Pathology/Lab Coding Alert

Understand lab procedures -- or lose rightful pay When you-re billing for molecular diagnostics studies that involve steps to "amplify" genes or fluorescent tags, you need to know about CPT 2008 code changes to keep your claims clean. Follow our experts- advice to update your molecular diagnostics coding savvy so you can pick the right codes. Revised CPT Terminology May Not Mean What You Think You-ve had codes for nucleic acid sequence and signal amplification for years, but CPT 2008 revises the definitions for clarity: - 83898 -- Molecular diagnostics; amplification, target, each nucleic acid sequence - 83900 -- Molecular diagnostics; amplification, target, multiplex, first two nucleic acid sequences - +83901 -- Molecular diagnostics; amplification, target, multiplex, each additional nucleic acid sequence beyond 2 (list separately in addition to code for primary procedure) - 83908 -- Molecular diagnostics; amplification, signal, each nucleic acid sequence. "CPT 2008 has removed the reference to patient nucleic acid and substituted the word -target- in codes 83898, 83900 and 83901" says Diana Voorhees, MA, CLS, MT (ASCP) SH, CLCP, principal with DV and Associates Inc. in Salt Lake City. "Similarly, CPT 2008 eliminates -patient nucleic acid- and changes word order for the 83908 code definition, but the description still indicates and differentiates that this code identifies signal amplification," Voorhees says. "Taken together, these changes should help clarify differences in lab procedures for amplification of a targeted nucleic acid versus amplification of a signal," she says. Do this: You should still use these codes the same way you did before the 2008 terminology clarification. Select the appropriate code(s) 83898 or 83900-83901 for target amplification based on whether the lab performs a multiplex reaction. You should still reserve 83908 to report signal amplification if the lab performs that step. New CPT 2008 text notes confirm this usage: - a note following 83898 states, For signal amplification, use 83908 - a note following 83908 states, For target amplification, see 83898, 83900, 83901. Don't Lose Multiplex Pay CPT 2008 makes other changes to clarify coding for multiplex reactions -- amplifications that involve more than one nucleic acid sequence in a single tube. Avoid this: Don't use multiple units of 83898 for multiplex reactions. To ensure that you select the more appropriate codes, CPT 2008 adds a text note following 83898 that states, "For multiplex target amplification, see 83900, 83901." Know unit of service: For the first two nucleic acid sequences in a multiplex reaction, list one unit of 83900. But if the tube contains additional nucleic acid sequences, you should list one unit of 83901 for each. Don't miss: Because it is an add-on code, you should only use 83901 with 83900 when the multiplex reaction involves more than [...]