Pathology/Lab Coding Alert

You won't have G0265 and G0266 to kick around anymore in 2008 -- but you-ll still have to distinguish between two disparate sets of freeze/thaw codes to get paid for your diagnostic and therapeutic cryopreservation procedures.

Because CMS removed HCPCS codes G0265 (Cryopreservation, freezing and storage of cells for therapeutic use, each cell line) and G0266 (Thawing and expansion of frozen cells for therapeutic use, each aliquot), Correct Coding Initiative version 14.0 removes mutually exclusive edit pairs that prohibited reporting those codes with 88240-88241.

"With this change, you-ll need to understand how to report stem cell and bone marrow transplant services for Medicare beneficiaries," says William Dettwyler, MT-AMT, president of Codus Medicus, a laboratory coding consulting firm in Salem, Ore.

Background: When CPT overhauled stem cell/bone marrow transplant codes in 2003, CMS introduced three new G codes for Medicare beneficiaries for the same services. This year, CMS removes the three HCPCS Level II codes -- G0265, G0266, and G0267 (Bone marrow or peripheral stem cell harvest, modification or treatment to eliminate cell type[s], [e.g., T-cells, metastatic carcinoma]).

Do this: Instead, you should use the appropriate CPT codes for Medicare beneficiaries, as directed in the HCPCS 2008 text note following the deleted codes:

- for G0265, see 38207 (Transplant preparation of hematopoietic progenitor cells; cryopreservation and storage)

- for G0266, see 38208 (- thawing of previously frozen harvest, without washing) or 38209 (- thawing of previously frozen harvest, with washing)

- for G0267, see 38210-38215 (... specific cell depletion within harvest, T-cell depletion; tumor cell depletion; red blood cell removal; platelet depletion; plasma [volume] depletion; cell concentration in plasma, mononuclear, or buffy coat layer).

Eliminating G0265 and G0266 may simplify freeze/thaw coding, but that still leaves the question of when to use the following two codes for freezing and thawing cells:

- 88240 -- Cryopreservation, freezing and storage of cells, each cell line

- 88241 -- Thawing and expansion of frozen cells, each aliquot

According to CPT text notes following these two codes, you should look to 38207 and 38208 for therapeutic cryopreservation, storage and thawing.

"You should reserve 38207 and 38208 for therapeutic bone marrow or stem cell transplant cases, and use 88240 and 88241 when labs freeze and thaw cells for diagnostic purposes, such as cytogenetic studies," Dettwyler says.

Don't miss: You should not use any of these codes for freezing and thawing reproductive tissue for procedures such as in vitro fertilization, because CPT provides other specific codes for those circumstances. Look to the reproductive medicine procedures (89250-89356) or Category III codes 0058T and 0059T for further information.