Check out the 2027 CPT® Changes That Could Impact Your Coding
Be ready for one of the largest CPT® revisions in recent history. With 300 new codes, 74 revised codes, and 80 deleted codes, the CPT® 2027 code set delivers one of the most significant updates seen in recent years and brings major changes across multiple specialties. From the migration of emerging technology codes into full Category I reporting and major maternity care restructuring, to new cardiovascular, gastrointestinal, behavioral health, laboratory, and Category III services, coders will need to deal with a wide range of additions, revisions, and deletions before Jan. 1, 2027. Use this update to get ahead of the changes coming your way! Prepare for a CCM Migration from Category III to Category I One of the most significant cardiovascular coding changes in CPT® 2027 is the full migration of cardiac contractility modulation (CCM) services from Category III to Category I status, reflecting broader clinical adoption and established utilization. New Category I codes 33290-33297 (Insertion of permanent cardiac contractility (CCM) system...) report CCM system implantation and removal services, including insertion of pulse generators and transvenous electrodes, as well as complete system removal. Additionally, codes 33307-33309 will report CCM pulse generator replacement, lead repositioning, and pocket revision services, while new codes 93154-93157 provide dedicated reporting for CCM programming, in-person interrogation, and remote monitoring services. The new code family creates a comprehensive lifecycle reporting structure for CCM devices, spanning implantation, revision, programming, and remote device management. Notably, implantation code 33290 includes fluoroscopic guidance and programming of sensing and therapeutic parameters, while remote monitoring is now separately reported through 93156, for the professional component, and 93157, for the technical component. This parallels reporting structures used for other implantable cardiac devices and is likely to generate coding questions related to physician work, remote monitoring workflows, and device management responsibilities. Corresponding Category III codes 0408T-0418T and 0948T-0949T have been deleted because their services are now represented by Category I codes rather than temporary tracking codes. Learn New Category I Codes for Advance Tricuspid Valve Therapy Reporting CPT® 2027 also expands structural heart reporting with new Category I codes for transcatheter tricuspid valve therapies. New code 33469 (Transcatheter tricuspid valve replacement (TTVR)...) reports transcatheter tricuspid valve replacement (TTVR) and includes several services commonly performed during the procedure, including right-heart catheterization, temporary pacemaker insertion, and selective right ventricular or right atrial angiography when performed. For repair procedures, codes 33466-33467 (Transcatheter tricuspid valve edge-to-edge repair (T-TEER)...) report transcatheter tricuspid valve edge-to-edge repair (T-TEER). Code 33466 describes the initial clip placement, while add-on code 33467 reports each additional clip during the same session. The introduction of these Category I codes coincides with the deletion of the Category III tricuspid valve codes 0569T-0570T (Transcatheter tricuspid repair) and 0646T (Transcatheter tricuspid valve implantation/replacement), signaling that these technologies have achieved sufficient clinical acceptance to warrant permanent CPT® reporting. Be Prepared for These Prostate Biopsy Revisions CPT® has made substantial revisions to the 55707-55715 code family. Notable deletions include 55712 (Biopsy, prostate, transperineal, MRI-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion) and 55713 (Biopsy, prostate, in-bore CT- or MRI-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion), while revisions all remove language for specific types of image guidance, such as ultrasound or magnetic resonance imaging (MRI), replacing with the more generic “including image guidance.” The descriptor changes also help reorganize the codes into regional and fusion-targeted lesion biopsies, while retaining the language for both transperineal and transrectal approaches. Examples include 55708 (Biopsy, prostate, transrectal, including imaging guidance, regional and fusion-targeted lesion(s)) and 55709 (Biopsy, prostate, transperineal, including imaging guidance, regional). Lastly, 55706 (Biopsies, prostate, needle, transperineal, stereotactic template guided saturation sampling, including imaging guidance) is also slated for deletion effective Jan. 1, 2027. Review Labor Management and Obstetric Code Restructure One of the largest changes to the CPT® code set occurs in the maternity code section. Starting Jan. 1, maternity services will be reported using an a la carte approach. For example, you’ll now use an individual evaluation and management (E/M) code to report each antepartum care visit rather than 59425-59426 (Antepartum care only …) for the total number of antepartum care visits during the pregnancy. You’ll also assign separate codes for labor management, vaginal or cesarean delivery, and postpartum care. For example, you’ll assign the following codes for a complex labor that takes place over two days resulting in a vaginal delivery of the patient’s first baby: For more information about the upcoming 2027 CPT® Maternity code changes, check out Revenue Cycle Insider’s in-depth breakdown in “Find out What Every OB Coder Needs to Know About the 2027 Maternity Coding Reset.” Plan for Endoscopic Submucosal Dissection Reporting The 2027 CPT® code set will add several codes related to gastrointestinal (GI) procedures. Two new codes in particular will allow you to report endoscopic submucosal dissection (ESD) procedures of the upper or lower GI tract: Each code also includes closure of the mucosa when the provider documents that portion of the service. Adapt to Behavior Service Changes in 2027 Effective Jan. 1, the Adaptive Behavior Services section of the CPT® code set will see extensive revisions to existing codes and new code additions for reporting behavior identification assessments, adaptive behavior treatment, family guidance, group services, and harmful behavior services. Codes in the 97151-97158 range are going to experience significant descriptor revisions in the new year. For example, 97152 (Behavior identification–supporting assessment, administered by technician, face-to-face with the patient, each 15 minutes) will no longer require a technician to be “under the direction of a physician or other qualified health care professional” to administer the assessment. That specificity will be deleted in 2027. The CPT® code set will also add new codes to this section regarding a patient’s harmful behavior assessment. These codes require specific components for reporting as follows: Additionally, multiple codes in the Adaptive Behavior Services section will include analysis of the treatment, guidance, or data. For example, 97157 (Multiple-family group adaptive behavior treatment guidance with analysis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of caregivers for multiple patients, each 15 minutes) will add “with analysis” to the treatment service in 2027 (underlined portions are upcoming revisions). Expect Plenty of New PLA Codes All told, you’ll have 99 new proprietary lab analyses (PLA) codes to choose from in 2027. These include numerous minimal residual disease (MRD) codes such as 0644U (Oncology (leukemia), minimal residual disease (MRD) detection for rearrangements, blood or bone marrow, personalized assay design and baseline quantification), and cell-free circulating tumor DNA (ctDNA), such as 0647U (Oncology (molecular residual disease), whole genome sequence analysis, cell-free DNA (cfDNA), whole blood, assessment utilizing patient-specific tumor inform) tests for various cancers. CPT® has also made significant additions and deletions to the transplant rejection PLA codes, such as the addition of 0662U (Transplantation medicine (kidney allograft rejection), mRNA, gene-expression profiling by real-time quantitative PCR of 12 genes (11 content and 1 housekeeping), urine, algorithm reported as a rejection risk score) and the deletion of 0544U (Nephrology (transplant monitoring), 48 variants by digital PCR, using cell-free DNA from plasma, donor-derived cell-free DNA, percentage reported as risk for rejection). CPT® 2027 also adds a significant number of PLA codes for lab tests that use algorithms for analyzing numerous test values to determine whether a patient is at a positive or negative risk for certain conditions. Among them are 0618U (Psychiatry (bipolar disorder), DNA methylation analysis of more than 10,000 sites, whole blood, algorithm reported as positive or negative risk) and 0620U (Oncology (hepatocellular carcinoma), DNA methylation analysis of more than 5,000 sites, whole blood, algorithm reported as positive or negative risk). Add These Analysis Panels to Further Genomic Sequence Understanding CPT® has also added several Category I and PLA genomic sequence analysis panels in 2027 to help increase our understanding of hereditary illnesses and disorders through DNA or RNA sequence analysis. Among them are 81409 (Alport syndrome, genomic sequence analysis panel...) and 81424 (Genetic testing for heritable complement-mediated thrombotic microangiopathy (CM-TMA)... genomic sequence analysis panel). One genomic sequence PLA code, 0585U (Targeted genomic sequence analysis panel, solid organ neoplasm...), has been deleted from the code set. Brace for a Wave of New Category III Codes Every year, CPT® rolls out a new set of Category III codes (T codes) for emerging technologies, procedures, and services. In 2027, Category III will expand with roughly 80 new codes — a high amount for any year. Coders across the spectrum need to take note of these T codes, as they span multiple specialties. Also, as 2027 progresses, watch for guidance on how to use these codes in publications like CPT® Assistant. Many of the new codes will deal with algorithmic analysis applications, such as codes like following: Note: This list highlights just a few of the new algorithmic analysis T codes arriving in 2027. Because these codes span multiple specialties, coders should review the complete code set to determine whether any of the additions will apply to their areas of expertise. There is also a new code for histotripsy, 1037T (Histotripsy of malignant pancreatic tissue). This relatively new therapeutic technique will likely be on payers’ radars, so you should make sure you know how to use 1037T before reporting it. In 2027, you’ll also have T codes for reporting implantable heart failure decompensation monitors and associated management services. The four-code set begins with 1050T (Insertion, subcutaneous heart failure decompensation monitor...) and ends with 1053T (Programming device evaluation (in-person or remote) of subcutaneous heart failure decompensation monitor, with analysis of physiologic parameters …). Finally, CPT® will add seven new codes for emergent liver allograft perfusion and monitoring technologies, ranging from 1072T (… each additional hour of monitoring and management (List separately in addition to code for primary procedure)) to 1078T (Liver allograft, hypothermic oxygenated perfusion; decannulation). There has been no guidance on the parent code for 1072T yet, though it will certainly be related to liver allografts, so you should stay tuned to Revenue Cycle Insider for more information. Revenue Cycle Insider Editorial Team
