New CPT Codes - Digestive, Urinary, and Reproductive System

This is Part 3 of a 5 part series on the new 2022 CPT codes.  In this one we will explore the digestive, urinary and reproductive system CPT changes. 

Digestive System

Several new codes were created in the digestive system. The first involves drug induced sleep endoscopy, (DISE):

• 42975 Drug induced sleep endoscopy, with dynamic evaluation of velum pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic.
• Patient is asleep.  General anesthesia given.  The endoscope looks at how things move such as how the tongue falls backward, and how the pharynx and nose move. This helps assess if surgical intervention can work. Do not report this code with 31231 for nasal endoscopy unless it is done for a separate condition. Also do not report with 31575 for laryngoscopy

A new code has been added for POEM:

• 43497 Lower esophageal myotomy, transoral (ie, per-oral endoscopic myotomy [POEM])

       ►(Do not report 43497 in conjunction with 32665, 43191, 43197, 43200, 43235)◄

• Used to treat conditions such as achalasia. Achalasia is a rare disorder that makes it difficult for food and liquid to pass from the esophagus  into your stomach. Achalasia occurs when nerves in the esophagus become damaged.
• Current CPT codes (32665, 43279, 43330) describe esophagomyotomy via  different approaches:
• Code 32665 describes esophagomyotomy via thoracoscopy
• Code 43279 describes laparoscopic esophagomyotomy
• Code 43330 describes esophagomyotomy via an open abdominal approach

A new category III code was created for gastrostomy with magnetic gastropexy:

• 0647T Insertion of gastrostomy tube, percutaneous, with magnetic gastropexy, under ultrasound guidance, image documentation and report    ►(Do not report 0647T with 76942)◄
• May be called PUMA-G System.  Allows gastrostomy tube insertion performed solely under US guidance without the need for fluoroscopy or endoscopy.

A new code have been developed for magnetically controlled capsule endoscopy:

• 0651T Magnetically controlled capsule endoscopy, esophagus through stomach, including intraprocedural positioning of capsule, with interpretation and report.

►(Do not report 0651T with 91110, 91111)◄

Three new codes for TRANSNASAL esophagogastroscopy.  This is a different method than placing the tube through the mouth.  Trans-nasally helps patients to avoid gag reflex during esophagogastroscopy:

• 0652T Esophagogastroscopy, flexible, transnasal; diagnostic,

including collection of specimen(s) by brushing or washing,

when performed (separate procedure)

• 0653T with biopsy, single or multiple
• 0654T  with insertion of intraluminal tube or catheter

Urinary System

New codes were created for balloon continence device to include insertion, side, removal, adjustment, etc. Old Category III codes for these, 0548T-0551T have been deleted. So this is not a new device.

• 53451  Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance
• ►(Do not report 53451 in conjunction with 52000, 53452, 53453, 53454, 76000)◄
• 53552 unilateral insertion, including cystourethroscopy and imaging guidance
• ►(Do not report 53452 in conjunction with 52000, 53451, 53453, 53454, 76000)◄
• 53453 removal, each balloon
• ►(Do not report 53453 in conjunction with 53451, 53452, 53454)◄
• 53454 percutaneous adjustment of balloon(s) fluid volume
• ►(Do not report 53454 in conjunction with 53451, 53452, 53453)◄
• ►(Report 53454 only once per patient encounter)◄

                  New code for Transperineal focal laser ablation of malignant  prostate tissue was created.  It may also be called “TPLA”.  The

                  access is through the perineal skin rather than the rectum.

• 0655T Transperineal focal laser ablation of malignant prostate tissue, including transrectal imaging guidance, with MR-

                 fused images or other enhanced ultrasound imaging  ►(Do not report 0655T in conjunction with 52000, 76376, 76377, 76872,      

                  76940, 76942, 76998)◄

Female Reproductive System

There are new codes for donor uterus transplantation that encompass every step of the process:

• 0664T Donor hysterectomy (including cold preservation); open, from cadaver donor
• 0665T open, from living donor
• 0666T laparoscopic or robotic, from living donor
• 0667T recipient uterus allograft transplantation from cadaver or living donor
• 0668T Backbench standard preparation of cadaver or living donor uterine allograft prior to transplantation, including dissection and removal of surrounding soft tissues and preparation of uterine vein(s) and uterine artery(ies), as necessary
• 0669T Backbench reconstruction of cadaver or living donor uterus allograft prior to transplantation; venous anastomosis, each
• 0670T arterial anastomosis, each

A new code for Endo-vaginal cryogen cooled monopolar radiofrequency remodeling was created.   The Viveve System is just one example.

• 0672T Endo-vaginal cryogen-cooled monopolar radiofrequency remodeling of the tissues surrounding the female

                  bladder neck and proximal urethra for urinary incontinence 

In Part 4 of this series, we will discuss the remaining new surgical CPT codes  in the surgery section for 2022.

The information contained in this post is valid at the time of posting. Viewers are encouraged to research subsequent official guidance in the areas associated with the topic as they can change rapidly.