Insider Pro Tips for Laboratory and Pathology Coding: Changes Make Waves Sweeping Deep into 2024

In 2024, a wave of new CPT? code changes swept charge masters, delivered by the American Medical Association (AMA), officially effective at the start of the new year. With a vast multitude of coding changes, it’s necessary to review the coding throughout the first half of the year to understand and solidify the nuances that could create challenges at any time. The current codes, guidelines, and parenthetical changes can be found in the 2024 CPT Professional codebook. Due to the abundance of updates, only select changes will be highlighted below. Let’s explore some expert tips and insights on these individual codes.

Cracking into Chemistry Coding Changes

82166 Anti-mullerian hormone (AMH)

The newly introduced code enables the quantitative assessment of AMH levels in serum.

Newly included in the 2024 AMA CPT Manual, the following chemistry-related PLA code for neurofilament light chain (NfL) analysis was added to CPT, having become effective on January 1, 2023, but first appearing in the 2024 AMA CPT Manual as a new code.

0361U Neurofilament light chain, digital immunoassay, plasma, quantitative

Code 0361U is for assessing neuronal damage related to various neurodegenerative diseases.

For additional details on the PLA code set including proprietary name and clinical laboratory or manufacturer, refer to Appendix O of the AMA CPT Manual. For the latest updates, go to https://www.ama-assn.org/practice-management/cpt/cpt-pla-codes.

87523 Infectious agent detection by nucleic acid (DNA or RNA); hepatitis D (delta), quantification, including reverse transcription, when performed

87593 Infectious agent detection by nucleic acid (DNA or RNA); Orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each

Microbiology Advancement

In 2024, new CPT codes were introduced in Microbiology. Notably, PLA code 0408U for COVID-19 infectious agent detection via bulk acoustic wave biosensor immunoassay made its debut in the 2024 AMA CPT Manual, with an effective date of October 1, 2023.

For comprehensive information regarding the conclusion of the COVID-19 public health emergency (PHE), please refer to Chapter 18. For detailed insights into the PLA code set, including the most recent additions pertaining to microbiology, consult Appendix O of the CPT Manual. For up-to-date information on PLA code updates, visit https://www.ama-assn.org/practice-management/cpt/cpt-pla-codes.

First introduced in 2022 to detect the Orthopoxvirus as a response to the monkeypox outbreak in the United States, CPT code 87593 is now making its debut in the 2024 edition of the CPT manual. Additionally, the following PLA codes, which were added for reporting microbiology-related services, first appeared in the 2024 AMA CPT Manual, but became effective in 2023:

0369U Infectious agent detection by nucleic acid (DNA and RNA), gastrointestinal pathogens, 31 bacterial, viral, and parasitic organisms and identification of 21 associated antibiotic-resistance genes, multiplex amplified probe technique

0370U Infectious agent detection by nucleic acid (DNA and RNA), surgical wound pathogens, 34 microorganisms and identification of 21 associated antibiotic-resistance genes, multiplex amplified probe technique, wound swab

0371U Infectious agent detection by nucleic acid (DNA or RNA), genitourinary pathogen, semiquantitative identification, DNA from 16 bacterial organisms and 1 fungal organism, multiplex amplified probe technique via quantitative polymerase chain reaction (qPCR), urine

0373U Infectious agent detection by nucleic acid (DNA and RNA), respiratory tract infection, 17 bacteria, 8 fungus, 13 virus, and 16 antibiotic-resistance genes, multiplex amplified probe technique, upper or lower respiratory specimen

0374U Infectious agent detection by nucleic acid (DNA or RNA), genitourinary pathogens, identification of 21 bacterial and fungal organisms and identification of 21 associated antibiotic-resistance genes, multiplex amplified probe technique, urine

0402U Infectious agent (sexually transmitted infection), Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Mycoplasma genitalium, multiplex amplified probe technique, vaginal, endocervical, or male urine, each pathogen reported as detected or not detected

0416U Infectious agent detection by nucleic acid (DNA), genitourinary pathogens, identification of 20 bacterial and fungal organisms, including identification of 20 associated antibiotic-resistance genes, if performed, multiplex amplified probe technique, urine

The following PLA code was deleted effective October 1, 2023, and referenced as such in the AMA CPT Manual for 2024:

0066U Placental alpha-micro globulin-1 (PAMG-1), immunoassay with direct optical observation, cervicovaginal fluid, each specimen

For qualitative evaluation of cervicovaginal fluid for specific amniotic fluid proteins such as PAMG-1, refer to existing CPT code 84112.

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