ACR Recommends CPT Code Placements for 2024 Medicare Hospital Outpatient Prospective Payment System

The American College of Radiology® (ACR®) submitted recommendations to the Centers for Medicare and Medicaid Services (CMS) March 1 regarding the placement and reimbursement of new Current Procedural Terminology® (CPT®) codes for the 2024 Hospital Outpatient Prospective Payment System (HOPPS).

The comment letter outlines the proposed ambulatory payment classification (APC) for percutaneous sacroiliac joint arthrodesis without the use of a transfixation device (2X000), a minimally invasive fixation procedure with placement of an intra-articular implant such as bone allografts. The College also provided an APC recommendation for analysis derived from augmentative software from a coronary computed tomography (CT) angiography data set for non-invasive fractional flow reserve (FFR, 7X005). Non-invasive FFRCT calculates the severity of coronary artery disease in symptomatic patients and is used to enhance physician decision making pertaining to treatment planning — either medical therapy or revascularization. The APC placements in different categories dictate the reimbursement for services performed. The College has suggested placement of these codes into the same APCs as their predecessor Category III codes.

For questions, contact Kimberly Greck, ACR Senior Economic Policy Analyst, or Christina Berry, ACR Team Lead, Economic Policy.