The CPT code for Human papillomavirus (HPV) has changed from to This code (87624) covers testing for HPV High Risk genotypes.

Size: px

Start display at page:

Download "The CPT code for Human papillomavirus (HPV) has changed from 87621 to 87624. This code (87624) covers testing for HPV High Risk genotypes."

Raymond Chandler
8 years ago
Views:

1 January CPT Code Updates Dear Client: The American Medical Association (AMA) publishes the Current Procedural Terminology (CPT) Coding Manual on an annual basis. For 2015, the AMA made several changes to the Pathology and Laboratory code section of the CPT manual, including 107 new codes, 47 deleted codes, and 32 revised codes. We have highlighted some important changes below. Toxicology Changes: The AMA added a section entitled Drug Assay that contains 63 new CPT codes ( ). The codes in the current 2014 Drug Testing section ( ) have been deleted. The 2015 revised codes allow for additional specificity in differentiating the type of specimen being tested. The drug procedures are now divided into the following subsections: Drug Assay Therapeutic Drug Assays Chemistry Under Drug Assay, presumptive procedures are used to identify possible use or non-use of a drug or drug class and may be followed by a definitive test to specifically identify drugs or metabolites. Definitive drug testing may be quantitative or qualitative and does not require prior presumptive testing. Therapeutic Drug Assays are performed to monitor clinical response to a known, prescribed medication. Microbiology Changes: The CPT code for Human papillomavirus (HPV) has changed from to This code (87624) covers testing for HPV High Risk genotypes. Pathology Changes: Immunohistochemistry (IHC) and In-situ Hybridization (ISH) code descriptors, the unit of service (UOS), has changed to per specimen rather than per block for each primary code. Each primary code will also read initial single antibody procedure for IHC and initial single probe stain procedure for ISH CPT Code Changes (01/2015) Page 1

We have highlighted some important changes below. Toxicology Changes: The AMA added a section entitled Drug Assay that contains 63 new CPT codes (80300-80377).

2 Additional 2015 changes include the following additions: New IHC add-on code for each additional antibody stain procedure New ISH add-on code for each additional single-probe procedure New IHC and ISH codes for reporting of multiplex probe stain procedures This summary of CPT code changes provides general guidelines based on the AMA s 2015 CPT Code Manual. Always confirm with the applicable payer to insure appropriate CPT code(s) are used in each case, as the billing party is responsible for its CPT coding. We hope you find this information beneficial to your office staff. Please contact our Client Services department toll-free at (888) or (414) should you have questions. Thank you for selecting as your laboratory services provider. Sincerely, 2015 CPT Code Changes (01/2015) Page 2

Always confirm with the applicable payer to insure appropriate CPT code(s) are used in each case, as the billing party is responsible for its CPT coding.

3 Attachment I 2015 CPTs in BOLD The CPT Codes listed are in accordance with the current edition of Current Procedural Terminology, a publication of the American Medical Association. CPT codes are provided for the convenience of our clients; however, correct coding often varies from one carrier to another. Consequently, the codes presented here are intended as general guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case. Molecular Pathology Changes Prostate Cancer Gene 3 (PCA3) Immunohistochemistry (IHC) changes *The number of units billed is dependent on the specific multiplex test that is performed. Initial single IHC antibody stain procedure, per specimen Each additional IHC antibody stain on a single specimen Each IHC multiplex antibody stain procedure (i.e., multiplex 88342, antibody stain procedure) 88343* Morphometric analysis, tumor immunohistochemistry, quantitative or semiquantitative, each single antibody stain, manual, per specimen Morphometric analysis, tumor immunohistochemistry, quantitative or semiquantitative, each single antibody stain, computer-assisted technology, per specimen In Situ Hybridization (ISH) changes *The number of units billed is dependent on the specific multiplex test that is performed. In situ hybridization, initial single probe, per specimen Each additional single probe stain procedure Each multiplex probe stain procedure, per specimen (i.e., multiplex probe stain procedure) * Morphometric analysis, in situ hybridization, quantitative or semiquantitative, initial single probe stain procedure, manual, per specimen Each additional single probe stain procedure, per specimen Each separately identifiable probe applied to the same specimen (i.e., multiplex probe stain procedure) * 2015 CPT Code Changes (01/2015) Page 3

Consequently, the codes presented here are intended as general guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

4 Microbiology Human Papillomavirus (HPV) high-risk with 16/18 genotype (includes: HPVAUTO, HPV ASCUS, and HPV ABOVE, as well as testing on rectal or tissue sources) Toxicology Acetaminophen, Quantitative Salicylate Valproic Acid, Free Amphetamines, Urine Barbiturates, Urine Barbiturate Rapid Screen Benzodiazepines, Urine Benzodiazepine Rapid Screen Cannabinoids, Urine Cocaine/Benzoylecgonine, Urine Ethanol, Urine Ethanol, Serum Methadone, Urine Methaqualone, Urine Opiates, Urine Oxycodone/Oxymorphone, Urine PCP, Urine Propoxyphene, Urine Tricyclic Rapid Screen, Serum Methanol Quantitative, Serum Acetone/Isopropanol, Quantitative, Serum Volatile Screen, Serum Ethylene Glycol, Quantitative, Serum Nicotine and metabolite, Quantitative, Serum Fentanyl, Quantitative, Urine Oxycodone, Quantitative, Urine Hydrocodone, Quantitative, Urine Methadone, Quantitative, Urine Tramadol, Quantitative, Urine Opiates, Quantitative, Urine , 80365, 80361, 80358, CPT Code Changes (01/2015) Page 4

80101 80301 8000549 Barbiturate Rapid Screen 80100 80301 8002065 Benzodiazepines, Urine 80101 80301 8000559 Benzodiazepine Rapid Screen 80100 80301 8000659 Cannabinoids, Urine 80101 80301 8000669

5 Toxicology Alprazolam (Xanax) Amiodarone Amitriptyline/Nortriptyline Amphetamine Confirmation Urine Barbiturate Confirmation Urine Benzodiazepine Confirmation Urine Buprenorphine Confirmation Urine Buprenorphine Urine Busulfan Cannabinoid Confirmation Urine Carbamazepine Epoxide Chlorpromazine Clomipramine Clonazepam Cocaine Benzoylecgonine Quant Urine Cocaine Meconium Cocaine Metabolite Confirmation Desipramine Dexamethasone Level Diazepam ((Valium) Diuretic Screen Urine Doxepin (Sinequan) Drug Investigation Urine Ethyl Glucuronide Urine Felbamate Fentanyl Confirmation Urine Fentanyl Screen and Confirmation Urine Flecainide Fluoxetine Gold Hydrocodone (Vicodin) Imipramine/Desipramine Lorazepam MDMA (Ecstasy) Qualitative Urine MDMA + Metabolites Confirmation Urine Mephobarbital Mephobarbital (Mebaral) 80184, 80184, Methadone Methadone Confirmation Urine Methsuximide CPT Code Changes (01/2015) Page 5

82491 80299 3551420 Cannabinoid Confirmation Urine 82542 80349 3508010 Carbamazepine 10-11 Epoxide 82542 80339 3507560 Chlorpromazine 84022 80342 3057570 Clomipramine 82542 80335 3507580 Clonazepam

6 Toxicology Morphine Nicotine Metabolite Urine Nortriptyline Olanzapine (Zyprexa) Opiate Confirmation Urine Opiate Meconium Oxazepam Oxycodone (Percodan) Oxycodone Confirmation Urine Paraldehyde and Acetaldehyde Toxicology Pentobarbital Propoxyphene Confirmation Urine Risperidone (Risperal) Sulfonylurea Screen THC Meconium Thioridazine (Mellaril) and Mesoridazine Trazodone Trilafon Warfarin CPT Code Changes (01/2015) Page 6

Acetaldehyde 82000 82492 Toxicology 3507910 Pentobarbital 82205 80345 3551465 Propoxyphene Confirmation Urine 83925 80367 3507735 Risperidone (Risperal) 82542 80342 3550493 Sulfonylurea Screen 82542

Toxicology CPT Code Changes for 2016

Toxicology CPT Code Changes for 2016 Beginning January 1, 2016, CMS deleted all 2015 drug testing G codes and will continue to not recognize the AMA CPT codes for drug testing. CMS created three G codes for presumptive testing and four G