AMA CPT® Assistant - 2021 Issue 8 (August)
Pathology and Laboratory Tier 2 to Tier 1 Code Conversions (August 2021)
August 2021 pages 10-11 Pathology and Laboratory Tier 2 to Tier 1 Code Conversions Important changes were made to the Molecular Pathology subsection of the Pathology and Laboratory section of the Current Procedural Terminology (CPT®) 2021 code set. In particular, four new Tier 1 codes were established to describe genetic analysis for follicular lymphoma (81278) and myeloproliferative neoplasms or disorders (81279, 81338, 81339). Previously, these services were reported with Tier 2 codes 81402 and/or 81403. However, since the initial inclusion of these codes in the Tier 2 subsection, their usage has increased and warrants conversion to separately identifiable...
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Article Overview
This CPT Assistant article explains an August 2021 update in the molecular pathology subsection of the Pathology and Laboratory section of CPT. It is intended for coding professionals, laboratorians, and clinicians who need to understand which genetic analysis services were moved from Tier 2 to Tier 1 and how the article frames the related clinical scenarios and procedural descriptions. The article also places the update in the context of follicular lymphoma and myeloproliferative neoplasm testing, along with the previously used molecular pathology tier codes.
Why This Topic Matters
Understanding these CPT molecular pathology code conversions helps support accurate reporting of laboratory testing and alignment with the updated code set structure. It is relevant for organizations that bill or document genetic testing services and need to track changes across CPT editions.
Article Sections
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August 2021 pages 10-11
Identifies the publication context and the general topic of the update within CPT Assistant.
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Pathology and Laboratory Tier 2 to Tier 1 Code Conversions
Introduces the molecular pathology update and the broad category of services affected by the code conversion.
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Tier 1 Molecular Pathology Procedures
Lists the newly established Tier 1 molecular pathology procedures discussed in the article.
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Clinical Example (81278) / Description of Procedure (81278)
Presents a representative scenario and associated procedure narrative for one of the updated molecular pathology services.
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Clinical Example (81279) / Description of Procedure (81279)
Presents a representative scenario and associated procedure narrative for another updated molecular pathology service.
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Clinical Example (81338) / Description of Procedure (81338)
Presents a representative scenario and associated procedure narrative for a molecular pathology service related to MPL testing.
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Clinical Example (81339) / Description of Procedure (81339)
Presents a representative scenario and associated procedure narrative for the related MPL sequence analysis service.
What You Will Learn
- Which molecular pathology services were converted from Tier 2 to Tier 1 in the August 2021 CPT update
- How the article frames the affected pathology and laboratory subsection
- What clinical context the article uses to illustrate the updated molecular testing services
- How the update is presented in relation to prior CPT molecular pathology tier reporting
Who Should Read This
- Medical coders
- Billing specialists
- Laboratory professionals
- Hematology and oncology practices
- Pathology practices
Codes Discussed
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