Use of the New Automated Test Panels
The 1998 CPT contains four new “clinically relevant” test panels, which are designed to replace automated, multichannel test codes 80002 through 80019 and HCPCS codes G0058 through G0060, which have been deleted. These new panels are as follows:
80049 BASIC METABOLIC PANEL: (the following 7 tests must be performed to use this code)
Carbon dioxide Chloride Creatinine Glucose Potassium Sodium Urea nitrogen (BUN)
80054 COMPREHENSIVE METABOLIC PANEL: (the following 12 tests must be performed to use this code)
Albumin Bilirubin, total Calcium Chloride Creatinine Glucose Alkaline phosphatase Potassium Protein Sodium Aspartate aminotransferase (AST), Serum glutamic- oxaloacetatic transami- nase (SGOT) Urea nitrogen (BUN)
80051 ELECTROLYTE PANEL: (the following 4 tests must be performed to use this code)
Carbon dioxide Chloride Potassium Sodium
80058 HEPATIC FUNCTION PANEL: (the following 6 tests must be performed to use this code)
Albumin Bilirubin, total Bilirubin, direct Alkaline phosphatase AST, SGOT Alanine aminotransferase (ALT), serum glutamic- pyruvic transaminase (SGPT)
This panel is the same as the already existing Hepatic Function Panel except that direct bilirubin has been added so that six rather than five tests are now included.
Although the automated multichannel test codes have been deleted from the CPT, the former list of automated multichannel tests has been retained by HCFA for use in pricing these tests. The following assays are classified as automated, multichannel tests:
Albumin Bilirubin, direct Bilirubin, total Calcium Carbon dioxide Chlorides Cholesterol Creatine kinase Creatinine Gamma glutamyl- transferase (GGT) Glucose Lactate dehydrogenase Phosphatase, alkaline Phosphorus Potassium Protein, total Sodium AST, SGOT ALT, SGPT Triglycerides Urea nitrogen (BUN) Uric acid
The new Medicare coding rules for automated, multichannel tests are effective January 1, 1998.
Under the old rules, all automated multichannel tests were to be bundled into the corresponding CPT code for the total number of automated multichannel tests performed. With the demise of the automated multichannel test codes from the CPT, Medicare has adopted the following new coding rules, which no longer require bundling of these tests.
Tests on Medicare’s uniform list of automated procedures may be billed using:
- (a) the new panel codes;
- (b) organ/disease panel codes that contain automated multichannel tests;
- (c) individual automated test codes; or
- (d) any combination of new automated test panels, organ/disease panels, and/or individual automated multichannel test codes.
This new policy means that it is now impossible to improperly unbundle automated multichannel because any combination of individual tests and panels that contain automated, multichannel tests are to be accepted by Medicare Carriers.