Pathology/Lab Coding Alert

See which updates are most likely to affect the services you code.

The May 2024 meeting of the CPT^® Editorial Panel resulted in the acceptance of several new pathology and lab codes that will be effective Jan. 1, 2025.

The published summary of panel actions includes placeholder codes (incomplete codes that provide an idea of a new code’s final location), and the codes may change before the release of the official code set. But this glimpse at likely changes will help you prepare for January 2025.

Tip: These updates are in addition to the codes already discussed in “Sneak a Peek at January 2025 CPT^® Path/Lab Changes,” in Pathology/Lab Coding Alert, Volume 25, Number 6.

Be Ready for These Additions and Revisions

Neurofilament light chain: The panel accepted code 83XX0 to report neurofilament light chain (NfL). The placeholder code digits suggest this will be in the Chemistry Procedures section. This is all the information the summary gives about the new code, but we do know that NfL is a type of protein in neurons, which are the cells responsible for transmitting nerve impulses in the brain and nervous system. When neurons are damaged or degenerate, NfL is released into the cerebrospinal fluid and bloodstream. Elevated levels of NfL in these fluids can serve as a biomarker for various neurological conditions, helping in the diagnosis, monitoring, and prognosis of these diseases.

MAAA, bacterial vaginosis-vaginitis: The panel accepted the addition of Multianalyte Assays with Algorithmic Analyses (MAAA) code 8XX00 for reporting bacterial vaginosis and vaginitis associated diseases. For a clue about what the code will represent, consider this: CPT^® will also be deleting 0352U (Infectious disease (bacterial vaginosis and vaginitis), multiplex amplified probe technique, for detection of bacterial vaginosis-associated bacteria (BVAB-2, Atopobium vaginae, and Megasphera type 1), algorithm reported as detected or not detected and separate detection of Candida species (C. albicans, C. tropicalis, C. parapsilosis, C. dubliniensis), Candida glabrata/Candida krusei, and trichomonas vaginalis, vaginal-fluid specimen, each result reported as detected or not detected).

The new code will be in the MAAA section. MAAAs use testing and algorithmic analysis of the tests (and possibly other patient information) to produce a score or probability.

Pneumocystis jirovecii, amplified probe technique: You can expect to see 87XX0, likely a microbiology procedure code, to report pneumocystis jirovecii by amplified probe technique. Pneumocystis jirovecii is a fungal organism that causes pneumocystis pneumonia (PCP), primarily in individuals with weakened immune systems, such as those with HIV/AIDS, cancer, or who are on immunosuppressive medications. PCP is a serious infection characterized by symptoms like cough, fever, and difficulty breathing. Amplified probe technique refers to a molecular diagnostic method used to detect specific DNA or RNA sequences in a sample. This technique often involves the use of polymerase chain reaction (PCR) to amplify the target genetic material, making it easier to detect even in small quantities.

Optical genome mapping: New code 88XX0 will represent the optical genome mapping method of identifying cytogenomic chromosomal abnormalities. The technique visualizes and analyzes the structure of DNA molecules to capture detailed maps of the genome (the complete set of genetic material in an organism). It allows for the detection of structural variations (cytogenomic chromosomal abnormalities), such as those associated with genetic disorders and diseases.

HPV combined reporting, pooled and individual genotyping results: If you report testing for high-risk types of human papillomavirus (HPV), watch for new code 87XX1. The update also will revise 87624 (Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68). CPT^® has not posted the specifics of the revision yet. A third part of this change is the deletion of 0500T (Infectious agent detection by nucleic acid (DNA or RNA), Human Papillomavirus (HPV) for five or more separately reported high-risk HPV types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) (ie, genotyping)).

Streptococcus pneumoniae antibody: There will be a new code, 86XX1, to report testing for streptococcus pneumoniae, a type of bacteria. It can exist harmlessly in some individuals, but it can also cause serious infections, particularly in young children, the elderly, and individuals with weakened immune systems.

Hereditary cancer disorders, cancer predisposition: You can expect multiple changes for genomic sequence analysis panels for hereditary cancer disorders beginning Jan. 1, 2025, as the table below illustrates.

And Get Ready for These Deletions

The CPT^® panel accepted deletion of these three codes because of low use:

• 86327 (Immunoelectrophoresis; crossed (2-dimensional assay))
• 86490 (Skin test; coccidioidomycosis)
• +88388 (Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies); in conjunction with a touch imprint, intraoperative consultation, or frozen section …)

Final tip: CPT^® also released updated Proprietary Laboratory Analyses (PLA) codes, effective Oct. 1, 2025. The update includes 45 new codes, two revised codes, and three deleted codes, which can be seen in this complete listing. The names associated with two codes will change as well.

Deborah Marsh, JD, MA, CPC, CHONC, Sr. Development Editor, AAPC