Pathology/Lab Coding Alert

Know the Lab Tests Affected


- Published on Sat, Jun 01, 2002



"The new national coverage decisions will impact reimbursement for 65 CPT Codes , which account for approximately 60 percent of laboratory claims, according to the negotiated rulemaking committee that authored the rule," says Laurie Castillo, MA, CPC, CPC-H, CCS-P, member of the national advisory board of the American Academy of Professional Coders (AAPC) and president of Physician Coding and Compliance Consulting in Manassas, Va. The committee which included representatives from CMS and 18 other organizations whose interests may be affected by the rule acted in response to a federal government mandate under the Balanced Budget Act of 1997. The title of each of the 23 policies and the affected CPT codes are listed below:



  • Urine Bacterial Culture 87086, 87088, 87184, 87186


  • Human Immunodeficiency Virus Testing (Prognosis and Monitoring) 87536, 87539


  • Human Immunodeficiency Virus Testing (Diagnosis) 86689, 86701, 86702, 86703, 87390, 87391, 87534, 87535, 87537, 87538


  • Blood Counts (CBC) 85007, 85008, 85013, 85014, 85018, 85021, 85022, 85023, 85024, 85027, 85031, 85048, 85590, 85595


  • Partial Thromboplastin Time (PTT) 85730


  • Prothrombin Time (PT) 85610


  • Serum Iron Studies 82728, 83540, 83550, 84466


  • Collagen Crosslinks 82523


  • Blood Glucose Testing 82947, 82948, 82962


  • Glycated Hemoglobin/Glycated Protein 82985, 83036


  • Thyroid Testing 84436, 84439, 84443, 84479


  • Lipids 80061, 82465, 83715, 83716, 83718, 83721,84478


  • Digoxin Therapeutic Drug Assay 80162


  • Alpha-fetoprotein (Afp) 82105


  • Carcinoembryonic Antigen (CEA) 82378


  • Human Chorionic Gonadotropin (hCG) 84702


  • Tumor Antigen by Immunoassay for CA 125 86304


  • Tumor Antigen by Immunoassay for CA 15-3/CA 27.29

    86300



  • Tumor Antigen by Immunoassay for CA 19-9 86301


  • Prostate Specific Antigen (Total PSA) 84153


  • Gamma Glutamyltransferase (GGT) 82977


  • Hepatitis Panel 80074


  • Fecal Occult Blood 82270.


  • Pathology/Lab Coding Alert
    Issue - Jun, 2002
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