Oncology & Hematology Coding Alert

Watch for your chance to replace 86316 with more specific 86305.

If your oncology practice has its own lab, heads up.

You're sure to find a few new lab codes "in CPT 2010 that you need to know," says Peggy Slagle, CPC, billing compliance coordinator at the University of Nebraska Medical Center in Omaha.

Get started with a look at these three codes you're likely to use in your oncology/hematology practice.

Heed New HE4 Code, 86305

CPT 2010 adds ovarian cancer marker code 86305 (Human epididymis protein 4 [HE4]). "HE4 has been shown to be elevated in a great percentage of women with epithelial ovarian carcinomas," says Brenda Chidester-Palmer, CPC, CCS-P, coding compliance manager of Kelsey-Seybold Clinic in Houston in her "2010 Oncology Coding Update" audio seminar (www.audioeducator.com).

The test helps monitor disease progression or recurrence, Chidester-Palmer adds. In an example provided by CPT Changes 2010: An Insider's View, the patient has her HE4 level tested monthly during her chemotherapy encounter, and monitoring the level helps the oncologist determine that chemo was effective.

Bonus: This code change allows for "more specificity in reporting. For instance, you can use 86305 for HE4 starting Jan. 1 rather than using generic code 86316 (Immunoassay for tumor antigen, other antigen, quantitative [e.g., CA 50, 72-4,549], each) for the test," points out William Dettwyler, MT-AMT, president of Codus Medicus, a laboratory coding consulting firm in Salem, Ore.

Add 86352 for Cellular Immune Status Test

You also have a new transplant management immune function marker code: 86352 (Cellular function assay involving stimulation [e.g., mitogen or antigen] and detection of biomarker [e.g., ATP]).

Code 86352 describes a test that assesses cellular immune status as a measurement of cell-mediated immunity (CMI) in whole blood and assists in management of cancers, HIV, and autoimmune disorders, Chidester-Palmer says.

Confirm Method Before Choosing 88738

CPT 2010 also adds a new lab code for a test that can aid in anemia and transfusion management: 88738 (Hemoglobin [Hgb], quantitative, transcutaneous). Keep in mind that transcutaneous means "through unbroken skin." This test involves a spectroscope device (hand-held, near-infrared) and eliminates the need to draw blood, Chidester-Palmer says. Code 85018 (Blood count; hemoglobin [Hgb]) remains appropriate for a hemoglobin test involving blood draw.