Pathology/Lab Coding Alert

Handy table summarizes microbiology, surgical pathology, and cytology changes.

If you've been wondering how to report influenza type and subtype identification or HIV integrase activity, newly created CPT 2011 codes will show you the way starting Jan. 1.

Last month Pathology/Lab Coding Alert gave you a clip-andsave chart for clinical lab tests -- this month we've got a companion chart for other pathology services. We've pulled together a brief description of clinical usage for the new and revised pathology codes so you'll have the inside scoop on CPT 2011 changes, thanks to this guide.

Check Out Expanded Influenza Coding

CPT 2011 includes three new codes for influenza typing -- 87501-87503 (Infectious agent detection by nucleic acid (DNA or RNA); influenza virus,..).

The purpose of the codes is to recognize analyte-specific molecular detection of influenza virus types and subtypes, according to Mary Steele Williams, COO and director of scientific programs for the Association for Molecular Pathology (AMP) in Bethesda, Md.

Although influenza subtype detection has had recognized importance for some time, it regained significance with the novel H1N1 pandemic last year, according to Williams.

You'll select among these three codes based on whether the lab identifies a single type or subtype (87501) or two types/subtypes (87502), and any additional types/subtypes (87503) for each additional type or subtype).

Focus on Integrase Coding

CPT 2011 provides 87906 (Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, other region [e.g., integrase, fusion]) for reporting HIV genotype analysis. "You should use this code for an HIV integrase test," says William Dettwyler, MT AMT, president of Codus Medicus, a laboratory coding consulting firm in Salem, Ore.

"Notice that both 87901 (Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, reverse transcriptase and protease regions) and 87906 describe HIV genotype analysis,but they're not sequential because the intervening code numbers were already taken," Dettwyler says.

Watch pricing: Labs that run the integrase test say that it is more complicated and as much work as the reverse transcriptase and protease regions together (87901), according to Dettwyler. But CMS proposes to crosswalk 87906 to one half the payment rate of 87901, which examines two regions.

Use This Look-Ahead Resource

Put this chart in your pathology coding tool kit for 2011. WatchPathology/Lab Coding Alert for in-depth CPT 2011 analysis and coding advice, such as the article "88172, 88177 Changes Could Smash MUE Roadblock" on page 89 of this issue.