The 2026 CPT® code set brings a targeted set of updates to the Radiology Section, reflecting advancements in imaging modalities, procedural technologies, radiation oncology, and evolving clinical practice patterns. In 2026 there are eight new radiology codes, nine deletions, and three code revisions, all driven by the need to streamline reporting, enhance specificity, and retire outdated or redundant codes. Hiacode
These changes align with what the American College of Radiology (ACR) has published and anticipated as essential updates for radiologists, IR teams, RCM professionals, and coders. American College of Radiology+1
1. New Category I Radiology Codes
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One of the most clinically relevant sets of new radiology codes involves computed tomography (CT) studies used in vascular and stroke diagnostics:
New CTA of the head and neck reporting codes now bundle services that were previously reported separately, improving accuracy and reducing the need to report pre- and post-contrast studies as standalone services. Bristol Healthcare Services Inc.
New CT cerebral perfusion (CTP) codes replace the earlier Category III code used for perfusion imaging and allow for reporting of perfusion studies as Category I procedures, reflecting wider clinical adoption in stroke care pathways. Bristol Healthcare Services Inc.
These updates better align radiology coding with current standards of care, particularly in emergent vascular imaging where CTA and CTP are integral to acute stroke protocols. Bristol Healthcare Services Inc.
b) Irreversible Electroporation (IRE)
Percutaneous IRE ablation — used for tumor destruction in organs such as the liver or prostate — receives two new Category I CPT codes in 2026. This upgrade from earlier experimental reporting supports reimbursement for image-guided tumor ablation procedures that have gained clinical acceptance. American College of Radiology+1
c) Prostate Biopsy Services
Prostate biopsy reporting has seen a substantial overhaul — nine new codes replace older prostate biopsy codes, and one legacy biopsy code (55700) is deleted. These new codes are meant to better reflect imaging-guided biopsy details and separate service components that were previously bundled inconsistently. Bristol Healthcare Services Inc.
This provides more granular reporting options that align with current clinical workflows and imaging guidance increasingly used during biopsy procedures. Bristol Healthcare Services Inc.
2. Radiation Oncology Reporting Changes
Radiation oncology codes — often housed within the broader radiology section — undergo major restructuring:
Traditional treatment delivery codes used for external beam radiation (e.g., IMRT and 3D conformal codes) are being deleted or revised and reorganized into more general Level 1, Level 2, and Level 3 radiation treatment delivery categories. Bristol Healthcare Services Inc.
Legacy codes such as 77385, 77386, and 77014 are being removed as part of consolidation and bundling efforts, with imaging guidance included in the new delivery definitions. Bristol Healthcare Services Inc.
This change simplifies radiation treatment reporting while requiring coders to understand how delivery complexity and guidance relate to the new levels. Bristol Healthcare Services Inc.
3. Other Interventional and Emerging Code Changes
Radiology also intersects with other updated procedural areas:
New CPT codes reflecting thoracic branch endograft services and lower extremity vascular procedures appear under radiology-related surgical coding, tying into the significant vascular revascularization restructuring happening in the Surgery section. Bristol Healthcare Services Inc.
Category III codes continue to capture emerging technologies relevant to radiology, such as high-intensity focused ultrasound (HIFU), hemodynamic IVC monitoring, and laser ablation of breast tumors, recognizing these as evolving technologies and enabling early use and tracking prior to possible Category I adoption. American College of Radiology+1
4. Deleted and Revised Radiology Codes
Nine older radiology codes have been deleted in 2026. Among these:
Legacy CT cerebral perfusion Category III code is removed in favor of new Category I reporting. Bristol Healthcare Services Inc.
Some obsolete imaging guidance or support codes are retired due to bundling into newer procedures. Bristol Healthcare Services Inc.
Additionally, three radiology codes receive descriptor revisions to clarify imaging guidance inclusion or service definitions. Hiacode
5. What This Means for Coding and Documentation
Documentation Requirements
Coders must prepare for:
Clear documentation of imaging modality, contrast use, and anatomical coverage for CTA and CTP coding.
Specific organ and imaging guidance details for procedures like IRE ablation and advanced biopsies.
Understanding how radiation oncology delivery levels are determined by treatment complexity and guidance. Bristol Healthcare Services Inc.
System and Workflow Changes
Encoder tools and charge masters must be updated with the new codes and deletions prior to January 1, 2026.
Clinical templates should prompt for the key elements (e.g., imaging guidance, organ site, lesion specifics) that support the new CPT structure. American College of Radiology
6. Final Thoughts
The Radiology Section updates in 2026 enhance the specificity and clinical relevance of CPT reporting for modern imaging and interventional services. These changes promote alignment with evidence-based practice, support accurate reimbursement, and encourage detailed documentation that reflects the true complexity and value of radiologic services.Â
