If you’re a radiology coding professional, staying current with annual CPT updates is not just good practice, it’s critical for accurate billing, fair reimbursement, and compliance with payer rules. As your trusted resource for clear medical coding guidance, here’s a practical breakdown of the most important radiology CPT code changes for 2026.
Why the 2026 Updates Matter
Radiology is one of the fastest-growing specialties for both diagnostic and interventional procedures. Every year, new technologies, AI tools, and evolving safety standards push coding forward. For 2026, the big themes are:
- More precise codes for complex interventional procedures.
- Expanded coding for AI-assisted diagnostics.
- Greater recognition of time and expertise for services like MRI safety.
- Updates to RVUs and payment policies that affect radiology’s bottom line.
1. New MRI Safety Supervision & Device Management Codes
Building on recent years, 2026 brings expanded codes for MRI safety services when patients have implanted devices.
What changed?
- New codes distinguish between basic device checks, complex reprogramming, and physicist consultations for patients with high-risk implants.
- Codes include time-based elements, so careful tracking is essential.
Example:
- 76X01: MRI safety check, simple device.
- 76X02: Add-on for each extra 30 minutes.
- 76X03: MRI with device reprogramming under physician supervision.
Tip: Always document total time, who performed each step, and patient consent.
2. New Category I Codes for AI-Assisted Imaging
Artificial Intelligence (AI) has become mainstream in radiology. The 2026 CPT set now includes new Category I codes for AI tools that:
- Detect lung nodules on chest CTs.
- Flag stroke signs on brain scans.
- Automate comparison of prior mammograms.
This shift from Category III to I means:
- AI tasks now have established RVUs.
- More payers will likely reimburse them.
Tip: Keep separate documentation showing how the AI output was used in final interpretation. Payers may audit this.
3. Interventional Radiology Additions
The biggest CPT expansions this year are in interventional oncology and pain management:
a) Liver Tumor Ablation
New codes for percutaneous microwave or cryoablation of liver lesions. These better distinguish:
- Single vs. multiple tumors.
- Guidance modality used (CT, MRI, or ultrasound).
b) Genicular Nerve Ablation
For chronic knee pain, genicular nerve radiofrequency ablation is now Category I. This makes it easier for outpatient radiology clinics to report pain procedures accurately.
Tip: Pair these codes with correct imaging guidance codes if they’re not bundled.
4. Updated Vascular Ultrasound Codes
Vascular labs should note new descriptors for duplex scans of extremity veins:
- Clearer language for complete vs. limited studies.
- Clarifies when repeat studies can be billed in the same session.
5. Revised Nuclear Medicine Codes
Nuclear cardiology sees:
- Updated codes for PET myocardial perfusion imaging with advanced protocols.
- Clarified bundling rules for tracer supply vs. technical component.
Tip: Watch NCCI edits — many radiology denials happen when contrast or tracer charges get double-billed.
6. Deleted or Consolidated Codes
Several older or low-volume procedures were deleted in 2026:
- Outdated plain film studies rarely used in modern practice.
- Some legacy bone density codes merged into broader DEXA scan descriptors.
Always scrub your chargemaster to avoid using deleted codes after January 1!
7. Medicare Payment and RVU Updates
CMS updated the Medicare Physician Fee Schedule for 2026. Key points:
- Small increase to the conversion factor — about +0.8% — but watch for service-specific changes.
- High-cost CT and MRI studies may have new prior auth or appropriate use criteria to qualify for full payment.
- CCTA (coronary CTA) continues to receive favorable reimbursement due to its preventive value.
Tip: Verify your top 10 codes’ new RVUs and cross-check payer contracts.
8. Practical Documentation & Compliance Reminders
Your coding is only as strong as your documentation. Here are best practices for 2026:
- Time-based services: Keep precise logs for MRI device checks, sedation, and prolonged studies.
- Imaging guidance: Note modality, approach, and medical necessity for needle placements, biopsies, or ablations.
- AI support: Save AI output reports in the patient’s chart.
- Physician supervision: Confirm that supervision levels match the new CPT definitions.
9. Watch for Edits & Denials
With new codes come new NCCI (bundling) edits and MUEs (Medically Unlikely Edits). Common radiology denial triggers:
- Double-billing guidance codes.
- Reporting separate code for contrast when it’s included.
- Using add-on codes without the primary code.
- Exceeding UOS limits for bilateral or multiple lesions.
Tip: Use coding software that flags these issues in real time.
10. Getting Ready: Action Steps for Radiology Practices
Here’s how to prepare your team before January 1, 2026:
- Train coders and radiologists on new code definitions, documentation requirements, and compliance traps.
- Update your EHR templates to prompt for required details, time, supervision, device info.
- Audit your most common procedures to catch bundling risks.
- Review payer bulletins — private payers may adopt new codes or local policies at different times.
- Stay connected with ACR, AMA CPT Assistant, and CMS updates for clarification.
