Seek Knowledge Security in a Time of 2026 Economic Turbulence
A storm of economic uncertainty is looming over 2026, and you can’t afford to navigate the changes without professional guidance. With sweeping coding changes, the most significant in years, professionals who walk into 2026 without expert insight will face a rising flood of new challenges that may sink reimbursement.. More accurate IR coding and reimbursement starts with an improved understanding of how IR procedures are performed.
We built Essentials of Interventional Radiology Coding on a simple but profound premise: that better IR coding starts with a strengthened understanding of how IR procedures are performed and how to pinpoint those key phrases in physician documentation.
With the multitude of changes for 2026, coders face major mounting challenges:
- In a landmark decision, lower extremity revascularization has been completely restructured, expanding from 15 codes to 46 new codes with revised definitions of complexity and vascular territory.
- CTA Head & Neck will see a consolidation into a bundled code, while CT cerebral perfusion (0042T) is retired and replaced by new Category I code(s).
- Ablation procedures now include new codes for irreversible electroporation (IRE) of liver and prostate tumors.
- Thoracic endografts (TEVAR) procedures have new and revised codes for aneurysm and branch endografts.
- Embolization codes are revised and bundled, particularly for head/neck and CNS procedures.
- Pain management overlap adds new Category I codes for PILD (percutaneous lumbar decompression) and genicular nerve ablation.
On top of these CPT shifts, regulatory and payment updates add new complexity: efficiency adjustments cut reimbursement for many non-time-based services, practice expense changes shift the economics of office vs hospital coding, and virtual direct supervision may become permanent.
This fully updated edition provides in-depth explanations of the “why” behind correct CPT®/HCPCS code assignments, plus valuable guidance for navigating physician documentation in all its variations. Whether you’re a new coder or a seasoned professional, this book is a go-to resource for mastering IR coding in 2026.
2026 Features and Benefits
Clearly and concisely, our IR coding experts cover many essential concepts, such as:
- Step by step through all 2026 additions, deletions, and revisions for reporting IR procedures
- Descriptions of IR procedures — diagnostic exams, therapeutic interventions, vascular angiography, and interventions — including subtle distinctions that make or break correct reporting
- Corresponding CPT®/HCPCS code descriptions and coding guidelines for each procedure, for both hospital (technical) and physician (professional) entities
- Explanations of add-on, radiological S&I, and imaging guidance codes, with guidelines for use
- Critical documentation elements that drive correct code selection, especially with new bundled code structures
- Guidance with IR coding concepts: component, hybrid, bundled, arterial, venous, selective, non-selective, and order of selectivity
- Overviews of must-know topics: diagnostic vs. therapeutic procedures, physician vs. hospital coding, Medicare payments, CPT® basics, and more
- Updated billing tips and expanded guidance for common problem areas
- Case examples applying the new 2026 CPT code sets to real-world scenarios
A Proven Learning and Quick-Reference Tool
- Organized by nonvascular and vascular IR, and then by body system and procedure type
- Anatomical illustrations visually translate procedures and CPT® assignments
- Full dictated reports with highlighted documentation key phrases at the end of each chapter
Looking for more valuable coding education and news? Check out our Interventional Radiology All-Access Pass and/or our Comprehensive Radiology All-Access Pass for a full range of comprehensive educational resources that reinforce reimbursement and your bottom line.
CPT® is a registered trademark of the American Medical Association.
*All-Access Pass subscribers receive 30% off the print version of the books included with their membership. This 30% does not include AMA fees or shipping and handling fees. For questions please email us.
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Introduction
Abbreviations
Modifiers
A Note About COVID-19
- Additional Supplies During the Public Health Emergency
The Basics
- Diagnostic vs. Therapeutic
- Global, Technical, and Professional
- Hospital vs. Physician Coding
- Physician / Other Qualified Healthcare Provider
- Guidance
- Moderate (Conscious) Sedation
- Coverage
- Evaluation and Management for Interventional Radiology
- Global Surgical Period
- 3D Printing
Part 1: NON-VASCULAR INTERVENTIONAL RADIOLOGY
Biopsy
Guidance
Aspiration Biopsy
Non-Aspiration Needle Biopsy
Breast Biopsy
Breast Localization Without Biopsy
Post-Procedure Mammogram
Specimen Radiograph
Soft Tissue Marker
Sample Cases: Biopsy
- Case 1: Ultrasound-Guided Fine Needle Aspiration Right Neck Lymph Node
- Case 2: Ultrasound Breast Biopsy Left
Drainage
Cyst Aspiration
Joint Aspiration
Catheter-Assisted Drainage
Pleural Aspiration / Drainage
Abdominal Aspiration / Drainage
- Paracentesis
- Tunneled Intraperitoneal Catheter
- Cholecystostomy Tube Placement
Drainage Catheter Check and Change
Sclerosis
Other Aspiration / Drainage
Sample Cases: Drainage
- Case 1: Fluoroscopic and Ultrasound-Guided Placement of a Suprapubic Catheter (14-French Pigtail)
- Case 2: Thoracentesis
- Case 3: CT-Guided Pelvic Abscess Drainage
- Case 4: Ultrasound-Guided Right Thoracentesis, Ultrasound and Fluoroscopic-Guided Right Perinephric Drain Placement
Ablation / Destruction
Tumor Ablation
Ablation — Electroporation
Ablation Guidance Codes
Nerve Destruction
Cyst Ablation
Sample Cases: Ablation
- Case 1: Pulmonary RFA
- Case 2: Renal Cyst Aspiration and Sclerosis
Pain Management Injections
Spinal Injections
- Epidural Injections
- Facet Joint Injections
- Thoracic Paravertebral Block
- Sacroiliac Joint Injection
- Blood Patch
Other Pain Management Injections
Sample Cases: Pain Management
- Case 1: Ultrasound-Guided Injection of the Posterior Knee
- Case 2: Synovial Cyst Aspiration and Facet Injection
Spinal Procedures
Lumbar Puncture
Myelography
Discography
Vertebroplasty, Vertebral Augmentation, and Sacroplasty
Lumbar Spine Allogeneic Injection
Sample Cases: Spinal Procedures
- Case 1: Diagnostic Lumbar Puncture and Intrathecal Methotrexate Injection
- Case 2: Vertebroplasty
Joint Procedures
Arthrography
- Shoulder
- Elbow
- Wrist
- Hip
- Knee
- Ankle
- Sacroiliac Joint
- CT/MR Arthrography
Aspiration, Arthrocentesis, Injection
Sample Cases: Joint Procedures
- Case 1: Shoulder MRI Arthrogram
- Case 2: Wrist Injection
- Case 3: Joint Injection and Aspiration
Digestive System, Biliary System and General Abdominal Procedures
Salivary Glands
Esophagus
Stomach
Colon and Rectum
Liver
Biliary Tract
Pancreas
General Abdomen / Peritoneum
- Drainage
- Biopsy
- Fiducial Markers
- Peritoneal Cavity Evaluation and Catheters
- Gastrostomy, Duodenostomy, Jejunostomy, Cecostomy and Other Colonic Tubes
Sample Cases: Digestive System, Biliary System, and General Abdominal Procedures
- Case 1: Cholangiogram, Biopsy, and Biliary Drainage
- Case 2: Cholangiogram with Stone Removal
- Case 3: Tunneled Peritoneal Catheter
Urinary System
Diagnostic Studies
Therapeutic Procedures
Sample Cases: Urinary System
- Case 1: Loopogram
- Case 2: Exchange of Nephroureteral Stent
- Case 3: Brush Biopsy and Ureteral Stent Placement
Part 2: VASCULAR INTERVENTIONAL RADIOLOGY
Vascular Interventional Radiology
Venous Access
Venipuncture
Central Venous Access
Placement
- Centrally Inserted
- Peripherally Inserted
- Repair
- Replacement
- Removal
- Guidance
- Other CVA Catheter/Device Procedures
Miscellaneous Venous Catheterization Procedures
Sample Cases: Venous Access
- Case 1: Temporary Dialysis Catheter Placement
- Case 2: Tunneled Catheter and PICC Line
- Case 3: Tunneled Dialysis Catheter (TDC) Removal
Treatment of Lower Extremity Incompetent Veins
Sample Case: Incompetent Veins
Diagnostic Angiography
Vascular Angiography Basics
Component Codes – Vascular Angiography
Catheterization
- Venous Non-selective Codes
- Venous Selective Codes
- Arterial Non-selective Codes
- Arterial Selective Codes
Diagnostic Imaging
- Venous S&I Codes
- Arterial S&I Codes
- Pulmonary S&I Codes
- Guidance
Sample Cases: Component Coding
- Case 1: Abdominal Aortogram with Bilateral Lower Extremities
- Case 2: Right Upper Extremity Angiogram
Complete Diagnostic Angiography
- Renal Angiography
- Carotid and Vertebral Diagnostic Angiography
- Arch, Carotid, and Vertebral Angiography
Sample Cases: Complete Angiography
- Case 1: Carotid/Vertebral Angiogram
- Case 2: Bilateral and Accessory Renal Artery Angiograms
Vascular Interventions
Angioplasty
Stent Placement
Atherectomy
Thrombolysis
Mechanical Thrombectomy
Embolization
Lower Extremity Revascularization
- Intravascular Lithotripsy
- Endovenous Femoral-Popliteal Arterial Revascularization
- Endovascular Venous Arterialization
Sample Cases: Vascular Interventions
- Case 1: Right Subclavian Angiogram and Stent
- Case 2: Aortic and Bilateral Iliac Artery Stenting
- Case 3: Popliteal Artery Stent
- Case 4: Visceral Embolization
Carotid / Vertebral Interventions
- Angioplasty and Stent Placement
- Intracranial Mechanical Thrombectomy / Thrombolysis
- Non-Thrombolytic Agent Administration
- Occlusion / Embolization
Sample Cases: Vascular Interventions
- Case 1: Carotid Arteriogram and Intervention
- Case 2: Carotid Embolization
Thoracic, Abdominal, and Iliac Stent Grafts
- EVAR—Abdominal Aortic Aneurysm (AAA) Stent-Grafts (Non-fenestrated)
- FEVAR—Fenestrated Endovascular Repair of the Visceral and Infrarenal Aorta
- TEVAR—Thoracic Endovascular Aneursym Repair
Sample Case: Endovascular Stent Graft
Arteriovenous Dialysis Graft Angiography and Intervention
- Percutaneous Creation of Arterivenous Fistula
Sample Case: Arteriovenous Grafts
Miscellaneous Vascular Interventions
- Vena Cava Filter
- Intravascular Foreign Body Removal
- Transcatheter Biopsy
- Transvenous Intrahepatic Portosystemic Shunts (TIPS)
- Thrombin Injection
- Transcatheter Ultrasound Ablation of Pulmonary Artery Nerves
- Y-90 Radioembolization
- Intravascular Ultrasound (IVUS)
Sample Cases: Miscellaneous
- Case 1: Transjugular Biopsy
- Case 2: IVC Filter Placement
