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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.
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