If the American Medical Association (AMA) and Centers for Disease Control and Prevention (CDC) ever picked a year to keep pathology coders busy, it’s surely 2019. This year alone you’ll find at least 93 pathology CPT® codes changes set to take effect January 1, 2019. And 8 new ICD-10-CM codes took effect as of Oct. 1, 2018.
All these changes will impact your lab test reporting in 2019, says coding and compliance manager Peggy Slagle, meaning it’s time to turbocharge your productivity. Slagle’s aim is to help you do just that in her 4-part webinar series on CPT® and ICD-10 laboratory and pathology coding—part of ProfEdOnDemand’s 2019 Coding Updates Virtual Boot Camp—where she arms attendees with reimbursement information for the new codes.
Here’s a preview of some of the newest codes:
Stay Abreast of 3 Deleted, 5 Added BRCA Codes
In 2019 you can say adios to BRCA codes 81211, 81213, and 81214, which will now be replaced by 5 codes a bit further down the list:
- 81163, BRCA1, BRCA2 gene analysis; full sequence analysis
- 81164, BRACA1, BRCA2 gene analysis; full duplication/deletion analysis
- 81165, BRCA1 gene analysis; full sequence analysis
- 81166, BRCA1 gene analysis; full duplication/deletion analysis
- 81167, BRCA2 gene analysis; full duplication/deletion analysis
Tip: More than anything, watch the definitions for each code, as those like 81166 and 81167 are identical except for one number (BRCA1 vs. BRCA2).
Switch out HCV Codes
No more will you see hepatitis C virus (HCV) code 0001M, which is now replaced by 81596, Infectious disease, chronic HCV infection, six biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, and haptoglobin) utilizing serum, prognostic algorithm reported as scores for fibrosis and necroinflammatory activity in liver.
Update your coding arsenal accordingly.
Interpret 1 Deleted, 7 New Chromosome Codes
If you’re used to coding for 0028U, Cyp2D6 gene analysis code, stop and instead use codes 0070U-0076U.
CYPD2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) gene analysis
- 0070U, Common and select rare variants
- 0071U, full gene sequence
- 0072U-0076U, targeted analysis
Don’t forget: Be careful with 0072U, as the definitions are very similar since they all relate to targeted analysis. The kind of targeted analysis differs based on the code, e.g. “CYP2D7-2D6 hybrid gene” for 0073U, but “3’ gene duplication/multiplication” for 0076U. Don’t forget also to list 0071U-0076U separately in addition to the primary procedure.
Are you behind? While most CPT® codes take effect Jan. 1, 2019, these gene analysis codes have an implementation date of Oct. 1, 2018 (as do 2019 ICD-10-CM updates). If you’re not using them already, make a note to do so promptly to avoid lost reimbursement.
Study 24 Additional Gene Analysis Codes
Gene analysis is a heavy theme in this year’s pathology CPT® codes changes. Here’s a brief list of what’s new:
- 81171-81172, AFF2 (gene analysis)
- 81173-81174, 81204, AR (androgen receptor)
- 81177, ATN1 (atrophin 1)
- 81178-81183, ATXN1-ATXN10 (ataxin 1-10)
- 81184-81186, CACNA1A (calcium voltage-gated channel subunit alpha1 A)
- 81188-81190, CSTB (cystatin B)
- 81271, 81274, HTT (huntingtin)
- 81284-81286, 81289, FXN (frataxin)
Munch on New ICD-10 Codes for Metabolism Disorders, Cannabis Use
Moving quickly to pathology ICD-10 code changes, don’t forget about the 8 new codes covered in a previous post. Covering the areas of psychiatry, cardiology, and neurology, these codes are:
- 81, Gamma aminobutyric acid metabolism disorders
- 89, Other amino-acid metabolism disorders
- 26, Sulfatase deficiency
- 41, Elevated lipoprotein(a)
- 49, Other hyperlipidemia
- 02, Plasminogen deficiency
Cannabis
- 23, Cannabis dependence with withdrawal
- 93, Cannabis use, unspecified with withdrawal
With all the pathology CPT® and ICD-10 additions, revisions, and deletions you’ve got coming at you, you’re probably feeling the need for a coding and reimbursement tune-up. That’s just what Slagle’s four pathology sessions during the 2019 Coding Updates Virtual Boot Camp are designed to give you. There’s no way you’ll walk away with anything but the fullest and most updated information to make 2019 a success.
