Documentation must include:
    • AI system used.
    • Physician interpretation of AI findings.

NEW CODE: 0740T

• Description: Dual-energy CT (DECT) imaging for enhanced tissue characterization and artifact reduction.
• Clinical Applications:
  • Identifies uric acid crystals in gout.
  • Differentiates soft tissue from bone in complex fractures.
• Modifiers:
  • 26: Professional component for interpretation.
  • TC: Technical component for the imaging procedure.
• Payer Guidelines:
  • Reimbursement contingent on preauthorization for specific indications.

2.2 Interventional Radiology
NEW CODE: Image-Guided Cryoablation for Pain Management

• Code: 5052T
• Description:
  • Cryoablation of nerves under ultrasound or CT guidance for pain management.
• Clinical Applications:
  • Effective for chronic pain syndromes, including:
    • Sacroiliac joint dysfunction.
    • Peripheral nerve entrapment syndromes.
• Payer Guidelines:
  • Requires preauthorization with detailed documentation of conservative management failure.

NEW CODE:
Image-Guided Biopsy with Tumor Mapping

• Description:
  • Combines biopsy with 3D tumor mapping using MRI or CT.
• Clinical Applications:
  • Ideal for oncologic biopsies requiring precise localization.
• Payer Guidelines:
  • Bundled payment includes imaging guidance, biopsy, and 3D mapping.

2.3 Nuclear Medicine and PET Imaging
NEW CODE: Quantitative PET Analysis

• Code: 5075T
• Description:
  • Quantitative assessment of metabolic activity in PET imaging using AI algorithms.
• Clinical Applications:
  • Tracks treatment response in cancer therapy.
  • Assesses myocardial viability in cardiac imaging.
• Payer Guidelines:
  • Requires documentation of baseline and follow-up studies.

3. Revised CPT Codes for Radiology
3.1 Diagnostic Radiology
Chest X-Ray (71045–71048)

• Revised Descriptor:
  • Includes clarifications on the number of views and anatomical structures assessed.
• Clinical Applications:
  • Improved documentation for pneumonia and pulmonary nodule assessments.
• Payer Guidelines:
  • Detailed report of views obtained and findings required for reimbursement.

CT Abdomen and Pelvis with Contrast (74177)

• Revised Descriptor:
  • Now specifies inclusion of both arterial and venous phases for vascular studies.
• Clinical Applications:
  • Enhanced utility in assessing aneurysms, tumors, and vascular anomalies.

3.2 Interventional Radiology
Revised Code: 37243

• Description:
  • Transcatheter therapy for arterial occlusions.
• Revised Descriptor:
  • Clarifies additional vessels treated within the same session.
• Modifiers:
  • 59: For separate anatomical sites treated during the same session.
• Payer Guidelines:
  • Preauthorization required for multiple-vessel interventions.

4. Deleted CPT CodesObsolete Imaging Modalities
Deleted Code: 76120

• Description:
  • Cineradiography of chest.
• Reason for Deletion:
  • Replaced by digital fluoroscopy codes that provide superior imaging and documentation.

5. Impact on Payer Policies
The 2025 CPT updates are aligned with payer demands for:

1. Bundled Codes:
   • Payers are reducing separate reimbursement for guidance or interpretation.
   • Documentation must reflect the full scope of services provided under bundled codes.
2. Outcome-Based Imaging:
   • For AI-assisted tools or advanced imaging like dual-energy CT, insurers require evidence of improved diagnostic accuracy.
3. Preauthorization:
   • Many new interventional radiology and nuclear medicine codes require detailed preauthorization.

6. Implementation Strategies for Radiology PracticesStaff Training

1. Educate radiologists and billing staff about new and revised codes.
2. Conduct workshops on integrating AI findings into clinical reports.

Optimize Documentation

• Include detailed procedural notes for interventional radiology, emphasizing the use of imaging guidance.
• Ensure structured reporting for advanced imaging techniques.

Technology Integration

• Update PACS and RIS systems to include new CPT codes.
• Implement AI algorithms to streamline reporting for advanced imaging modalities.

Audits and Compliance

• Conduct quarterly audits to ensure compliance with updated codes.
• Address denied claims by refining preauthorization and documentation workflows.

7. Clinical Case Examples
Case 1: Dual-Energy CT for Gout

• Scenario: A 55-year-old male with recurrent joint pain in the toes.
• Procedure: Dual-energy CT to detect uric acid crystals.
• Outcome: Confirmed gout diagnosis; treatment initiated with urate-lowering therapy.

Case 2: AI-Assisted PET for Cancer Response

• Scenario: A 60-year-old female undergoing chemotherapy for breast cancer.
• Procedure: AI-assisted PET imaging to quantify metabolic changes in tumor.
• Outcome: Demonstrated reduction in tumor activity, confirming treatment efficacy.

8. Conclusion: Embracing the 2025 Radiology Updates
The 2025 CPT updates empower radiology practices to leverage advanced technologies and optimize patient care. By adopting these changes, radiology providers can:

1. Enhance Diagnostic Accuracy:
   • Use new imaging modalities like AI-assisted PET and dual-energy CT.
2. Streamline Billing:
   • Bundle services to reduce denials and improve efficiency.
3. Stay Competitive:
   • Offer cutting-edge services, such as cryoablation and 3D tumor mapping.

2025 CPT Changes, Deletions, and Revisions for Radiology
Introduction: The Importance of CPT Updates for RadiologyRadiology plays a central role in modern healthcare, providing essential diagnostic and therapeutic services across numerous specialties. The 2025 CPT updates introduce new codes, refine existing ones, and eliminate outdated codes to reflect advancements in technology and align with value-based care initiatives. These updates impact radiology practices by:

• Emphasizing bundled codes for imaging and interpretation.
• Recognizing emerging technologies such as artificial intelligence (AI) and dual-energy CT.
• Streamlining interventional radiology procedures through enhanced coding clarity.

This guide offers radiologists and practice administrators an in-depth understanding of these updates, including strategies to ensure compliance, maximize reimbursement, and optimize patient care.

1. Historical Perspective on CPT Codes in Radiology
Radiology has undergone remarkable transformation since the CPT coding system was introduced in 1966. The journey from analog X-rays to AI-powered imaging underscores the importance of regular CPT updates.
Key Milestones in Radiology Coding

• 1990s: Introduction of codes for advanced imaging modalities like CT and MRI.
• 2000s: Integration of interventional radiology with imaging guidance codes.
• 2010s: Expansion of PET imaging codes and the emergence of bundled services.
• 2020s: Recognition of AI-assisted imaging and the integration of structured reporting.

The 2025 CPT updates continue this evolution, prioritizing innovation and efficiency.

2. New CPT Codes for Radiology
The 2025 updates introduce several new codes to address emerging technologies and improve specificity in reporting.

2.1 Advanced Imaging Technologies
0739T: AI-Assisted Analysis of Imaging Data

• Description:
  • AI-driven analysis of diagnostic imaging data, including automated lesion detection and volumetric quantification.
• Clinical Applications:
  • Oncology: Tumor detection and volume tracking.
  • Cardiology: Plaque characterization in coronary CT angiography.
  • Neurology: Early detection of white matter lesions in multiple sclerosis.
• Payer Guidelines:
  • Experimental classification for many insurers.
  • Claims must document:
    • Specific AI platform used.
    • Physician review and interpretation of AI findings.

0740T:  Dual-Energy CT (DECT)

• Description:
  • Advanced imaging technique that uses two energy levels to enhance tissue characterization.
• Clinical Applications:
  • Differentiating uric acid crystals from other types of joint deposits in gout.
  • Reducing artifacts in metal implants during post-surgical imaging.
• Modifiers:
  • 26: Professional component (interpretation).
  • TC: Technical component (imaging acquisition).
• Reimbursement Challenges:
  • Requires detailed documentation of clinical necessity for preauthorization.

2.2 Interventional Radiology
5052T: Cryoablation Under Imaging Guidance

• Description:
  • Image-guided cryoablation of peripheral nerves for pain management.
• Clinical Applications:
  • Sacroiliac joint dysfunction.
  • Peripheral nerve entrapment.
• Payer Guidelines:
  • Preauthorization required with evidence of conservative treatment failure.
  • Coverage typically limited to chronic pain syndromes.

Image-Guided Biopsy with 3D Tumor Mapping

• Description:
  • Combines biopsy with MRI or CT-based tumor mapping for enhanced precision.
• Clinical Applications:
  • Oncologic biopsy requiring spatial localization of lesions.
• Payer Guidelines:
  • Bundled payments cover guidance, biopsy, and mapping.

2.3 Nuclear Medicine and PET Imaging
5075T: Quantitative PET Imaging

• Description:
  • AI-assisted quantification of metabolic activity in PET scans.
• Clinical Applications:
  • Monitoring treatment response in cancer.
  • Assessing myocardial viability in ischemic heart disease.
• Payer Guidelines:
  • Coverage contingent on baseline and follow-up imaging comparisons.

3. Revised CPT Codes for Radiology
3.1 Diagnostic Radiology
Chest X-Ray Codes (71045–71048)

• Revised Descriptions:
  • Clarifications on the number of views and anatomical structures assessed.
• Clinical Applications:
  • Diagnosing pneumonia, pleural effusion, and pulmonary nodules.
• Payer Guidelines:
  • Detailed radiology reports are essential for claim approval.

CT Abdomen and Pelvis with Contrast (74177)

• Revised Descriptions:
  • Now includes arterial and venous phases for vascular imaging.
• Clinical Applications:
  • Detecting abdominal aneurysms, tumors, and vascular anomalies.

3.2 Interventional Radiology
​37243: Transcatheter Therapy for Arterial Occlusions

• Revised Descriptions:
  • Specifies treatment of additional vessels within the same session.
• Clinical Applications:
  • Managing arterial occlusions in peripheral vascular disease.
• Payer Guidelines:
  • Requires detailed documentation of vessels treated.

4. Deleted CPT Codes for Radiology76120: Cineradiography of the Chest

• Reason for Deletion:
  • Replaced by digital fluoroscopy codes, which offer superior diagnostic capabilities.

5. Implementation Strategies for Radiology Practices
5.1 Staff Training

• Train radiologists and technologists on new and revised codes.
• Conduct workshops on documenting AI-assisted and advanced imaging findings.

5.2 Technology Updates

• Update RIS/PACS systems to include new CPT codes.
• Integrate AI platforms for automated imaging analysis.

5.3 Documentation Best Practices

• Emphasize the importance of structured reporting.
• Ensure that all imaging guidance and clinical outcomes are documented in procedural notes.

6. Case StudiesCase Study
1: AI-Assisted PET Imaging

• Scenario: A 55-year-old patient undergoing chemotherapy for lymphoma.
• Procedure: Quantitative PET imaging to assess tumor response.
• Outcome: AI analysis demonstrated a significant reduction in metabolic activity, guiding continued therapy.

Case Study 2: Dual-Energy CT for Gout

• Scenario: A 40-year-old male with recurrent toe pain.
• Procedure: DECT to identify uric acid deposits.
• Outcome: Gout confirmed; treatment initiated.

7. Trends and Future Considerations
​The 2025 CPT updates align with broader trends in radiology:

1. AI Integration:
   • AI tools are becoming essential for advanced diagnostics.
2. Focus on Bundling:
   • Reducing separate claims for guidance and interpretation simplifies billing.
3. Patient-Centered Care:
   • Codes now prioritize outcomes and diagnostic precision.

8. The 2025 CPT updates for radiology provide new opportunities for practices to deliver cutting-edge care. By embracing these changes, radiologists can:

• Enhance Diagnostic Accuracy: Leverage AI and advanced imaging techniques.
• Streamline Operations: Adopt bundled codes for seamless billing.
• Optimize Reimbursement: Align with payer requirements for outcome-based care.

Practices that proactively adapt to these updates will be well-positioned to thrive in the evolving healthcare landscape.

2025 CPT Changes, Deletions, and Revisions for Radiology