2025 CPT Code Changes Simplified: What Your HIM Team Needs to Know
2025 CPT Code Changes Simplified: What Your HIM Team Needs to Know
January 1, 2025, is the effective date for all 2025 CPT code changes. This includes 420 updates: 270 new codes, 112 code deletions, and 38 revisions to existing codes (AMA). Some of these changes will not directly affect health information management functions.
For example, 37% of the additions are for proprietary laboratory analyses (PLA) codes in the Pathology and Laboratory section. Other new codes are for emerging medical services reflected in the Category III codes. These accounted for about 30% of the new codes, with 81 codes added.
The AMA’s CPT & RBRVS 2025 Annual Symposium in November 2024 included a comprehensive review of the updates. Here’s a brief synopsis of those changes.
Digital Medicine (DM) and Augmented/Artificial Intelligence (AI) Category III Codes
In 2023 the AMA formed the Digital Medicine Coding Committee (DMCC) to support the CPT Editorial Panel on coding issues that involve or may include DM or AI. For 2025 seven AI-associated Category III codes are implemented.
For example, codes 0902T-0905T are assigned for augmentative algorithmic analysis of ECG input. Code 0932T is for use of an AI platform to assess heart failure with preserved ejection fraction.
Other changes include the addition of codes 0877T-0880T for AI analysis of chest CT data to provide diagnostic subtype classification of interstitial lung disease. New Category III code 0898T is used to report noninvasive prostate estimation mapping. This uses AI analysis of data such as image-guided fusion biopsy to better visualize the location and extent of cancer in the prostate.
New Codes in the Surgery Section
There was a total of 33 new Category I codes in the Surgery Section along with 13 deletions and 5 revisions. This includes codes 15011-15018 for Skin Cell Suspension Autograft (SCSA) procedures, including grafting, autograft preparation and spray-application of the SCSA.
New codes 49186-49190 replace deleted codes to report the intra-abdominal excision or destruction of peritoneal, mesenteric, or retroperitoneal tumors or cysts, reported based on the maximum length of tumor(s).
Category III codes for Chimeric Antigen Receptor T-Cell (CAR-T Therapy) were converted to Category I codes 38225-38228.
MR-Monitored Transurethral Ultrasound of Prostate for treatment of prostate cancer is reported with new codes 51721, 55881 and 55882. Treatment of benign prostatic hypertrophy via insertion and removal of a temporary device for ischemic remodeling of the bladder neck and prostate is reported with new codes 53865 and 53866.
Ablation of thyroid nodule(s) is coded with new codes 60660 and 60661. A Category III code has converted to new Category I code 61715 for intracranial MRI-guided ultrasound ablation, a non-invasive method to ablate tissue within the skull.
Administration of local anesthetics for postoperative pain control within a specific anatomical location is reported with new codes, with codes 64466-64469 for injections and infusions into the thoracic planes, and codes 64473 and 64474 for lower extremity planes.
New code 66683 is reported for implantation of an iris prosthesis for absence of the iris or trauma
Evaluation and Management
Seventeen new codes were implemented for telemedicine services (98000-98016), with codes 99441-99443 for telephone services deleted. Numerous guidelines and parenthetical notes accompany these changes.
Of note, CMS has designated codes 98000-98015 as “invalid” and is only adopting code 98016 for Brief Synchronous Communication Technology Service (e.g. Virtual Check in).
Medicine Section
Immunization codes are found in this section and the AMA’s Immunization Coding Caucus (ICC) has made some changes, including the release of new immunization codes three times a year, instead of twice a year.
Codes are now released on April 1st (effective July 1st), July 1st (effective October 1st), and October 1st (effective on January 1st the following year). New vaccine codes are listed in the section, including codes for avian flu, mRNA Influenza vaccine and others.
Other updates include a new code for computerized ophthalmic diagnostic imaging of the retina, transcranial doppler studies, medical genetics and genetics counseling, and RSV monoclonal antibody injections.
Radiology and Pathology and Laboratory Sections
Six new codes and a new subsection were added in the Radiology section for Magnetic Resonance safety implant/foreign body safety processes. These identify the work associated with assessing and providing safety services related to performing MR examination in the presence of implanted medical devices or foreign bodies.
Most new codes for the Pathology and Laboratory section were in the Proprietary Laboratory (PLA) area, accounting for 101 of these new codes. PLA codes are an addition to the CPT code set for manufacturers that want to more specifically identify their test. There were also 14 new Pathology and Laboratory codes for tests and analyses.
Continuing Education on the 2025 CPT Code Changes
This brief synopsis gives you a taste of the changes coming for January 1, 2025. YES is your go-to source for comprehensive presentations on all of the changes that will give you and your staff up to speed on all of the details of the 2025 updates.
Ann Zeisset, RHIT, CCS, CCS-P, Contract Educator, co-authored this article with Teri Jorwic, MPH, RHIA, CCS, CCS-P, FAHIMA, Contract Educator.
