No Grace Period for New and Revised 2007 CPT-4 Codes


To:      PSA Affiliated Practices

From:  John R. Outlaw, Chief Compliance Officer

Re:      Reminder -- No Grace Period for New 2007 CPT Codes

This is a reminder that the Centers for Medicare and Medicaid Services (CMS) implemented a policy change a couple of years ago eliminating the 90-day grace period for converting to the use of new procedure codes. Therefore, the following new and revised CPT-4 codes for 2007 are now required for all services provided on or after January 1, 2007.

NEW CPT CODES for 2007

Chemistry 

82107:  Alpha-fetoprotein (AFP); AFP-L3 fraction isoform and total AFP (including ratio)

83698:  Lipoprotein-associated phospholipase A2, (Lp-PLA2)

83913:  Molecular diagnostics; RNA stabilization

The 83913 code was specifically created to report the stabilization of ribonucleic acid (RNA) in molecular pathology techniques.  Prior to 2007, molecular diagnostic CPT code descriptors only recognized the preservation of nucleic acid material. 

Immunology

86788:  Antibody; West Nile virus, IgM

86789: Antibody; West Nile virus

Microbiology

87305:  Infection agent antigen detection by enzyme immunoassay technique, qualitative or semiqualitative,
            multiple-step method; Aspergillus

87498:  Infectious agent detection by nucleic acid (DNA or RNA); enterovirus, amplified probe technique

87640:  Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, amplified probe
            technique

87641:  Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, methicillin
            resistant, amplified probe technique (For assays that detect methicillin resistance and identify
            Staphylococcus aureus using a single nucleic acid sequence, use 87641)

87653:  Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group B, amplified probe
            technique

87808:  Infectious agent detection by immunoassay with direct optical observation; Trichomonas vaginalis

REVISED CPT CODES for 2007

Microbiology

87088:  Culture, bacterial; with isolation and presumptive identification of each isolate, urine

This revision was created to clarify the AMA’s intent that each isolate identified in a bacterial culture of a urine specimen should be separately coded. 

Cytopathology 

88106:  Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with
            interpretation

88107:  Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears and simple filter
            preparation with interpretation
            (For non-gynecological selective cellular enhancement including filter transfer techniques, use 88112)

The 88106 and 88107 were created to report simple filter methodologies.  However, some coders mistakenly applied these codes when the newer filter transfer techniques such as thin layer methodologies were performed.  In addition to revising the 88106 and 88107 codes, the 2007CPT-4 manual includes an instructional note clarifying that the 88112 code is to be assigned when cellular enhancement techniques or the thin layer methodology is performed.

Surgical Pathology

89060:  Crystal identification by light microscopy with or without polarizing lens analysis; tissue or any body 
            fluid (except urine)
            (Do not report 89060 for crystal identification on paraffin-embedded tissue)

The 89060 previously stated “Crystal identification by light microscopy with or without polarizing lens analysis; any body fluid.”  The code revision allows coders to now assign the 89060 code when smears from a tissue sample are evaluated for crystals.  The parenthetical note clearly advises that this code is not to be assigned for crystal identification in paraffin embedded tissue.  In order to report the 89060 code, the physician must issue a report with findings.