Q&A: Are new laboratory testing codes valid for reporting?

Q: Our laboratory has been running some testing for “proprietary laboratory analyses” for colorectal and ovarian cancer. The codes they gave me are not active, but they said they are the testing codes provided by the manufacturer. The codes are 0002U and 0003U. Are these valid codes to report on a claim?

A: Yes, the codes are valid. The CPT Editorial Panel approved three codes effective February 1, 2017. Because they were released in February, they were not included in the January update to the I/OCE nor in Addendum B. The three new codes, including the two you reference, are:

• 0001U, red blood cell antigen typing, DNA, human erythrocyte antigen gene analysis of 35 antigens from 11 blood groups, utilizing whole blood, common RBC alleles reported
• 0002U, oncology (colorectal), quantitative assessment of three urine metabolites (ascorbic acid, succinic acid and carnitine) by liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring acquisition, algorithm reported as likelihood of adenomatous polyps
• 0003U, oncology (ovarian) biochemical assays of five proteins (apolipoprotein A-1, CA 125 II, follicle stimulating hormone, human epididymis protein 4, transferrin), utilizing serum, algorithm reported as a likelihood score

These codes will be in the April updates to the I/OCE and Addendum B. The effective date is retroactive to February 1, 2017, and all three codes are reportable under the OPPS. Code 0001U has been assigned status indicator A (services paid under fee schedule or payment system other than OPPS) and 0002U and 0003U are assigned to status indicator Q4 (conditionally packaged laboratory tests).

Editor’s note: Denise Williams, RN, CPC-H, senior vice president of revenue integrity services at Revant Solutions, in Fort Lauderdale, Florida, answered this question.

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