Pathology/Lab Coding Alert

Question: When I’m trying to find a tier 1 molecular pathology test code in the CPT^® manual, I find it very confusing. The codes are in numerical order, but it seems like half of them have a red note that states, “code is out of numerical sequence,” and the other half have a # symbol in front of them. Could you please explain this?

South Carolina Subscriber

Answer: The organizational structure for the CPT^® Tier 1 Molecular Pathology section is alphabetical by gene name, not numerical.

If CPT^® had never added new gene tests since creating the Tier 1 Molecular Pathology section, the numerical and alphabetical listings would align. But in fact, this section has welcomed new codes every year, often multiple new codes. The new codes had to take on later sequential numbers, but that didn’t align with where the codes were placed alphabetically.

Solution: CPT^® accommodates this discrepancy in the following two ways:

• Place a red number in numerical order with a note that “code is out of numerical sequence. See [code range where you’ll find the code definition].”
• Identify the numerically “misplaced” code with a # in the left margin.

This whole process is called resequencing, and it occurs throughout the CPT^® manual. But you are correct to observe that the phenomenon is prevalent in the Tier 1 Molecular Pathology section.

Do this: If you’re looking for a molecular pathology procedure for a specific gene, scroll through the section alphabetically. Or you can use a code lookup tool that lets you search by keyword.