Wednesday, 22 October 2014

Pathology and Laboratory CPT code list

• CPT Divided into fourteen subsections:

Organ or Disease Oriented Panels 80048* - 80076
Drug Testing 80100 - 80103
Therapeutic Drug Assays 80150 - 80299
Evocative/Suppression Testing 80400 - 80440
Consultations (Clinical Pathology) 80500 - 80502
Urinalysis 81000 - 81099
Chemistry 82000 - 84999
Hematology and Coagulation 85002 - 85999
Immunology 86000 - 86849
Transfusion Medicine 86850 - 86999
Microbiology 87001 - 87999
Anatomic Pathology 88000 - 88099
Cytopathology 88104 - 88199
Cytogenetic Studies 88230 - 88299
Surgical Pathology 88300 - 88399
Transcutaneous Procedures 88400
Other Procedures 89050 - 89399

Laboratory and pathology cpt code 80500, 80502, 88300,88309, 88342

Laboratory and pathology codes during colonoscopy episode

Description CPT/HCPCs

Consultations (Clinical pathology)

Clinical Pathology Consultation, Limited, Without Review Of Patient's History And Medical Records : 80500

Clinical Pathology Consultation, Comprehensive, For A Complex 
Diagnostic Problem, With Review Of Records : 80502

Surgical Pathology

Level I - Surgical Pathology, Gross Examination Only : 88300

Level III - Surgical Pathology, Gross And Microscopic (Abscess, Colon, Colsotomy, Hematoma, Soft Tissue Debridement) : 88304

Level IV - Surgical Pathology, Gross And Microscopic (Colon Biopsy, Lymph Node Biopsy, Colorectal Polyp) : 88305

Level V - Surgical Pathology, Gross And Microscopic (Colon, Segmental Resection, Other Than For Tumor, Liver Biopsy Or Partial Resection) : 88307

Level VI - Surgical Pathology, Gross And Micoscopic (Colon, 
Resection For Tumor, Total Colon Resection) : 88309

Special Stains, Histochemical With Frozen Section : 88314

Consultation And Report On Referred Slides Prepared Elsewhere : 8321 

Consultation And Report On Referred Material Requiring Preparation Of Slides : 88323

Consultation, Comprehensive, With Review Of Records And Specimens : 88325

Immunohistochemistry (including tissue immunoperoxidase), each antibody : 88342

Pathology service under ASC setup - Would insurance reimburse

Non-ASC Facility Services

Non-ASC facility services include a number of items and services furnished in an ASC that can be reimbursed under other Florida Workers’ Compensation Manuals which are not reimbursable to an ASC facility.

The following are examples of non-ASC facility services that must be billed and reimbursed to those providers under other Florida Workers’ Compensation Reimbursement Manual policies and guidelines:

• Physician and other recognized health care practitioner services;

• Sale, lease, or rental of durable medical equipment for ASC patients to use at home;

• Services furnished by an independent laboratory; and

• Hospital-based Ambulance services.

Pathology/Laboratory Services

Preadmission pathology or laboratory services, when required by the physician and performed by the ASC on a date other than the date of surgery, shall be reimbursed in accordance with the Fee Schedule established for health care providers in the Florida Workers Compensation Health Care Provider Reimbursement Manual, Rule 69L-7.020, F.A.C.

Pathology or laboratory services provided by an Independent Clinical Laboratory shall be billed and reimbursed directly to the laboratory service provider according to the fee schedule in rule 69L-7.020, F.A.C. However, the ASC shall be reimbursed for procedure code 36415 for the collection of a blood specimen that must be conveyed to an independent laboratory.

Lab CPT codes list which can be performed by CLIA certified providers. Providers with a CLIA certificate may conduct the following laboratory tests in their offices:

Description Codes Description Codes

Urinalysis 81000- 81003

Crystal Identification 89060

Glucose 82947- 82948

ESR 85651, 85652

Prothrombin time 85610

BM Aspiration 85097

Tuberculosis Intra-Dermal Skin Test 86580

Platelet 85007

Urine Pregnancy Test 81025

Bilirubin Direct 82248

Tissue Exam (KOH) Prep 87220

Bilirubin Total 82247

Wet Mounts 87177, 87210

Hemoglobin Glycated 83036

FOBT (Hemocult) 82270

Blood Smear 85060

Strep Test Group A 87070, 87880

Molecular Cytogenetics Chromosomal 88273

CBC 85025- 85048

Molecular Cytogenetics Interphase 88274

BUN, Creatinine 82565

Special Stains Group I 88312

Potassium 84132

Special Stains Group II 88313

Hemoglobin 85018

Clinical Pathology Consultation Limited 80500

Semen Analysis 89300 - 89320

Clinical Pathology Consultation Comprehensive 80502

Sperm Evaluation 89329

Lead Testing 83655

Cervical Mucus Penetration Test 89330

Rapid Flu Test 87804

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