Pathology/Lab Coding Alert

Question: When a physician orders an evocative/ suppression panel for hormones, the group of tests may or may not be a listed CPT panel. Sometimes the physician orders all tests in a panel plus a few extra, or he may order a list of tests that doesn't neatly fit into a lab panel code. How should we code for these services?


North Carolina Subscriber


Answer: Some evocative/suppression panels are very straightforward, such as 80400 (ACTH stimulation panel; for adrenal insufficiency), which includes only Cortisol (82533 x 2). But many other lab panels include a much longer list of required tests that a physician may wish to tweak to meet a patient's specific needs.

When your physician orders a lab panel, the first thing you should do is look at the list of CPT lab panel codes to see if the ordered tests fit into a certain code.

If the ordered tests fall short of meeting all the requirements for a specified lab panel code, or if there's simply no code to describe the list of ordered tests, you have no choice but to report all the tests separately.

If the ordered tests fit into a specified code but there are some tests left over, report the appropriate lab panel code plus the additional tests separately.

Documentation, please: Physicians can clarify any lab panel confusion by documenting ordered lab panels with the same descriptions listed in the CPT manual . Instruct your physicians not to use abbreviations or other descriptions, but rather to write the names of the lab panels exactly as they appear in CPT. And if the physician orders a specified lab panel plus other tests, he should specify which CPT lab panel he is ordering and list all additional tests.