Laboratory and Pathology Sees New Year Changes

Wondering what CPT® 2010 holds in store for laboratory and pathology coding? “From chemistry to surgical pathology, you’ll find new codes in CPT 2010 that you need to know,” Peggy Slagle, CPC, billing compliance coordinator at the University of Nebraska Medical Center in Omaha recently told Pathology/Lab Coding Alert. Fifteen to be precise.

In the Chemistry subsection, look for three new codes and one revised code that will allow for more accurate test reporting.

CPT® 2010 adds new Chemistry codes:

  • 83987 pH; exhaled breath condensate;
  • 84145 Procalcitonin (PCT); and
  • 84431 Thromboxane metabolite(s), including thromboxane if performed, urine.

Also for 2010, the description for pH code 83986 has been revised, replacing “except blood” for “not otherwise specified.”

In the Immunology subsection of CPT® 2010, you’ll find three new codes that will also allow more specificity when reporting certain tests.

The new Immunology codes are:

  • 86305 Human epididymis protein 4 (HE4);
  • 86352 Cellular function assay involving stimulation (eg. mitogen or antigen) and detection of biomarker (eg, ATP); and
  • 86780 Antibody; Treponema pallidum.

Beginning Jan. 1, for example, you can use 86305 for HE4 rather than generic code 86316 Immunoassay for tumor antigen, other antigen, quantitative (eg, CA 50, 72-4, 549], each, advises William Dettwyler, MTAMT, president of Codus Medicus in Salem, Ore.

In the Tissue Typing subsection, you’ll find two new codes effective Jan. 1, 2010 that describe newer types of crossmatching tests.

The new Tissue Typing codes are:

  • 86825 Human leukocyte antigen (HLA) crossmatch, noncytotoxic (eg, using flow cytometry); first serum sample or dilution; and
  • 86826 Human leukocyte antigen (HLA) crossmatch, noncytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (List separately in addition to primary procedure).

The Surgical Pathology subsection in CPT® 2010 also sees two, fresh new codes. Capture your lab work using the following codes for ancillary study tissue preparation:

  • 88387 Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies); each tissue preparation (eg, a single lymph node); and
  • 88388 Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies) each tissue preparation (eg, a single lymph node); in conjunction with a touch imprint, intraoperative consultation, or frozen section, each tissue preparation (eg, a single lymph node) (List separately in addition to code for primary procedure).

Other new additions to the Laboratory and Pathology section include Microbiology codes 87150 Culture typing; identification by nucleic acid (DNA or RNA) probe, direct probe technique, per culture or isolate, each organism probed; 87153 Culture typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16S rRNA gene); and 87493 Clostridium difficile, toxin gene(s), amplified probe technique.

Lastly, you’ll find new code 88738  Hemoglobin (Hgb), quantitative, transcutaneous in the In Vivo (eg, Transcutaneous) Laboratory Procedures section; and 89398 Unlisted reproductive medicine laboratory procedure in the Reproductive Medicine Procedures section.

 Guidelines Change, Too

The introductory language in the Organ or Disease-Oriented Panels subsection of the Pathology and Laboratory section was also revised to clarify that users should not report multiple panel codes that include any of the same constituent analytes performed from the same patient collection. In accordance with this change, the parenthetical notes following panel codes 80047, 80053, and 80076 were deleted; and in the guidelines, the term “analytes” was changed to “tests,” and the phrase “(eg, do not report 80047 in conjunction with 80053)” was added. All references to code 82310 found in the panel codes were corrected to state, “Calcium, total.” One final change of which you should be aware: Code 80055 now includes a cross reference note to clarify that when syphilis screening is performed using a treponemal antibody approach (86780), code 80055 Obstetric panel should not be assigned.

Sources: Coding News, ACOG

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