Pathology/Lab Coding Alert

Question: When we perform an unlisted procedure such as a CPAS urinalysis, how should we code it? Should we list a CPT code that describes a similar procedure, such as 81005 so that we get paid?

Utah Subscriber

Answer: No, you should not bill a CPT code for a "similar" procedure if you-re performing a service that does not have a specific CPT or HCPCS Level II code. In three- to five-digit numeric codes, ICD-10 uses the following format:

- The codes begin with an alpha character (A to Z)

- A category code has three characters in the format alpha, numeric, numeric (such as A10)

- Subcategories have four or five characters, made by placing a digit or two digits after a decimal (such as A79.8 or H15.81)

- Codes may include an "x" as a dummy fifth-character place holder for some six-character codes to permit future expansion (such as T37.0x1)

- Codes may have a seventh-character extension that is an alpha character (such as S52.001A).

Learn more: CMS intends to host a series of conference calls including Q&A sessions which will cover the ways in which ICD-10 will differ from the current ICD-9 system.

If you are puzzled by the differences in code lengths or other disparities between the current method and ICD-10, tune into the calls on Nov. 12 (for non-hospital Part A and Part B providers), or Nov. 17 (for physicians). Or you can simply check out CMS- PowerPoint presentation on the topic. You can access both online at http://www.cms.hhs.gov/ICD10.

Tip: Let our experts ground you with some solid information in the upcoming teleconference, "ICD-10 Preparation: What You Need to Know NOW," available on the Internet at http://www.audioeducator.com/industry_conference.php?id=1304.