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In CPT ’03, clinical laboratory changes only
A CPT overhaul for hematology
Correction
December 2002
Leslie Narramore
CPT changes for 2003 affect clinical laboratory services
exclusively, unlike past years in which surgical pathology also saw revisions.
Changes to the clinical laboratory section in CPT 2003 include those for organ-
or disease-oriented panels, chemistry, hematology, transfusion medicine, microbiology,
and cytopathology. Changes affecting pathologists were made also in the therapeutic
apheresis codes and in the category III section of CPT.
Organ- or disease-oriented panels
Since IgM-specific tests have become available for some of the included assays,
a universally common panel of analytes no longer exists. Therefore, the Torch
antibody panel (80090) was deleted. Report the codes of the individual tests
performed.
Chemistry
An editorial change was made to the existing code for heavy metal screening
(83015) to indicate that the metals listed in the code’s parenthetical
reference are only examples and not the only metals that can be reported with
this code.
The addition of code 83880 will allow laboratories to report natriuretic peptide
testing, also known as BNP. Formerly, it was necessary to report code 83520
(Immunoassay, analyte, quantitative; not otherwise specified) for this
test.
New code 84302 was added to report sodium analyses for specimens other than
serum and urine.
Hematology
Many changes were made to the hematology section of CPT to reflect contemporary
clinical practice and terminology. For a summary of new, revised, and deleted
codes, and explanations for the changes, see “A
CPT overhaul for hematology,”.
An editorial change was made to the existing code for D-dimer fibrin degradation
(85378) to clarify that the code can be reported for qualitative or semiquantitative
methods.
Also related to the 85378 family, new code 85380 was added to capture qualitative
or semiquantitative ultrasensitive D-dimer assays. If testing for quantitative
ultrasensitive D-dimer assays, use code 85379 (Fibrin degradation products,
D-dimer; quantitative). A new, more specific code for this service is expected
to be added in CPT 2004.
Transfusion medicine
Existing codes 86930–86932 have been revised to clarify the intent of
the code descriptors. Use code 86932 only if an institution must prepare, freeze,
and thaw a unit of blood. Use code 86931 if it is necessary only to thaw a frozen
unit of blood before transfusion. Use code 86930 if it is necessary only to
prepare and freeze a unit of blood.
Microbiology
The existing code for primary source smears for inclusion bodies or parasites
(87207) was revised to clarify the intent of the code. The word “intracellular”
was removed and the example of cytomegalovirus was replaced with trypanosomes.
An editorial change was made to the existing code for 87254 to clarify that
this code is to be used for centrifuged enhanced shell vial techniques.
New code 87255 was added to the virus isolation family (87250– 87254)
to capture new technologies such as virus-specific enzymatic activity.
The addition of two new codes to the infectious agent antigen detection by immunofluorescence
family (87260–87299) will allow institutions to report enterovirus and
cytomegalovirus by direct fluorescent antibody. Use new code 87267 for enterovirus
and 87271 for cytomegalovirus.
Cytopathology
Two new codes will allow laboratories to report automated, thin-layer Pap tests
screened by an automated system under physician supervision. Previously, such
services were coded using the unlisted cytopathology procedure code 88199. Use
new code 88174 to report automated thin-layer Pap tests screened by an automated
system under physician supervision. Use new code 88175 only when the Pap test
receives the services described in 88174 and is also rescreened manually. More
information on the cytopathology codes will be published next month in CAP TODAY
in the “PAP/NGC Program Review” section.
Apheresis
The codes for therapeutic apheresis (36520 and 36521) were deleted and replaced
by a family of more specific codes for the individual constituents of blood
removed. The new codes describe therapeutic apheresis for white blood cells
(36511), red blood cells (36512), platelets (36513), and plasmapheresis (36514).
There are also new codes that differentiate between the type of adsorption or
filtration used (36515 and 36516).
Category III
Code 0041T was added for Conducting Polymer Array Sensing, or CPAS, testing.
Code 0043T was added for noninvasive testing for measurements of end-tidal carbon
monoxide, or ETCOc, to detect the rate of hemolysis. Complete descriptors
for the new and revised codes listed here can be found in the 2003 version of
the CPT book. CPT is copyrighted by the American Medical Association. Call the
AMA at 800-621-8335 or log on to www.amapress.com
to purchase the CPT book.
Leslie Narramore is CAP policy representative, professional and economic affairs,
Washington, DC.
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