The American Medical Association issued new CPT III codes for CT and MRCP quantification (see page 4), representing key milestones for quantitative and incidental/population health imaging.
CT Quantification Codes – The AMA’s 2022 CPT III update includes two new codes for quantitative CT tissue characterization, interpretation, and reporting. These codes could be a big deal for AI firms and radiology departments hoping to launch CT-based population health solutions (and eventually bill for them), such as Nanox AI’s HealthCCSng CAC scoring product and UCSF’s automated CAC scoring system. They also come just six months after the AMA added a similar CPT III code for using AI to automatically detect vertebral fractures in existing CT scans (covering Nanox AI’s VCF solution).
MRCP Quantification Codes – The AMA also added CPT III codes for quantitative magnetic resonance cholangiopancreatography (QMRCP) interpretation and reporting. These codes are a solid step for MRCP quantification products like Perspectum’s MRCP+ and could help drive adoption for this far less-subjective MRCP interpretation method. In the process, it might even change ERCP’s role to a purely therapeutic procedure.
About CPT III Codes – Since there’s often confusion about CPT III codes, it’s worth noting that they are intended to help collect clinical data for emerging technologies / procedures to support future coverage and regulatory decisions. CPT III codes don’t have assigned RVUs, so actual reimbursements would be up to payors.
The Takeaway
It’s pretty clear that the AMA is starting to see value in image quantification, AI, and incidental detection. In the last six months the AMA has issued four quantitative imaging CPT III codes, all of which directly support key imaging AI use cases (CT tissue characterization, CT vertebral fracture detection, ultrasound tissue characterization, MRI post-processing) and two that support key population health and incidental detection applications (CT tissue characterization, CT vertebral fracture detection).
