Insider Pro Tips for Laboratory and Pathology Coding: Changes Make Waves Sweeping Deep into 2024

Insider Pro Tips for Laboratory and Pathology Coding: Changes Make Waves Sweeping Deep into 2024

In 2024, a wave of new CPT® code changes swept charge masters, delivered by the American Medical Association (AMA), officially effective at the start of the new year. With a vast multitude of coding changes, it’s necessary to review the coding throughout the first half of the year to understand and solidify the nuances that could create challenges at any time. The current codes, guidelines, and parenthetical changes can be found in the 2024 CPT Professional codebook. Due to the abundance of updates, only select changes will be highlighted below. Let’s explore some expert tips and insights on these individual codes.

Cracking into Chemistry Coding Changes
CPT codeCPT descriptionRevenue Code
82166Anti-mullerian hormone (AMH)0300, 0301, 0309

The newly introduced code enables the quantitative assessment of AMH levels in serum.

Newly included in the 2024 AMA CPT Manual, the following chemistry-related PLA code for neurofilament light chain (NfL) analysis was added to CPT, having become effective on January 1, 2023, but first appearing in the 2024 AMA CPT Manual as a new code.

CPT codeCPT descriptionRevenue Code
0361UNeurofilament light chain, digital immunoassay, plasma, quantitative0300, 0301, 0309

Code 0361U is for assessing neuronal damage related to various neurodegenerative diseases.

For additional details on the PLA code set including proprietary name and clinical laboratory or manufacturer, refer to Appendix O of the AMA CPT Manual. For the latest updates, go to https://www.ama-assn.org/practice-management/cpt/cpt-pla-codes.

Microbiology Advancement

In 2024, new CPT codes were introduced in Microbiology. Notably, PLA code 0408U for COVID-19 infectious agent detection via bulk acoustic wave biosensor immunoassay made its debut in the 2024 AMA CPT Manual, with an effective date of October 1, 2023.

For comprehensive information regarding the conclusion of the COVID-19 public health emergency (PHE), please refer to Chapter 18. For detailed insights into the PLA code set, including the most recent additions pertaining to microbiology, consult Appendix O of the CPT Manual. For up-to-date information on PLA code updates, visit https://www.ama-assn.org/practice-management/cpt/cpt-pla-codes.

CPT codeCPT descriptionRevenue Code
87523Infectious agent detection by nucleic acid (DNA or RNA); hepatitis D (delta), quantification, including reverse transcription, when performed0300, 0306, 0309
87593Infectious agent detection by nucleic acid (DNA or RNA); Orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each0300, 0306, 0309

First introduced in 2022 to detect the Orthopoxvirus as a response to the monkeypox outbreak in the United States, CPT code 87593 is now making its debut in the 2024 edition of the CPT manual. Additionally, the following PLA codes, which were added for reporting microbiology-related services, first appeared in the 2024 AMA CPT Manual, but became effective in 2023:

CPT codeCPT descriptionRevenue Code
0369UInfectious agent detection by nucleic acid (DNA and RNA), gastrointestinal pathogens, 31 bacterial, viral, and parasitic organisms and identification of 21 associated antibiotic-resistance genes, multiplex amplified probe technique0300, 0306, 0309
0370UInfectious agent detection by nucleic acid (DNA and RNA), surgical wound pathogens, 34 microorganisms and identification of 21 associated antibiotic-resistance genes, multiplex amplified probe technique, wound swab0300, 0306, 0309
0371UInfectious agent detection by nucleic acid (DNA or RNA), genitourinary pathogen, semiquantitative identification, DNA from 16 bacterial organisms and 1 fungal organism, multiplex amplified probe technique via quantitative polymerase chain reaction (qPCR), urine0300, 0306, 0309
0373UInfectious agent detection by nucleic acid (DNA and RNA), respiratory tract infection, 17 bacteria, 8 fungus, 13 virus, and 16 antibiotic-resistance genes, multiplex amplified probe technique, upper or lower respiratory specimen0300, 0306, 0309
0374UInfectious agent detection by nucleic acid (DNA or RNA), genitourinary pathogens, identification of 21 bacterial and fungal organisms and identification of 21 associated antibiotic-resistance genes, multiplex amplified probe technique, urine0300, 0306, 0309
0402UInfectious agent (sexually transmitted infection), Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Mycoplasma genitalium, multiplex amplified probe technique, vaginal, endocervical, or male urine, each pathogen reported as detected or not detected0300, 0306, 0309
0416UInfectious agent detection by nucleic acid (DNA), genitourinary pathogens, identification of 20 bacterial and fungal organisms, including identification of 20 associated antibiotic-resistance genes, if performed, multiplex amplified probe technique, urine0300, 0306, 0309

The following PLA code was deleted effective October 1, 2023, and referenced as such in the AMA CPT Manual for 2024:

CPT codeCPT descriptionRevenue Code
0066UPlacental alpha-micro globulin-1 (PAMG-1), immunoassay with direct optical observation, cervicovaginal fluid, each specimen0300, 0306, 0309

For qualitative evaluation of cervicovaginal fluid for specific amniotic fluid proteins such as PAMG-1, refer to existing CPT code 84112.

Celebrate Lab Week With MedLearn and an Exclusive Offer!

Lab Week has arrived offering a time dedicated to honoring and celebrating the invaluable contributions of medical lab professionals and pathologists. As an expression of gratitude for your unwavering commitment to healthcare excellence, we have an exclusive limited- time offer.

From April 16th to April 26th, you can enjoy a generous 20% discount on our Laboratory All Access Pass using the code LABWEEK24. Whether you’re a newcomer or a longtime supporter, this offer is our way of saying thank you for being part of our community. Don’t miss out on this chance to unlock unparalleled access to our lab resources at an unbeatable price!*

Print Friendly, PDF & Email
Facebook
Twitter
LinkedIn

Bryan Nordley

Bryan Nordley is a seasoned professional writer, strategist, and researcher with over a decade’s worth of combined experience. Bryan launched his professional health writing career at the University of British Columbia’s Faculty of Medicine, one of the top 30 faculty of medicine programs in the world, working under the School of Public Health as a communications assistant. From there, he expanded his expertise and knowledge into private healthcare and podiatry before taking the role of healthcare writer at MedLearn Media. Bryan is the lead writer for the MedLearn Publishing brand previously producing both the acclaimed radiology and laboratory compliance manager newsletter products, while currently writing the compliance questions of the week which reach over 10,000 subscribers, creating the MedLearn Publishing Insights blogs and collaborating with operations and nationally renowned subject matter experts, in addition to serving as an editor for a variety of MedLearn publications along with marketing initiatives. Bryan continues to keep his pulse on the latest healthcare industry news, analyzing and reporting with strategic insight.

Related Stories

Leave a Reply

Please log in to your account to comment on this article.

Featured Webcasts

Navigating AI in Healthcare Revenue Cycle: Maximizing Efficiency, Minimizing Risks

Navigating AI in Healthcare Revenue Cycle: Maximizing Efficiency, Minimizing Risks

Michelle Wieczorek explores challenges, strategies, and best practices to AI implementation and ongoing monitoring in the middle revenue cycle through real-world use cases. She addresses critical issues such as the validation of AI algorithms, the importance of human validation in machine learning, and the delineation of responsibilities between buyers and vendors.

May 21, 2024
Leveraging the CERT: A New Coding and Billing Risk Assessment Plan

Leveraging the CERT: A New Coding and Billing Risk Assessment Plan

Frank Cohen shows you how to leverage the Comprehensive Error Rate Testing Program (CERT) to create your own internal coding and billing risk assessment plan, including granular identification of risk areas and prioritizing audit tasks and functions resulting in decreased claim submission errors, reduced risk of audit-related damages, and a smoother, more efficient reimbursement process from Medicare.

April 9, 2024
2024 Observation Services Billing: How to Get It Right

2024 Observation Services Billing: How to Get It Right

Dr. Ronald Hirsch presents an essential “A to Z” review of Observation, including proper use for Medicare, Medicare Advantage, and commercial payers. He addresses the correct use of Observation in medical patients and surgical patients, and how to deal with the billing of unnecessary Observation services, professional fee billing, and more.

March 21, 2024
Top-10 Compliance Risk Areas for Hospitals & Physicians in 2024: Get Ahead of Federal Audit Targets

Top-10 Compliance Risk Areas for Hospitals & Physicians in 2024: Get Ahead of Federal Audit Targets

Explore the top-10 federal audit targets for 2024 in our webcast, “Top-10 Compliance Risk Areas for Hospitals & Physicians in 2024: Get Ahead of Federal Audit Targets,” featuring Certified Compliance Officer Michael G. Calahan, PA, MBA. Gain insights and best practices to proactively address risks, enhance compliance, and ensure financial well-being for your healthcare facility or practice. Join us for a comprehensive guide to successfully navigating the federal audit landscape.

February 22, 2024
2024 SDoH Update: Navigating Coding and Screening Assessment

2024 SDoH Update: Navigating Coding and Screening Assessment

Dive deep into the world of Social Determinants of Health (SDoH) coding with our comprehensive webcast. Explore the latest OPPS codes for 2024, understand SDoH assessments, and discover effective strategies for integrating coding seamlessly into healthcare practices. Gain invaluable insights and practical knowledge to navigate the complexities of SDoH coding confidently. Join us to unlock the potential of coding in promoting holistic patient care.

May 22, 2024
2024 ICD-10-CM/PCS Coding Clinic Update Webcast Series

2024 ICD-10-CM/PCS Coding Clinic Update Webcast Series

HIM coding expert, Kay Piper, RHIA, CDIP, CCS, reviews the guidance and updates coders and CDIs on important information in each of the AHA’s 2024 ICD-10-CM/PCS Quarterly Coding Clinics in easy-to-access on-demand webcasts, available shortly after each official publication.

April 15, 2024

Trending News

Happy World Health Day! Our exclusive webcast, ‘2024 SDoH Update: Navigating Coding and Screening Assessment,’  is just $99 for a limited time! Use code WorldHealth24 at checkout.

SPRING INTO SAVINGS! Get 21% OFF during our exclusive two-day sale starting 3/21/2024. Use SPRING24 at checkout to claim this offer. Click here to learn more →