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Time to know the AMA's

2026 CPT changes

Madesh Ragu CPC, CIRCC

Disclaimer

This presentation is designed to offer basic information for

coding and billing. The information presented here is based

on the experience, training and interpretation of the author.

Although the information has been carefully researched and

checked for accuracy and completeness, the instructor does

not accept any responsibility or liability with regard to errors,

omissions, misuse or misinterpretation. This material is

intended as an Educational guide and should not be

considered a legal/consulting opinion.

Objectives

The annual update to the CPT code set created 418 editorial

changes, including

• 288 additions,
• 46 revisions and
• 84 deletions

With 11,525 codes that describe the medical procedures and

services available to patients, the CPT code set continues to grow

and evolve with the rapid pace of innovation in medical science

and health technology.

288 New 46 Revised 84 Deleted 418 Total Changes

Why it’s important

• Ensure accurate medical billing and reimbursement
• Reflect advancements in medical technology and procedures
• Necessary for compliance with healthcare regulations Staying updated is crucial for healthcare providers to properly document services, avoid claim denials, and maintain revenue cycle efficiency, as new codes are added, existing ones are revised, and others are deleted to keep the code set current. Maintained and updated by the AMA's CPT Editorial Panel.

Summary of Changes

Topics Added Deleted Revised Code Count Evaluation and Management 2 0 4 173 Anesthesia 0 0 0 276 Surgery 77 24 12 5933 Radiology procedure 8 9 3 662 Pathology and Laboratory procedures

Medicine services and procedures 37 17 18 1091 Category II Codes 0 0 0 565 Category III Codes 78 21 4 607 PLA Codes 79 13 3 537 MAAA 0 0 0 14 Total 288 84 46 11525

• 11163

• 11321

• 11525

Evaluation and Management

• ADDITION
  • Addition of two CPT codes to this system
• DELETION
  • There are no deletions to this system
• REVISION
  • There are four revised codes in this system

Evaluation and Management

New and Revised Remote Physiologic Monitoring Treatment Management Services CPT Codes Old Description 2026 new update 99470 (New) NA RPM treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring 1 real-time interactive communication with the patient/caregiver during the calendar month; first 10 minute 99457 (Revised) RPM treatment management services, in a calendar month requiring interactive communication with the patient/caregiver during the month; first 20 minutes first 20 minutes

• 99458 (Revised) each additional 20 minutes each additional 20 minutes 2 - Revised Code 1 – New code

Evaluation and Management

New and Revised Remote Physiologic Monitoring Treatment Management Services Time validation: Be precise 99470 requires 10 minutes; 99457 requires 20 minutes

Integumentary system

• ADDITION
  • There are no additions to this system
• DELETION
  • There are no deletions to this system
• REVISION
  • One revised code in this system

Integumentary system

• For 2026, CPT code 10040 has been updated to remove the term "acne surgery" from its description.
• This change reflects that the code isn't limited to acne treatment but applies more broadly to the extraction of various small skin lesions. 1 - Revised Code

Musculoskeletal system - Code revision

Arthrodesis, sacroiliac joint:

• 27278 – Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of intra-articular device(s), without cortical piercing
• 27279 – Placerment 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 sacrurm New 2026 CPT Coding Guidelines
• Do not report 27278 and 27279 for the same joint
• Use modifier 50 when the procedure is performed bilaterally.
• Hybrid procedures (involving both intra- and transarticular devices) are reported with 27279 when any device pierces the cortices. 2 - Revised Codes

Musculoskeletal system – New Codes

New 2026 CPT Codes

• 27458 – Femur Osteotomy with Externally Controlled Intramedullary Lengthening Device
• 27713 – Tibia (Including Fibula) Osteotomy with Externally Controlled Intramedullary Lengthening Device
• Limb lengthening is a surgical process that allows gradual bone growth to correct length discrepancies or congenital deformities 2 - New Codes

Respiratory System

• ADDITION
  • There are no additions to this system
• DELETION
  • There are no deletions to this system
• REVISION
  • There are no revisions to this system

Cardiovascular system

• ADDITION
  • Addition of 48 CPT codes to this system
• DELETION
  • There are 20 deletions to this system
• REVISION
  • There are four revised codes in this system