Regional Laboratory
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Beginning January 1, 1998, there are numerous CPT coding changes for the laboratory. There are several new codes for microbiology, immunology, cytopathology and for laboratory procedures related to reproductive medicine. A summary of these new CPT codes and code changes for 1998, along with the appropriate description of each test or service, is provided on page two of this newsletter.
However, the most important or significant change for CPT 1998 is the official elimination of the automated multichannel CPT codes 80002 – 80019. After April 1, 1998, CPT codes 80002 – 80019 are no longer valid and may not be used to bill Medicare or Medicaid. Effective January 1, 1998, Medicare will recognize three new automated chemistry panels. HCFA will allow a three month grace period whereby laboratories may bill either the old 80000 series codes or the new panel codes, but not both. As of April 1, 1998, only the new panel codes will be accepted.
The three new panels are as follows:
80049 Basic Metabolic Panel (Panel must include the following tests.)
Carbon Dioxide Chloride
Creatinine Glucose
Potassium Sodium
Urea Nitrogen (BUN)
80051 Electrolyte Panel (Panel must include the following tests.)
Carbon Dioxide Chloride
Potassium Sodium
80054 Comprehensive Metabolic Panel (Panel must include the following tests.)
Albumin Bilirubin, Total or Direct
Calcium Chloride
Creatinine Glucose
Phosphatase, Alkaline Potassium
Protein, Total Sodium
Urea Nitrogen (BUN) Transferase, Aspartate Amino (AST) (SGOT)
There are two revisions to existing panels.
80050 General Health Panel (Panel must include the following tests.)
Comprehensive Metabolic Panel (See 80054)
CBC with Differential
TSH
80058 Hepatic Function Panel (Panel must include the following tests.)
Albumin Bilirubin, Total Bilirubin, Direct Phosphatase, Alkaline
Transferase, Alanine Amino (ALT) (SGPT)
Transferase, Aspartate Amino (AST) (SGOT)
Please remember that you may not order any CPT coded panels for screening purposes for Medicare or Medicaid patients. The general health panel 80050 traditionally has been and continues to be considered a screening service and therefore not covered by Medicare.
Organ/Disease Oriented Panels
New
80049 Basic Metabolic Panel
80051 Electrolyte Panel
80054 Comprehensive Metabolic Panel
Revised
80050 General Health Panel (Comprehensive Metabolic Panel, 80054, is added.)
80058 Hepatic Function Panel (must include total and direct bilirubin)
Deleted
80002-19 Automated Multichannel Profile Codes
Therapeutic Drug Assays
New
80201 Topiramate (used to assess serum/plasma levels of this anti-epileptic drug
approved for use in conjunction with other anti-epileptic drugs)
Chemistry
New
83019 Helicobacter Pylori, Breath Test (including drug and breath sample collection kit)
Revised
84484 Troponin, Quantitative
Immunology
New
86704-09 New family of 8 hepatitis-related antibody codes relocated in immunology
Revised
86360 T Cells; absolute CD4 and CD8, count including ratio
Microbiology
New
87797 (direct probe)
87798 (amplified probe)
87799 (quantification)
Anatomic Pathology
Revised
Cytopathology
New
Replaces previous physician interpretation codes 88151, 88157. (To report technical component, see 88142, 88150, 88152, 88155, 88156-58.)
Other Lab Procedures/Reproductive Medicine
New
89251 Culture, fertilization of oocyte(s); with co-culture of embryos
89252 Assisted oocyte fertilization, microtechnique, any method
89253 Assisted embryo hatching, microtechniques, any method
89254 Oocyte identification from follicular fluid
89255 Preparation of embryo for transfer, any method
89256 Preparation of cryopreserved embryos for transfer, includes thaw
89257 Sperm ID from aspiration, other than seminal fluid
89258 Embryo cryopreservation
89259 Sperm cryopreservation
Sources: CPT 1998; CPT Assistant, Nov. 1997.