Preview What’s New for Path/Lab in CPT® 2018

CPT® 2018 news is taking on momentum. Checking out the MPFS 2018 proposed rule offered us a handy preview of new codes coming in CPT® 2018 priced under MPFS. Let’s turn our attention now to what path/lab coders can expect. We’ll focus here on changes where you’ll have more than one new option to choose from. For more complete analysis, check out Pathology/Lab Coding Alert (if this is your specialty, you’ll be glad you did!).

Note: Adjustments may occur to these codes before the code set implementation date of Jan. 1, 2018.

Make Room for Molecular Pathology Additions

  • HPA: Expect eight new codes for human platelet antigen genotyping. In each code descriptor, you’ll find the wording “eg, neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura.” Check for revisions to 81400 (Molecular pathology procedure, Level 1 …) that remove HPA.
  • IDH1: Watch for two new codes specific to isocitrate dehydrogenase. The clinical example given is glioma. IDH1 references in level-4 code 81403 will be removed.
  • ASXL 1: Plan on two gene sequence analysis codes for additional sex combs like 1. Examples listed are myelodysplastic syndrome, myeloproliferative neoplasms, and chronic myelomonocytic leukemia.
  • CYP3A: Two is also the number of codes for cytochrome P450 family 3 subfamily A. The example for these gene analysis codes is drug metabolism. Watch for changes removing CYP3A from level-2 code 81401 .
  • G6PD: Prepare for three new glucose-6-phosphate dehydrogenase gene analysis codes. Jaundice and hemolytic anemia are the examples in the descriptors.
  • HBA1/HBA2: Three codes will join CPT® 2018 for alpha globin 1 and alpha globin 2 gene analysis. Examples include alpha thalassemia, Hb Bart hydrops fetalis syndrome, and HbH disease. HBA1/HBA2 references will be deleted from level-5 code 81404 and level-6 code 81405.
  • HBB: Four new codes for hemoglobin, subunit beta list the clinical examples of sickle cell anemia, beta thalassemia, and hemoglobinopathy. Expect removal of HBB from level 2, 4, and 5 codes 81401, 81403, and 81404.

Focus on Oncology for MAAA

  • Breast: Watch for two new mRNA gene expression profiling codes for breast cancer. One is for an “algorithm reported as a recurrence risk score” and the other involves an “algorithm reported as index related to risk of distant metastasis.”
  • Prostate: You’ll have another two codes for prostate cancer tests. Here the algorithms will be reported as “a disease-specific mortality risk score” and “a likelihood of prostate cancer detection on repeat biopsy.”

Look 2 Places for Zika Tests

  • Immunology: You’ll have a code specific to immunoassay to evaluate for IgM antibodies to Zika virus.
  • Microbiology: You’ll have a separate code for Zika virus detection by nucleic acid by amplified probe technique.

What About You?

Do you see a code you’ve been waiting for? This isn’t a complete listing, but was there one you were hoping for you didn’t see?


Deborah works on a wide range of TCI SuperCoder projects, researching and writing about coding, as well as assisting with data updates and tool development for our online coding solutions. Since joining TCI in 2004, she’s covered the ins and outs of coding for radiology, cardiology, oncology and hematology, orthopedics, audiology, and more.

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