E/M Coding Alert - 2015 Issue 37
Drug Coding: CPT® 2016 Pares Down Chromatography Choices
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Article Overview
This article explains a set of 2016 CPT updates that narrow the options for reporting chromatography and mass spectrometry procedures for non-drug analytes, while also summarizing related Medicare drug testing coding developments. It is relevant to laboratory coders, pathology practices, and revenue cycle staff who need to track CPT revisions, distinguish non-drug from drug testing code families, and monitor CMS payment policy proposals for presumptive and definitive drug testing. The discussion stays at a high level on code-set changes, the types of procedures affected, and the status of federal guidance.
Why This Topic Matters
Laboratory and pathology coding teams need to know which CPT chromatography and mass spectrometry options remain available, and they also need awareness of CMS’s evolving drug-testing framework because payer policy may differ from CPT conventions.
Article Sections
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Simplify Non-Drug Chromatography
Covers the CPT 2016 reduction in available chromatography and mass spectrometry reporting options for non-drug analytes and the related shift in how these procedures are organized in the code set.
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Watch for Medicare Rules
Summarizes Medicare and CMS drug testing coding activity, including the status of preliminary payment determinations and proposed federal drug-testing code structures.
What You Will Learn
- How CPT 2016 changes the laboratory code structure for chromatography and mass spectrometry procedures
- How the article distinguishes non-drug analyte reporting from drug testing reporting
- What CMS was proposing for Medicare drug testing code categories and payment policy
- Why laboratory coders should monitor differences between CPT reporting and Medicare guidance
Who Should Read This
- Medical coders
- Laboratory billing staff
- Pathology practices
- Revenue cycle teams
- Compliance staff
Codes Discussed
Code Ranges Discussed
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