ICD-10 and CPT 2020

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The American Medical Association (AMA) has made Current Procedural Terminology (CPT) code changes to the 2020 edition of the CPT coding manual. In addition, CMS has also made changes to Healthcare Common Procedure Coding System (HCPCS) codes.

Diagnostic Laboratory of Oklahoma (DLO) will be implementing these changes effective January 1, 2020. Overall, the changes for 2020 affect the way we bill some of our tests. These tests may also be included in panels or profiles. The below chart lists the tests affected and the appropriate CPT code changes.

DLO Order Code DLO Test Name 2019 CPT Coding 2020 CPT Coding
92571 PALB2 Sequencing and Deletion/Duplication 81406, 81479 81307, 81479
92587 BRCAvantage Plus® (BRCA1, BRCA2, TP53, PTEN, CDH1, STK11, PALB2) 81162, 81321, 81323, 81404, 81405 x2, 81406 x2, 81479 81162, 81307, 81321, 81323, 81404, 81405 x2, 81406, 81479
94877 Familial Hypercholesterolemia (FH) Panel 81405, 81406 (x2), 81479 81405, 81406 x2, 81407, 81479
16897 PIK3CA Mutation Analysis 81404 81309
18902 Colorectal Cancer Mutation Panel (KRAS, PIK3CA, BRAF, NRAS) 81275, 81276, 81210, 81404, 81311 81275, 81276, 81210, 81309, 81311
36943 Pharmacogenomics Panel 81225, 81226, 81227, 81230, 81231, 81232, 81247, 81306, 81400, 81381 (x4), 81283, 81291, 81328, 81335, 81350, 81355, 81479 81225, 81226, 81227, 81230, 81231, 81232, 81247, 81306, 81400, 81404, 81381 (x4), 81283, 81291, 81328, 81335, 81350, 81355, 81479
90961 Chromosomal Microarray, Hematologic Malignancy, ClariSure® Oligo-SNP 81406 81277
38842 Chromosomal Microarray, Solid Tumor FFPE, Clarisure(R) Oligo-SNP 81406 81277
36296 Adalimumab Drug Level and Anti-drug Antibody for IBD 83520, 80299 83520, 80145
36297 Adalimumab Drug Level and Anti-drug Antibody for Rheumatic Diseases 83520, 80299 83520, 80145
36298 Adalimumab Level for IBD 80299 80145
36299 Adalimumab Level for Rheumatic Diseases 80299 80145
36303 Infliximab Level for IBD 80299 80230
36310 Infliximab Level for Rheumatic Diseases 80299 80230
36311 Infliximab Level and Anti-drug Antibody for IBD 83520, 80299 83520, 80230
36312 Infliximab Level and Anti-drug Antibody for Rheumatic Diseases 83520, 80299 83520, 80230
93176 Infliximab Quantitation with Reflex to Antibodies to Infliximab, Serum 80299 with reflex to 82397 80230 with reflex to 82397
16262 Lacosamide 80299 80235
94010 Posaconazole 80299 80187
94096 Voriconazole 80299 80285
94692 Voriconazole, CSF 80299 80285
91475 SureSwab®, Mycoplasma genitalium, Real-Time PCR 87798 87563
91477 SureSwab®, Mycoplasma/Ureaplasma Panel, Real-Time PCR 87798 x4 87798 x3, 87563
36962 Sexually-Transmitted Infections (STIs) Cervicitis Panel 87491, 87591, 87661, 87798 87491, 87591, 87661, 87563
36963 Sexually-Transmitted Infections (STIs) Increased Risk Panel 87491, 87591, 87661, 87798 87491, 87591, 87661, 87563
36964 Sexually-Transmitted Infections (STIs) Male Urethritis Panel 87491, 87591, 87661, 87798 87491, 87591, 87661, 87563
36965 Sexually-Transmitted Infections (STIs)Pelvic Inflammatory Disease(PID)Panel 87491, 87591, 87661, 87798 87491, 87591, 87661, 87563

We appreciate your support and look forward to continuing to serve all of your laboratory needs. We at DLO will make every effort to assist you with the transition to the 2020 AMA CPT coding being used for our test offerings.

Note: The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.