Pathology/Lab Coding Alert

Although most of the CPT Codes 2003 changes that affect laboratories and pathology practices clarify procedures you already perform, you should refamiliarize yourself with the altered codes to ensure proper coding.

"Most of the new lab codes this year do not involve novel or unique technologies," says Stephen N. Bauer, MD, FCAP, the College of American Pathologist's (CAP) representative to the AMA's CPT Advisory committee.

Although only hematology, cervical cytology and stem cell services encompass significant modifications, you need to know how other changes might impact your lab. The modified codes go into effect Jan. 1, 2003, for Medicare, although some carriers and third-party payers may take longer to implement them.

"Even if your insurers allow a three-month grace period before requiring these codes, you should not wait until April 1 to learn how to use them," says Laurie Castillo, MA, CPC, CPC-H, CCS-P, member of the National Advisory Board of the American Academy of Professional Coders and president of Physician Coding and Compliance Consulting in Virginia.

(See "CPT 2003 Overhauls Hematology Codes" in this issue for a complete discussion of blood service code changes, and upcoming issues of Pathology/Lab Coding Alert for analysis of stem cell and cervical cytology changes.) Use New Codes for Specific Reporting "With few new procedures, most codes added in CPT 2003 either replace or expand on existing codes for a similar service," Castillo says.

CPT 2003 adds two new codes for specific direct fluorescent antibody (DFA) tests, replacing two codes for the same procedures that were added just last year. "The two codes added last year, 87198 (Cytomegalovirus, direct fluorescent antibody [DFA]) and 87199 (Enterovirus, direct fluorescent antibody [DFA]), were really just in the wrong place," Castillo says. The codes were listed in microbiology as stand-alone codes in CPT 2002, but the 2003 version deletes the old codes and moves the tests to the family of codes for infectious agent antigen detection by immunofluorescent technique ... (87260-87300). You should now report these specific DFA tests with the following new codes:   87267 Infectious agent antigen detection by immunofluorescent technique; Enterovirus, direct fluorescent antibody (DFA)     87271 ... Cytomegalovirus, direct fluorescent antibody (DFA).   Another new microbiology code is 87255 (Virus isolation; including identification by non-immunologic method, other than by cytopathic effect [e.g., virus specific enzymatic activity). "This code reports virus isolation by methods other than immunofluorescence stain, which is described by the preceding code (87254)," Castillo says.

Two new chemistry codes in CPT 2003 allow more specific coding. For example, you should report a B-Natriuretic peptide test, which may [...]