Don’t Overlook Obstetric Panel Alternative
CPT® 2016 introduced a new obstetric panel code, 80081 Obstetric panel (includes HIV testing), which is identical to the long-standing obstetric panel 80055 Obstetric panel, with one exception: The newer code includes HIV testing.
Required components for both codes include:
- Blood count, complete (CBC), and automated differential WBC count (85025 or 85027 and 85004)
- Blood count, complete (CBC), automated (85027) and appropriate manual differential WBC count (85007 or 85009)
- Hepatitis B surface antigen (HBsAg) (87340)
- Antibody, rubella (86762)
- Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART) (86592)
- Antibody screen, RBC, each serum technique (86850)
- Blood typing, ABO (86900)
- Blood typing, Rh (D) (86901)
To these tests, 80081 adds HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies, single result (87389). CPT® also specifically instructs, “When syphilis screening is performed using a treponemal antibody approach , do not use 80081. Use the individual codes for the tests performed in the obstetric panel.”
Remember: When reporting a panel code, each test listed in the panel description must be performed. If any single test defined as part of a panel is not performed, seek out a different panel code (e.g., If an obstetric panel is performed without an HIV test and all other tests are performed, continue to report 80055). If no panel code properly describes the tests performed, report the code(s) to describe the individual tests performed, rather than the panel code.
You may not report two or more panel codes including the same tests (for instance, you would never report 80081 and 80055 together); however, you may report test(s) performed in addition to panel components. The American Medical Association’s (AMA) CPT® Changes 2016: An Insider’s Guide is careful to note, “The panel components are not intended to limit performance of other tests. If tests are performed in addition to the tests listed for a panel, the additional tests are reported separately in addition to the panel code.” This instruction is supported by guidelines within the CPT® codebook.
Raemarie Jimenez, CPC, CPB, CPMA, CPPM, CPC-I, CANPC, CRHC, CCS, is vice president, AAPC Member and Certification Development.
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