CPT 2021 Lab Code Updates

CPT® 2021 code updates for quarters 2 and 3 have been released by the American Medical Association (AMA). The new, revised, and deleted codes will be updated in Codify by AAPC as the changes go into effect. Make sure your practice updates other coding resources such as the CPT® 2021 code book and electronic health record system software.

Proprietary Laboratory Analyses (PLA) Code Changes

In Appendix O – Multianalyte Assays with Algorithmic Analyses and PLA there are several new codes, as well as a few code deletions and one code revision, that will become effective either April 1 or July 1.

New lab codes, effective April 1 are:

0242U – Targeted genomic sequence analysis panel, solid organ neoplasm, cell-free circulating DNA analysis of 55-74 genes, interrogation for sequence variants, gene copy number amplifications, and gene rearrangements

0243U – Obstetrics (preeclampsia), biochemical assay of placental-growth factor, time-resolved fluorescence immunoassay, maternal serum, predictive algorithm reported as a risk score for preeclampsia

0244U – Oncology (solid organ), DNA, comprehensive genomic profiling, 257 genes, interrogation for single-nucleotide variants, insertions/deletions, copy number alterations, gene rearrangements, tumor-mutational burden and microsatellite instability, utilizing formalin-fixed paraffin-embedded tumor tissue

0245U – Oncology (thyroid), mutation analysis of 10 genes and 37 RNA fusions and expression of 4 mRNA markers using next-generation sequencing, fine needle aspirate, report includes associated risk of malignancy expressed as a percentage

0246U – Red blood cell antigen typing, DNA, genotyping of at least 16 blood groups with phenotype prediction of at least 51 red blood cell antigens

0247U – Obstetrics (preterm birth), insulin-like growth factor-binding protein 4 (IBP4), sex hormone-binding globulin (SHBG), quantitative measurement by LC-MS/MS, utilizing maternal serum, combined with clinical data, reported as predictive-risk stratification for spontaneous preterm birth

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Deleted lab codes, effective April 1:

  • 0098U
  • 0099U
  • 0100U
Category III Code Changes

Category III codes are “temporary codes for emerging technology, services, procedures, and service paradigm,” according to AMA’s CPT® Professional 2021 code book. Payers generally do not cover such services, so these codes are primarily for reporting purposes only.

New Category III codes, effective July 1:

0640T – Noncontact near-infrared spectroscopy studies of flap or wound (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation [StO2]); image acquisition, interpretation and report, each flap or wound

0641T – Noncontact near-infrared spectroscopy studies of flap or wound (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation [StO2]); image acquisition only, each flap or wound

0642T – Noncontact near-infrared spectroscopy studies of flap or wound (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation [StO2]); interpretation and report only, each flap or wound

0643T – Transcatheter left ventricular restoration device implantation including right and left heart catheterization and left ventriculography when performed, arterial approach

0644T – Transcatheter removal or debulking of intracardiac mass (eg, vegetations, thrombus) via suction (eg, vacuum, aspiration) device, percutaneous approach, with intraoperative reinfusion of aspirated blood, including imaging guidance, when performed

0645T – Transcatheter implantation of coronary sinus reduction device including vascular access and closure, right heart catheterization, venous angiography, coronary sinus angiography, imaging guidance, and supervision and interpretation, when performed

0646T – Transcatheter tricuspid valve implantation/replacement (TTVI) with prosthetic valve, percutaneous approach, including right heart catheterization, temporary pacemaker insertion, and selective right ventricular or right atrial angiography, when performed

0647T – Insertion of gastrostomy tube, percutaneous, with magnetic gastropexy, under ultrasound guidance, image documentation and report

0648T – Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained without diagnostic MRI examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session

0649T – Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic MRI examination of the same anatomy (eg, organ, gland, tissue, target structure) (List separately in addition to code for primary procedure)

0650T – Programming device evaluation (remote) of subcutaneous cardiac rhythm monitor system, with iterative adjustment of the implantable device to test the function of the device and select optimal permanently programmed values with analysis, review and report by a physician or other qualified health care professional

0651T – Magnetically controlled capsule endoscopy, esophagus through stomach, including intraprocedural positioning of capsule, with interpretation and report

0652T – Esophagogastroduodenoscopy, flexible, transnasal; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)

0653T – Esophagogastroduodenoscopy, flexible, transnasal; with biopsy, single or multiple

0654T – Esophagogastroduodenoscopy, flexible, transnasal; with insertion of intraluminal tube or catheter

0655T – Transperineal focal laser ablation of malignant prostate tissue, including transrectal imaging guidance, with MR-fused images or other enhanced ultrasound imaging

0656T – Vertebral body tethering, anterior; up to 7 vertebral segments

0657T – Vertebral body tethering, anterior; 8 or more vertebral segments

0658T – Electrical impedance spectroscopy of 1 or more skin lesions for automated melanoma risk score

0659T – Transcatheter intracoronary infusion of supersaturated oxygen in conjunction with percutaneous coronary revascularization during acute myocardial infarction, including catheter placement, imaging guidance (eg, fluoroscopy), angiography, and radiologic supervision and interpretation

0660T – Implantation of anterior segment intraocular nonbiodegradable drug-eluting system, internal approach

0661T – Removal and reimplantation of anterior segment intraocular nonbiodegradable drug-eluting implant

0662T – Scalp cooling, mechanical; initial measurement and calibration of cap

0663T –  Scalp cooling, mechanical; placement of device, monitoring, and removal of device (List separately in addition to code for primary procedure)

0664T – Donor hysterectomy (including cold preservation); open, from cadaver donor

0665T – Donor hysterectomy (including cold preservation); open, from living donor

0666T – Donor hysterectomy (including cold preservation); laparoscopic or robotic, from living donor

0667T – Donor hysterectomy (including cold preservation); recipient uterus allograft transplantation from cadaver or living donor

0668T – Backbench standard preparation of cadaver or living donor uterine allograft prior to transplantation, including dissection and removal of surrounding soft tissues and preparation of uterine vein(s) and uterine artery(ies), as necessary

0669T – Backbench reconstruction of cadaver or living donor uterus allograft prior to transplantation; venous anastomosis, each

0670T – Backbench reconstruction of cadaver or living donor uterus allograft prior to transplantation; arterial anastomosis, each

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Lastly, one code is revised, effective July 1:

0493T – Contact near-infrared spectroscopy studies of lower extremity wounds (eg, for oxyhemoglobin measurement)

See the revised guidelines in the Introduction section of CPT® 2021 for more information about AMA’s process for releasing Category I, II, and II codes and updating the CPT® code set annually and throughout the year.

CPT® 2021 Errata and Technical Corrections

AMA also published CPT® 2021 errata and technical corrections on Dec. 1, 2020.

Category I Code Changes

Category I codes are used to report professional services. Code changes released Dec. 1, 2020, are effective Jan. 1, 2021, and include:

In the Evaluation and Management section of CPT® 2021, the parenthetical note under complex chronic care service code 99489 is revised. Strike out deleted code 98969.

For More Information: https://www.aapc.com/blog/52627-cpt-2021-update-new-lab-category-iii-codes/

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