Pathology/Lab Coding Alert

"The new national coverage decisions will impact reimbursement for 65 CPT Codes , which account for approximately 60 percent of laboratory claims, according to the negotiated rulemaking committee that authored the rule," says Laurie Castillo, MA, CPC, CPC-H, CCS-P, member of the national advisory board of the American Academy of Professional Coders (AAPC) and president of Physician Coding and Compliance Consulting in Manassas, Va. The committee which included representatives from CMS and 18 other organizations whose interests may be affected by the rule acted in response to a federal government mandate under the Balanced Budget Act of 1997. The title of each of the 23 policies and the affected CPT codes are listed below:   Urine Bacterial Culture 87086, 87088, 87184, 87186 Human Immunodeficiency Virus Testing (Prognosis and Monitoring) 87536, 87539 Human Immunodeficiency Virus Testing (Diagnosis) 86689, 86701, 86702, 86703, 87390, 87391, 87534, 87535, 87537, 87538 Blood Counts (CBC) 85007, 85008, 85013, 85014, 85018, 85021, 85022, 85023, 85024, 85027, 85031, 85048, 85590, 85595 Partial Thromboplastin Time (PTT) 85730 Prothrombin Time (PT) 85610 Serum Iron Studies 82728, 83540, 83550, 84466 Collagen Crosslinks 82523 Blood Glucose Testing 82947, 82948, 82962 Glycated Hemoglobin/Glycated Protein 82985, 83036 Thyroid Testing 84436, 84439, 84443, 84479 Lipids 80061, 82465, 83715, 83716, 83718, 83721,84478 Digoxin Therapeutic Drug Assay 80162 Alpha-fetoprotein (Afp) 82105 Carcinoembryonic Antigen (CEA) 82378 Human Chorionic Gonadotropin (hCG) 84702 Tumor Antigen by Immunoassay for CA 125 86304 Tumor Antigen by Immunoassay for CA 15-3/CA 27.29 86300 Tumor Antigen by Immunoassay for CA 19-9 86301 Prostate Specific Antigen (Total PSA) 84153 Gamma Glutamyltransferase (GGT) 82977 Hepatitis Panel 80074 Fecal Occult Blood 82270.