January 2015 2015 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 80000 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 (80300-80377). The codes in the current 2014 Drug Testing section (80100-80104) 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 87621 to 87624. 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. 2015 CPT Code Changes (01/2015) Page 1
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) 611-3438 or (414) 805-7600 should you have questions. Thank you for selecting as your laboratory services provider. Sincerely, 2015 CPT Code Changes (01/2015) Page 2
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 489160 Prostate Cancer Gene 3 (PCA3) 81479 81313 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 88342 88342 Each additional IHC antibody stain on a single specimen 88341 88342 Each IHC multiplex antibody stain procedure (i.e., multiplex 88342, 88344 antibody stain procedure) 88343* Morphometric analysis, tumor immunohistochemistry, quantitative or semiquantitative, each single antibody stain, 88360 88360 manual, per specimen Morphometric analysis, tumor immunohistochemistry, quantitative or semiquantitative, each single antibody stain, computer-assisted technology, per specimen 88361 88361 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 88365 88365 Each additional single probe stain procedure 88364 88365 Each multiplex probe stain procedure, per specimen (i.e., multiplex probe stain procedure) 88366 88365* Morphometric analysis, in situ hybridization, quantitative or semiquantitative, initial single probe stain procedure, manual, 88368 88368 per specimen Each additional single probe stain procedure, per specimen 88369 88368 Each separately identifiable probe applied to the same specimen (i.e., multiplex probe stain procedure) 88377 88368* 2015 CPT Code Changes (01/2015) Page 3
Microbiology 5600005 5600089 5600095 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 87621 87624 8000540 Acetaminophen, Quantitative 80301 80302 1000909 Salicylate 80101 80329 8001335 Valproic Acid, Free 80164 80165 8000649 Amphetamines, Urine 80101 80301 8002080 Barbiturates, Urine 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 Cocaine/Benzoylecgonine, Urine 80101 80301 3508089 Ethanol, Urine 80101 80301 8000500 Ethanol, Serum 80101 80301 8002095 Methadone, Urine 80101 80301 8000707 Methaqualone, Urine 80101 80301 8000679 Opiates, Urine 80101 80301 8000708 Oxycodone/Oxymorphone, Urine 80101 80301 8000689 PCP, Urine 83992 80301 8002200 Propoxyphene, Urine 80101 80301 8000569 Tricyclic Rapid Screen, Serum 80101 80301 8000590 Methanol Quantitative, Serum 84600 80320 8002051 Acetone/Isopropanol, Quantitative, Serum 80101 80320 8000580 Volatile Screen, Serum 84600 80320 8000630 Ethylene Glycol, Quantitative, Serum 82693 80320 3551345 Nicotine and metabolite, Quantitative, Serum 83887 80323 8004005 Fentanyl, Quantitative, Urine 80101 80354 8004020 Oxycodone, Quantitative, Urine 80101 80365 8004010 Hydrocodone, Quantitative, Urine 80101 80361 8004015 Methadone, Quantitative, Urine 80101 80358 8004025 Tramadol, Quantitative, Urine 80101 80373 8004030 Opiates, Quantitative, Urine 80101 80354, 80365, 80361, 80358, 80373 2015 CPT Code Changes (01/2015) Page 4
Toxicology 3508130 Alprazolam (Xanax) 80154 80346 3507512 Amiodarone 82542 80299 3507547 Amitriptyline/Nortriptyline 80152 80335 3551430 Amphetamine Confirmation Urine 82145 80324 3551440 Barbiturate Confirmation Urine 82205 80345 3551390 Benzodiazepine Confirmation Urine 80154 80346 3550907 Buprenorphine Confirmation Urine 83925 80348 3550906 Buprenorphine Urine 80101 80301 3507505 Busulfan 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 80154 80346 3507545 Cocaine Benzoylecgonine Quant Urine 82520 80353 3507601 Cocaine Meconium 80101 80301 3551480 Cocaine Metabolite Confirmation 82520 80353 3507580 Desipramine 80160 80335 3526085 Dexamethasone Level 82542 80375 3508100 Diazepam ((Valium) 80154 80346 3508069 Diuretic Screen Urine 80100 80377 3507984 Doxepin (Sinequan) 80166 80335 3507502 Drug Investigation Urine 80100 80303 3551770 Ethyl Glucuronide Urine 80101 80302 8001200 Felbamate 82542 80339 3551545 Fentanyl Confirmation Urine 83925 80354 3551540 Fentanyl Screen and Confirmation Urine 80101 80302 3507720 Flecainide 82542 80299 8001210 Fluoxetine 82542 80332 3508277 Gold 80172 80375 3550417 Hydrocodone (Vicodin) 83925 80361 3507517 Imipramine/Desipramine 80174 80335 3507790 Lorazepam 80154 80346 3507504 MDMA (Ecstasy) Qualitative Urine 80101 80301 3551532 MDMA + Metabolites Confirmation Urine 82145 80359 3507810 Mephobarbital 82205 80345 3507815 Mephobarbital (Mebaral) 80184, 80184, 82205 80345 3507732 Methadone 83840 80358 3551470 Methadone Confirmation Urine 83840 80358 3507840 Methsuximide 83858 80339 2015 CPT Code Changes (01/2015) Page 5
Toxicology 3507870 Morphine 83925 80301 3508015 Nicotine Metabolite Urine 80101 80302 3507547 Nortriptyline 80182 80335 3550319 Olanzapine (Zyprexa) 82542 80342 3551410 Opiate Confirmation Urine 83925 80361 3507604 Opiate Meconium 80101 80301 3507875 Oxazepam 82491 80346 3550419 Oxycodone (Percodan) 83925 80365 3551400 Oxycodone Confirmation Urine 83925 80365 3507905 Paraldehyde and Acetaldehyde 82000 82492 Toxicology 3507910 Pentobarbital 82205 80345 3551465 Propoxyphene Confirmation Urine 83925 80367 3507735 Risperidone (Risperal) 82542 80342 3550493 Sulfonylurea Screen 82542 80377 3507603 THC Meconium 80101 80301 3507820 Thioridazine (Mellaril) and Mesoridazine 84022 80342 3508040 Trazodone 82542 80338 3508060 Trilafon 84022 80342 3508110 Warfarin 82471 80375 2015 CPT Code Changes (01/2015) Page 6