Pathology/Lab Coding Alert

  CCI limits some -- but not all -- molecular diagnostics The upside to the latest molecular diagnostics/array edits is not what CCI bundles -- but what it doesn-t. Leaving molecular diagnostic preparation codes (83890-83892, 83898-83901) out of the equation clarifies that you can report these services in addition to the appropriate array code (88384-88386). The Correct Coding Initiative (CCI), version 13.2, is effective July 1. You can view the edits on the Internet at www.cms.hhs.gov/NationalCorrectCodiNitEd/01_overview.asp. Method Makes Array The latest CCI edits clarify coding among various code families that describe molecular techniques by introducing 69 new edit pairs involving the following array codes: - 88384 -- Array-based evaluation of multiple molecular probes; 11 through 50 probes - 88385 -- - 51 through 250 probes - 88386 -- - 251 through 500 probes. CCI pairs each of these codes with each other and with each of the codes from molecular cytogenetics (88271-88275), in situ hybridization (ISH, 88365-88368) and many molecular diagnostics codes (83893-83897 and 83902-83914). What's similar: All of these tests use nucleic acid probes -- small segments of DNA or RNA flagged with a marker such as a fluorescent dye -- that the lab can use to identify patient protein or genetic material to help characterize disease. What's different: Arrays, commonly called "gene chips," are devices that can hold many genetic probes in specific positions on a solid surface. "Array technology involves nucleic acid probes or DNA sequences imbedded in a platform such as a slide, chip or microbeads," says Diana Voorhees, MA, CLS, MT(ASCP)SH, CLCP, principal with DV and Associates Inc. in Salt Lake City. "Microarrays" might pack thousands of probes on a tiny chip, but an array can also be as few as 12 probes fixed on a slide. You-ll recognize when your lab is using an array because it is generally a commercial product that a lab purchases and uses to analyze a given specimen. You-ll just use one code to report the entire analysis and interpretation involving many probes. For instance: If the pathologist interprets a test that has 44 probes as part of an array device that the lab purchases and uses, you should report 88384 for the test. You should document your code selection by stating that the lab used an array-based evaluation. Although arrays often involve large numbers of probes, the method, not the number of probes, is the key to code selection, Voorhees says. In contrast: Molecular diagnostics codes describe each step of the process that the lab performs, so you-ll report multiple codes for a single analysis and interpretation. For instance, if the lab analyzes the same 44 specific nucleic acid probes as the preceding example but not using [...]