Pathology/Lab Coding Alert

Question: Our lab prepares paraffin-embedded tissue for microarray analysis by the pathologist using 230 probes. We lyse and extract the cells, perform automated nucleic acid purification and PCR to amplify three nucleic acid sequences of interest. Our pathologist interprets the test results. How should we report the service?


Colorado Subscriber

Answer: Report the microarray based on the number of probes--88385 (Array-based evaluation of multiple molecular probes; 51 through 250 probes), for your example.

Pricing for the array codes takes into account the pathologist's professional service, including test interpretation. You should not separately report the interpretation using molecular diagnostics codes (83912, Molecular diagnostics; interpretation and report).

You can use the molecular diagnostics codes to report specimen preparation, however. In your example, you can bill for steps that precede the array test. These include the following:

- 83907--Molecular diagnostics; lysis of cells prior to nucleic acid extraction (e.g., stool specimens, paraffin-embedded tissue)

- 83891--- isolation or extraction of highly purified nucleic acid

Automated systems generally result in -highly purified nucleic acid,- which points to this code rather than 83890 (- molecular isolation or extraction).

- 83898--- amplification of patient nucleic acid, each nucleic acid sequence.

Report three units of this code because you state that you perform polymerase chain reaction (PCR) to amplify three nucleic acid sequences.