The 2018 updates to CPT® and ICT-10 mean plenty of changes are in store for your lab and pathology practice. Coders, providers, billers, managers, collectors and clinicians need to be brought up to speed on these revised codes.
Coding expert Ellen Garver explained the changes in an audio conference for ProfEdOnDemand, “Spotlight on 2018 CPT® and ICD-10 Changes for your Lab/Pathology Practice.” In all, said Garver, there are 40 new codes, 17 revised codes, and 14 deleted codes.
For CPT® 2018 molecular pathology, there are Tier 1 and Tier 2 changes. This shuffle means that many codes are promoted. There are new codes for hemoglobin, beta, for example:
- 81361 has moved from 81401
- 81362 has no prior Tier 2 code
- 813613 has moved from 81403
- 81364 has moved from 81401
And for HBA1/HBA2:
- 81258 has no prior Tier 2 code
- 81259 has moved from 81405
- 81369 has moved from 81404
Tier 2 additions for 2018 include:
- 81401 Level 2—LINCOO518 expression analysis (melanoma) and PRAME expression analysis (melanoma)
- 81405 Level 6—CPOX, CTRC and PKLR full gene sequences
- 81406 Level 7—ANOS1, HMBS and PPOX full gene sequences
So what’s included in Tier 1 and Tier 2?
- “All analytical services performed in the test” from cell lysis and quantitation to detection
- All variants (don’t separately report unlisted variants)
- Not interpretation
- No prep preceding cell lysis, such as: microdissection (88380-88381), macro tissue prep (88387-+88388) or archived specimen selection (88363)
For microbiology, new Category 1 codes include:
- 87634: Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus, amplified probe technique
- 87662: Infectious agent detection by nucleic acid (DNA or RNA); Zika virus, amplified probe technique
There are also new Category III codes:
- 0005T—Infectious agent detection by nucleic acid (DNA or RNA), Human Papillomavirus (HPV) for five or more separately reported high-risk HPV types related to genotyping
- 0495T, +0496T—Initiation and monitoring marginal (extended) cadaver donor lung(s) organ perfusion system by physician or qualified health care professional
- CPT® 2018 also deletes a slew of rarely used codes, from 83499 for hydroxyprogesterone to 88154 for pap, manual with computer assisted rescreening.
The changes for 2018 are broad and varied, noted Garver, who gives participants a rundown of the new, updated and deleted codes, what PLA codes are and how to use them, the specific changes for ICD-10, personal diagnosis responsibility, and ICD-10 basics and common lab and pathology codes.
