2026 CPT Update Brings Major Changes for Radiology
The 2026 CPT (Current Procedural Terminology) update represents one of the most significant coding revisions in recent years for radiology. With 288 new codes, 46 revised, and 84 deleted, these numbers reflect the rapid technological evolution of the field. For imaging centers and diagnostic services, understanding these changes is essential to maintain accurate billing and avoid claim denials.
Updates of this magnitude often catch many practices off guard. Those who fail to keep up risk incorrect billing or missing out on reimbursement for procedures that now have specific codes. Let’s examine the key changes.
New Codes for CT Angiography and Cerebral Perfusion
One of the most relevant changes for diagnostic radiology involves CT angiography (CTA) and CT cerebral perfusion. The new code 70471 now covers head and neck CTA with contrast, bundling non-contrast images when performed in the same session. Additionally, add-on code +70472 describes CT cerebral perfusion when performed in the same session as a head CT or head and neck CTA.
Code 70473 covers CT cerebral perfusion when performed without a concurrent head CT or CTA. This separation is crucial to reflect current clinical practice, especially in stroke care, where rapid diagnosis is decisive. Professionals working with integrated PACS systems will notice the direct impact of these changes on workflow.
Lower Extremity Revascularization: Complete Redesign
Perhaps the most radical change affects lower extremity revascularization coding. Legacy codes 37220-37235 have been deleted and replaced by approximately 46 new codes that reflect lesion complexity and multiple vascular territories, including inframalleolar interventions.
This complete redesign demands heightened attention from interventional radiologists and their billing teams. Coding is now more granular, allowing for more accurate reimbursement but also demanding greater technical knowledge during coding. Those familiar with efficient PACS workflows understand how proper coding integration can streamline operations.
AI Diagnostics Receive Category I Codes
A notable development reflecting technological evolution is the inclusion of new Category I codes for artificial intelligence diagnostic tools. There are now specific codes for AI that detects lung nodules on chest CTs and AI that identifies stroke signs on brain scans. This formalization in the CPT table represents a milestone for AI adoption in radiological practice, as it enables reimbursement for these services.
New Category III Codes for Emerging Technologies
Beyond Category I codes, the update brings new Category III codes (temporary, for technologies under evaluation) including:
- Hemodynamic inferior vena cava (IVC) monitoring
- Benign prostate ablation using high-intensity focused ultrasound (HIFU)
- Laser ablation of breast tumors
- Neurovascular optical coherence tomography
- Tumor treating fields dosimetry
These codes signal where the field is heading and allow healthcare facilities to begin tracking utilization of these emerging technologies.
Impact on Radiation Therapy
The update also includes new codes for radiation therapy treatment delivery and superficial radiation therapy, directly affecting radiation therapy services and their coding routines.
Practical Recommendations
To prepare adequately: review all deleted codes and identify their replacements; update billing and reporting systems with the new codes; train coding staff on lower extremity revascularization changes; and verify whether AI tools in use have corresponding CPT codes. The ACR (American College of Radiology) provides detailed resources to assist with this transition.