Pathology/Lab Coding Alert

Don't miss these new codes and notes for molecular diagnostics and more.

Avoid denials in 2009 by using this chart to quickly master the CPT code changes affecting your lab. Keep the chart close to use as a handy reference tool throughout the year.

Heads up: Some of the most important changes you-ll see this year are in the text notes. Make sure you pay attention to these new AMA instructions to make sure you don't miss out on legitimate pay.

Study the chart below to make sure that beginning Jan. 1, you start using any of the seven new codes that represent tests your lab performs.

Don't miss: You shouldn't keep using a generic method-code for any of these tests for which CPT now adds a new, analyte-specific test code, says William Dettwyler, MT-AMT, president of Codus Medicus, a laboratory coding consulting firm in Salem, Ore.

* 2009 payment based on crosswalk code(s) national limit amount from the 2008 Clinical Laboratory Fee Schedule (CLFS).

Correct coding for molecular diagnostics (83890-83914) has always been about identifying and reporting each step that the lab carries out for a particular study. But sometimes coders were uncertain about the unit of service -- for instance, can you only report one extraction per molecular diagnostics study?

CPT 2009 helps clarify the unit of service for several molecular diagnostics codes, according to Elizabeth Sheppard, HT(ASCP), manager, technical marketing for Ventana Medical Systems in Tucson, Ariz.

Separate DNA and RNA extraction: CPT 2009 modifies two codes as follows (new text underlined) to clarify that you can separately report each nucleic acid extraction:

- 83890 -- Molecular diagnostics; molecular isolation or extraction, each nucleic acid type (i.e, DNA or RNA)

- 83891 -- - isolation or extraction of highly purified nucleic acid, each nucleic acid type (i.e, DNA or RNA)

Similarly, you can report many steps once for each nucleic acid preparation. CPT 2009 adds a text note at the beginning of the molecular diagnostics codes that defines what constitutes a nucleic acid preparation:

"Each nucleic acid preparation may include a digestate, undigested nucleic acid, or other uniquely modified nucleic acid sample (e.g., newly synthesized oligonucleotide)."

Remember this: Use the following codes once for each nucleic acid preparation:

- 83893 -- - dot/slot blot production, each nucleic acid preparation

- 83894-- - separation by gel electrophoresis (e.g. agarose, polyacrylamide), each nucleic acid preparation

- 83897 -- - nucleic acid transfer (e.g., Southern, Northern , each nucleic acid preparation

- 83909 -- - separation and identification by high resolution technique (e.g., capillary electrophoresis), each nucleic acid preparation.

Finally, CPT 2009 clarifies that you should use the following two codes per enzyme treatment or per specimen:

- 83892 -- - enzymatic digestion, each enzyme treatment

- 83907 -- - lysis of cells prior to nucleic acid extraction (e.g., stool specimens, paraffin embedded tissue), each specimen.

Editor's note: See Pathology/Lab Coding Alert Vol. 9,