Pathology/Lab Coding Alert

Question: When physicians order the hepatitis panel to follow a patient's course of treatment, our lab gets denials. Why?

California Subscriber

Answer: CMS provides two indications for ordering the hepatitis panel:
 
1. To detect viral hepatitis infection when there are abnormal liver function test results, with or without signs or symptoms of hepatitis, and
 
2. Prior to and subsequent to liver transplantation.

Patients with a negative result may need a repeat panel when the time of exposure or stage of the disease is unknown, CMS regulations also state.
 
The panel (80074, Acute hepatitis panel) includes several specific tests:

- 86709 -- Hepatitis A antibody (HAAb); IgM antibody

- 86705 -- Hepatitis B core antibody (HBcAb), IgM antibody

- 87340 -- Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple step method; hepatitis B surface antigen (HBsAg)

- 86803 -- Hepatitis C antibody.

Important point: After the physician has established a hepatitis diagnosis, you may report only individual tests, as necessary, rather than the entire 80074 panel. In other words, the physician should not repetitively order this test panel for a single patient when monitoring progress or changes after he has identified the initial specific cause of hepatitis.