Pathology/Lab Coding Alert

CPT 2002 contains several changes for pathology/laboratory coding . The section includes 11 new, 15 revised and six deleted codes, as well as some changes to the narrative instructions. The modified codes go into effect Jan. 1, 2002, for Medicare, although some carriers and third-party payers may take longer to implement them. "Although some insurers allow a three-month grace period before requiring their use, coders should not wait until April 1 to learn how to use these codes," says Laurie Castillo, MA, CPC, CPC-H, CCS-P, member National Advisory Board of the American Academy of Professional Coders and president of Physician Coding and Compliance Consulting in Virginia.
Codes Moved for Consistency
"Probably one of the biggest changes for anatomic pathology involves removing four codes from pathology and placing them in the surgery section of CPT," reports R.M. Stainton, MD, president of Doctor's Anatomic Pathology in Jonesboro, Ark. The services involve bone marrow aspiration or biopsy and fine needle aspiration (FNA).
 
Although the codes have been moved to the surgery section, pathologists will still report these services, using the new codes, if they perform the procedure. In the introductory "Instructions for Use of CPT," the AMA states: "It is important to recognize that the listing of a service or procedure and its code number in a specific section of this book does not restrict its use to a specific specialty group. Any procedure or service in any section may be used to designate the services rendered by any qualified physician or healthcare professional."
 
"The reason these services were moved to the surgery section is that they were more consistent with surgical procedure, whether it is conducted by a surgeon, pathologist or radiologist. The interpretation of the aspirate or biopsy is still reported with the appropriate code from the pathology section," Stainton says.
 
The following code deletions, additions and changes involve the new codes for FNA and bone marrow sampling. The new codes and their definitions appear in bold type:
  85095 has been deleted. To report, use 38220.
38220 bone marrow aspiration. This code has a similar definition as deleted code 85095, which read bone marrow; aspiration only.

The text of the following two notes were changed to include 38220:
  85100 has been deleted. To report, use 38220 and 85097.
85101 has been deleted. For aspiration, use 38220.

Other revised changes to bone marrow codes include the following:
  85097 bone marrow, smear interpretation. This code is revised from the old definition, which read bone marrow; smear interpretation only, with or without differential cell count.