What is the biggest change with the new lower extremity revascularization coding set in 2026?
According to subject matter expert Laura Manser, CPC, CPCO, CDEO, CPMA, CEMC, CIRCC, RCC, “The biggest change is the expansion to four vascular territories with the addition of the inframalleolar territory, which recognizes that work below the ankle is distinct and often more complex. The new add-on code structure creates a clearer hierarchy that differentiates between simple lesions (stenosis) and complex lesions (100% occlusion), allowing practices to accurately capture the additional work involved in total occlusions. Lithotripsy now has dedicated add-on CPT® codes, which is significant because this technology is being used more frequently for calcified lesions and previously couldn’t be properly reported. Finally, there’s clearer modifier guidance for bilateral procedures, which eliminates previous ambiguity about how to report work done on both legs. Overall, the new structure is more granular, better reflects modern endovascular techniques, and provides a logical framework that should reduce confusion once people get over the learning curve.”
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