Pathology/Lab Coding Alert

New blood-test code 8648x changes how you manage TB testing

A new test for tuberculosis will probably replace the standard skin-testing method - and CPT Codes 2006 code changes will give your lab a new way to report it.

Blood Test Trumps Skin Test

A blood test that detects interferon-gamma secreted by T-cells in tuberculosis patients is more precise than the century-old skin test, according to a study published in the Journal of the American Medical Association.

Your lab should see more of these tests, not only because they're more accurate but also because the test does not require the time and patient follow-up for results.
 
Code Changes Reflect Technology

You'll find a new lab code for the TB blood test in CPT 2006. Codes announced by CMS as part of the clinical laboratory fee schedule pricing forum include new code 8648x (Tuberculosis test, cell mediated immunity measurement of gamma interferon antigen response). An "x" substitutes for the last digit of the code because the AMA had not fully assigned the code number prior to its release for the meeting.

CPT 2006 also deletes 0010T, the Category III code with the same code description as new code 8648x.

The AMA uses Category III "new-technology" codes to accumulate usage data so they can convert temporary codes to Category I CPT codes in a timely fashion, says Melanie Witt, RN, CPC, MA, an independent coding consultant in Fredericksburg, Va.

Warning: You won't be able to use CPT's TB skin-test code starting Jan. 1, 2006. The clinical lab codes released by CMS reveal that CPT 2006 will delete code 86585 (Skin test; tuberculosis, tine test). Although the TB skin test was in the CPT pathology and laboratory section, labs did not typically perform the test, which involved evaluating a skin response to the TB tine prick. Labs will perform the new TB blood test, however.

Editor's Note: For a list of additional clinical laboratory code changes you can expect in 2006, see "Sneak a Peek at New Laboratory Codes for 2006" later in this issue.