Pathology and Laboratory, 82378, 84153, 86316 (Q&A) (August 1996)

August 1996 page 11a Coding Consultation Pathology and Laboratory, 82378, 84153, 86316 (Q&A) Question Our clinic is providing the new CA27.29 antigen test for our patients with Stage II and Stage III breast cancer. How should this service be coded? AMA Comment The correct code for the CA27.29 test is 86316 Immunoassay for tumor antigen (eg, cancer antigen 125) each. Although the code lists CA 125, this is only an example, and the code is not limited to the reporting of tests for that antigen. Cancer antigen 27.29 is a tumor marker that is present...

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Note:  The following article synopsis was NOT provided by the AMA. It was created by Find-A-Code/innoviHealth.

Article Overview

This article reviews a pathology and laboratory coding question from CPT Assistant focused on how to report a tumor marker assay discussed in the context of breast cancer follow-up. It is relevant to laboratory coders, pathology practices, and clinic billing staff who work with CPT coding guidance for immunoassay and tumor marker testing. The discussion centers on identifying the appropriate CPT code and clarifying how the article frames the test in relation to other commonly referenced laboratory assays.

Why This Topic Matters

Correct reporting of laboratory tumor marker testing affects claim accuracy, coding consistency, and alignment with CPT guidance in oncology-related lab services. The article helps readers understand the coding context for a specific assay without relying on assumptions from an abbreviated code listing.

Article Sections

  1. Coding Consultation

    Introduces the coding question presented to CPT Assistant and the laboratory service context in which it arises.

  2. Question

    Presents the clinical and billing scenario prompting the coding inquiry.

  3. AMA Comment

    Summarizes the editorial guidance provided by the AMA on the laboratory coding topic and its relationship to related pathology and laboratory services.

What You Will Learn

  • How the article frames a laboratory coding question in oncology-related testing
  • What general CPT guidance the article provides for a tumor marker assay
  • How the discussion distinguishes the assay from other referenced laboratory tests
  • The laboratory and pathology coding context addressed by the AMA commentary

Who Should Read This

  • Laboratory coders
  • Pathology billing staff
  • Oncology clinic billing teams
  • Revenue cycle specialists
  • Coding auditors

Codes Discussed


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