Ob-Gyn Coding Alert

Question: What is the CPT code for an SAL test?

Illinois Subscriber

Answer: SalEst is a screening test done on pregnant women who have or are at risk for premature labor to assess the likelihood that they will deliver in the short-term. It tests for salivary estriols, which is measured from saliva that a woman spits into a lab container. The uses for this screening test are similar to that of fetal fibronectin for predicting preterm delivery. (Fetal fibronectin has been around for a while longer and has its own CPT code). Even though the test was approved by the federal Food and Drug Administration at the end of April 1998, it has not become mainstream nor a standard of care to date, therefore there is no CPT code for this procedure.

Melanie Witt, RN, CPC, MA, the former program manager for the American College of Obstetrics and Gynecology (ACOG) department of coding and nomenclature and an independent coding educator has learned, the test is mailed to the company that developed it and a result is sent back to the physician in 24 hours. I assume your physician is buying the test kit, which includes a prepaid next-day-delivery shipping bag, so you are trying to get paid for the test kit, not the interpretation of the laboratory value. In this case, you might be better off billing it as a supply because the only laboratory test code that you can bill is 89399 (unlisted miscellaneous pathology test). I am not sure how many payers are reimbursing for this test, but according to the companys information, at least two are, says Witt.