Pathology/Lab Coding Alert

Prepare to update how you code MPO and DCP.

From a marker for myocardial infarction (MI) to transcutaneous hemoglobin assessments, next year's CPT update will give your lab more specific codes for up-and-coming diagnostic tests.

Update From Method to Marker

When your lab identifies a disease marker or test that doesn't have a specific CPT code, you have to report the service using a nonspecific code that describes the lab method or a specific Category III code, if available. But you shouldn't keep using the generic-method codes when CPT adds a new, analyte-specific test code, says William Dettwyler, MT-AMT, president of Codus Medicus, a laboratory coding consulting firm in Salem, Ore.That's why you should get ready to change the way you report the following two tests:

1. MPO: Physicians might order serum myleoperoxidase when a patient presents with chest pain but shows a normal EKG and troponin-negative test results.

2009 way: As shown in the table on page 83, CPT 2009 introduces 83876 (Myeloperoxidase [MPO]) for this test, and you should report the finalized code beginning Jan.1, 2009.

2008 way: For 2008 services, labs use a generic test code based on lab method, such as 83516 (Immunoassay for analyte other than infectious agent antibody or infectious agent antigen, qualitative or semiquantitative; multiple step method) to describe the test.

 2. DCP: To follow patients with chronic liver disease who are at increased risk for liver cancer, physicians might order des-gamma-carboxy-prothrombin to aid in the diagnosis of hepatocarcinoma. 2009 way: CPT 2009 provides 83951 (Oncoprotein; des-gamma-carboxy-prothrombin [DCP]) to report DCP after the first of next year. 2008 way: A general code such as 86316 (Immunoassay for tumor antigen, other antigen, quantitative [e.g., CA 50, 72-4, 549], each) is the only way a lab can report DCP until the new code becomes effective in January.