Health Information Management

Tip: Keep an eye on evolving molecular pathology codes

APCs Insider, May 17, 2013

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Why do some molecular pathology codes clearly list variants as examples, not an exclusive list, while other codes don’t? The answer may lie in the rapid scientific advances that are being made for some gene mutations and associated tests. This may explain why the code for FLT3 was created to cover only the ITD variants, for example, even though there are other variants of interest such as the D835 variant.

Some genes already have multiple molecular pathology codes, which means coders must know exactly what is being tested. For example, for KRAS gene testing (v-Ki-ras2 Kirsten rat sarcoma viral oncogene), Tier 1 CPT code 81275 covers variants in codons 12 and 13, while Tier 2 CPT code 81403 covers variants in exon 3 (codon 61). In addition, labs test for other variants in the KRAS gene, which require coders to report unlisted code 81479.
 
The tip is adapted from “New molecular pathology coding still complex” in the April Briefings on APCs.



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