Pathology/Lab Coding Alert

READER QUESTIONS:

Specific AFP/AFP-L3 Ensures Pay

Question: Our lab determined total AFP and the L3 fraction isoform for a patient with an elevated AFP to rule out hepatocellular carcinoma. Should we report 82015 for the total AFP and 82491 for the L3 fraction by highpressure liquid chromatography?

Utah Subscriber

Answer: No, CPT provides a single, more specific code for the test you describe. You should report an AFP and AFP-L3 test with calculated ratio as 82107 (Alphafetoprotein [AFP]; AFP-L3 fraction isoform and total AFP [including ratio]).

Before CPT added 82107, you did have to use two CPT codes: 82105 (Alpha-fetoprotein [AFP]; serum) described the total AFP test, and you had to use a nonspecific method code for the AFP-L3 fraction. The most appropriate code, as you mentioned, was 82491 (Chromatography, quantitative, column [e.g., gas liquid or HPLC]; single analyte not elsewhere specified, single stationary and mobile phase).