Pathology/Lab Coding Alert

Question: We have clients who order MPO blood tests following troponin-negative test results. for patients with chest pain but a normal EKG. We perform the analysis using MS/MS, and bill the service with 83789. Some payers are denying the claims. What could be the problem?

Texas Subscriber

Answer: You must always bill the most specific CPT^® code available to describe the service you provide — and in this case, that’s not 83789 (Mass spectrometry and tandem mass spectrometry [e.g., MS, MS/MS, MALDI, MS-TOF, QTOF], non-drug analyte[s] not elsewhere specified, qualitative or quantitative, each specimen).

Code 83789 states that it’s for a non-drug analyte that is “not elsewhere specified.” But CPT^® provides a specific code for blood myeloperoxidase (MPO), which is the test you said that you’re providing. Instead of 83789, you should be reporting 83876 (Myeloperoxidase [MPO]).

Opportunity: If you’re also providing the troponin test that you mentioned as having “negative” results, you should separately bill 84512 (Troponin, qualitative) for the test. Don’t confuse this code with the code for a quantitative troponin test: 84484 (Troponin, quantitative).