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Also, remember to note revisions and T code additions.

The CPT^® 2026 code list is out, and it contains several changes that neurosurgery coders will want to note.

The basics: There will be several new codes dealing with spinal decompression and diagnostic radiology, as well as some important revisions and a slew of new Category III codes, or T codes, for you to take in.

Check out this breakdown of the CPT^® 2026 changes you’ll want to note, so you can be ready when the codes take effect on Jan. 1, 2026.

Use These Codes for Decompression With Ligamentum Flavum Involvement

CPT^® 2026 will add a trio of codes to the end of the Spine and Spinal Cord/Injection, Drainage, or Aspiration set (62263-62327). The new codes are:

• 62330 (Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, CT or fluoroscopy), bilateral; one interspace, lumbar)
• 62231 (… additional interspace(s), lumbar (List separately in addition to code for primary procedure)
• 63032 (… with repair of annular defect by implantation of bone-anchored annular closure device, including all imaging guidance, 1 interspace, lumbar (List separately in addition to code for primary procedure))

There will also be a slight revision to 62287, whose descriptor currently reads: “Decompression procedure, percutaneous, of nucleus pulposus of intervertebral disc, any method utilizing needle based technique to remove disc material under fluoroscopic imaging or other form of indirect visualization, with discography and/or epidural injection(s) at the treated level(s), when performed, single or multiple levels, lumbar.” The new descriptor will delete “procedure” and add a hyphen to “needle based.”

In addition to the above additions and revision, CPT^® is adding a code to the Neurostimulators (Peripheral Nerve) set (64553-64568): 64567 (Percutaneous electrical nerve field stimulation, cranial nerves, without implantation).

Tip: Check and see if your physicians perform any procedures resembling the above descriptors on their patients. If they do, confer with all interested parties to see if you should be using these new codes.

CPT^® Grants CTA a Standalone Code

CPT^® 2026 will also add three new codes to the Diagnostic Radiology (Diagnostic Imaging)/ Head and Neck section of the code book (70010-70559), including a code for computed tomographic angiography (CTA). Those codes are:

• 70471 (Computed tomographic angiography (CTA), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing)
• 70472 (Computed tomographic (CT) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent CT or CT angiography of the same anatomy (List separately in addition to code for primary procedure))
• 70473 (Computed tomographic (CT) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent CT or CT angiography of the same anatomy)

According to Johns Hopkins Medicine, a CTA “is a type of medical test that combines a CT scan with an injection of a special dye to produce pictures of blood vessels and tissues in a part of your body. The dye is injected through an intravenous (IV) line placed in your arm or hand.”

Revisions Clean Up These Arthrodesis and Transcatheter Codes

In addition to the revision to 62287, CPT^® 2026 also revises two arthrodesis codes and two transcatheter placement/occlusion codes. Here is a look at the 2025 descriptors of the codes, and then the 2026 descriptors (underlined text indicates material CPT^® added; strikethrough text indicates material CPT^® deleted):

• 27278
  • 2025 descriptor: Arthrodesis, sacroiliac joint, percutaneous, with image guidance, including placement of intra-articular implant(s) (eg, bone allograft[s], synthetic device[s]), without placement of transfixation device
  • 2026 descriptor: Arthrodesis, sacroiliac joint, percutaneous, or minimally invasive, with image guidance, includingincludes obtaining bone graft when performed, unilateral placement of intra-articular implant(s) (eg, bone allograft[s], synthetic device[s]), without placement of transfixation device; placement of intra-articular device(s), without cortical piercing
• 27279
  • 2025 descriptor: Arthrodesis, sacroiliac joint, percutaneous or minimally invasive (indirect visualization), with image guidance, includes obtaining bone graft when performed, and placement of transfixation device
  • 2026 descriptor: Arthrodesis, sacroiliac joint, percutaneous or minimally invasive (indirect visualization), with image guidance, includes obtaining bone graft when performed, and placement of transfixation device; placement of transarticular device(s) and/or intra-articular device(s) piercing the lateral or medial cortices of the ilium and the lateral cortex of the sacrum
• 61624
  • 2025 descriptor: Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), percutaneous, any method; central nervous system (intracranial, spinal cord)
  • 2026 descriptor: Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), including all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention, percutaneous, any method; central nervous system (intracranial, spinal cord)
• 61626
  • 2025 descriptor: Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), percutaneous, any method; non-central nervous system, head or neck (extracranial, brachiocephalic branch)
  • 2026 descriptor: Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), including all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention, percutaneous, any method; non-central nervous system, head or neck (extracranial, brachiocephalic branch)

Do this: Some CPT^® code revisions are seemingly miniscule, and some are extensive. You need to make sure you pay attention to all the revisions, great and small, because even one word or punctuation mark can make a difference in the meaning of a code.

Sort Through T Codes for Neurosurgery-Relevant Entries

There is also a slew of new T codes that you might need to use based on the surgeries your physicians perform. These are temporary codes that CPT^® uses for data collection, and it’s very serious about you using T codes instead of unlisted procedure codes. “Use of unlisted codes does not offer the opportunity for the collection of specific data. If a Category III code is available, this code must be reported instead of a Category I unlisted code,” CPT^® states.

This year, there are around 15 T codes that might be used in a neurosurgery practice. Among the new entries are:  

• 0956T (Partial craniectomy, channel creation, and tunneling of electrode for sub-scalp implantation of an electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance)
• 0960T  (Replacement of sub-scalp implanted electrode array, receiver, and telemetry unit with tunneling of electrode for continuous bilateral electroencephalography monitoring system, including imaging guidance)
• 0984T  (Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (List separately in addition to code for primary procedure))

Best bet: Do a thorough check of the Category III section of CPT^® 2026 and note any new neurosurgery-related procedures you might be coding for.

Chris Boucher, MS, CPC, Senior Development Editor, AAPC