Pathology/Lab Coding Alert

Question: A physician ordered an HCV RNA PCR test and HCV RNA quantification. In addition to the codes for the tests, can we report the molecular-diagnostics interpretation with 83912? If so, should we report CPT 83912 for each test or only once for interpreting both tests?

Missouri Subscriber
Answer: You should not report 83912 (Molecular diagnostics; interpretation and report) for the interpretation of infectious agent antigen detection tests, even though they employ some molecular diagnostics techniques.
 
Code 83912 is part of a family of codes (83890-83912) used for analysis of nucleic acids, usually to diagnose genetic disorders. Each of these codes describes a separate technique such as nucleic acid extraction (83890 or 83891), gel electrophoresis (83894), gene amplification (83898), etc. The pathologist then interprets the entire series of tests to further define the diagnosis. Use 83912 to describe the interpretation and report on the entire series of tests, not on each individual step.
 
The tests you inquired about, however, are comprehensive tests that include multiple steps to manipulate nucleic acids, as well as the final interpretation of those tests. You should not report each step of a hepatitis C virus RNA polymerase chain reaction (HCV RNA PCR) test using the molecular diagnostics codes. Rather, you should report the single code 87521 (Infectious agent antigen detection by nucleic acid [DNA or RNA]; hepatitis C, amplified probe technique), which includes each step such as nucleic acid isolation and amplification by PCR, as well as the interpretation of the test results. Similarly, for the HCV RNA quantification, report 87522 (...; hepatitis C, quantification).
 
Do not report the molecular diagnostics interpretation code (83912) with either 87521 or 87522. In fact, the National Correct Coding Initiative edits bundle these codes with 83912 because 87521 and 87522 are comprehensive codes that include the interpretation.