A: Category III codes are temporary codes for emerging technologies, services, and procedures. They are used to track utilization and collect data to support eventual conversion to a permanent Category I code (standard reimbursement). Since unlisted codes cannot track specific data, the AMA requires providers to use Category III codes whenever possible. 

A: Because CPT code X529T (effective July 1, 2026) is a new Category III tracking code, it does not yet have a nationally established Relative Value Unit (RVU) or fee schedule. While not guaranteed, the existence of the code allows you to negotiate with payers and submit claims for the distinct service provided. Instead, payers will determine reimbursement amounts through Individual Consideration—a process where payment is assessed on a claim-by-claim basis rather than a fixed rate. To secure appropriate payment, clinicians and billing teams must proactively "build the case" for the service's value in each claim. Submitting robust documentation that details the physician’s time and the high cognitive complexity of interpreting connectomic data can be helpful, as can "cross-walking" the service to comparable established codes (such as functional mapping) to provide a pricing benchmark. Additionally, providing invoices for the technical costs of the Quicktome® platform may help justify the expense to payers.

Feel free to use this draft Letter of Medical Necessity template as a starting point for your Individual Consideration. 

A: Yes, X529T is for the analysis of previously performed MRI and can be reported separately from the imaging. However, it should not be reported in conjunction with certain codes like 70551-70553 or 76376/76377 on the same date of service for the same purpose. Consult the CPT® Manual for specifics.

A: CPT X529T will be effective July 1, 2026.