Pathology/Lab Coding Alert

Question: When our lab performs a Treponema pallidum antibody test to diagnose syphilis infection for a patient who has not had a prior test, should we report 86781? Washington Subscriber Answer: Starting Jan. 1, you should report a new CPT 2010 code for the test you describe: 86780 (Antibody; Treponema pallidum). This new code solves a longstanding problem that your question illuminates. Problem: Prior to the introduction of 86780, the only code CPT provided for Treponema pallidum was a confirmatory test: 86781 (Antibody; Treponema pallidum, confirmatory test [e.g., FTA-abs]). Because the primary test that labs used to identify Syphilis infection sometimes has false positives (86592, Syphilis test; qualitative [e.g., VDRL, RPR, ART]), physicians would order 86781 to confirm the diagnosis. Current coding: Some labs prefer to offer Treponema pallidum antibody as the primary test to diagnose Syphilis because it is more specific and perhaps easier to run. "With the new [...]