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Regional Medical Laboratory
4142 South Mingo Road
Tulsa, OK. 74146-3632
MEMORANDUM
TO:
RML Clients
FROM:
Carol Ghere, MT (ASCP) SI, Compliance Officer
DATE:
January 2, 2015
SUBJECT:
2015 CPT4 Code Changes from American Medical Association (AMA)
2015 CPT4 Code Changes from AMA
The American Medical Association (AMA) CPT code changes for 2015 will become effective on January 1,
2015. CPT4 codes for both presumptive and definitive drug classes have been changed in 2015.
Presumptive codes have been grouped into two drug classes, and for the most part drug screening,
which billed multiples of 80101 per drug, are being replaced by a single code for any quantity. The
definitive drug codes also have new CPT codes. Medicare is choosing not to honor the new drug CPT
codes and instead has published a list of G codes to be used. There are specific G codes for each
definitive drug. A single code, G6058, is the code to be used for confirmation testing for all definitive
drugs. HPV testing has new codes and there have been some revisions for microbiology PCR testing.
Anatomic pathology has some unique code changes for 2015 related to immunohistochemical stains and
FISH testing. The first stain will be billed with the current CPT code, but there are new codes for
additional stains on the same specimen. Prostate biopsies consisting of multiple specimens must be
billed to Medicare with a G0416. Gross and microscopic exam for prostate needle biopsies, any method
or any number of specimens, will bill the G0416. G0417 through G0419 have been deleted. In 2014,
G0416 only applied to biopsies with greater than 10 specimens. Other payers will continue to be billed
an 88305 for each biopsy submitted.
A complete list of RML procedures that have new, deleted, or revised AMA CPT codes for 2015 can be
found on our website at www.rmlonline.com and clicking on the billing section at the top of the page.
The listing includes the test code, test name, CPT from 2014 and the new 2015 CPT code. We are also
listing the new G codes supplied by Medicare. For anatomic pathology, we have provided a more
detailed explanation of the new codes for stains.
The listed CPT codes reflect RML’s interpretation of CPT coding requirements. We recommend that you
confirm the correct CPT’s to use for billing. These suggested code changes are being made based on
review of the AMA and Medicare guidelines. We will publish any new or updated information as soon as
it is made available from any regulatory body or reference laboratory.
Should you have any other questions or need additional information, please contact
[email protected].
2015 CPT codes changes
Listed in order of RML Test Code Numbers
Current Test
1516350
1516355
2008650
2025650
2938975
3602125
3608250
3608350
3609000
3609075
3611375
3611975
3622403
3622405
3632070
3650775
3651550
3653530
3653600
3653650
3656525
3661000
3801000
4000050
4000800
4000800
4000805
4001400
4001540
4003300
4004525
4004550
4006150
4006450
4006900
4007500
4007800
4013050
4013100
4030005
4032025
4066250
4066450
4300050
4300075
4300075
4300080
4301000
4301050
4301100
4301150
4301210
4301300
4301350
2014 Code
87621
87621
84022
82542
80100
83925
82205
83925
82205
82651
80154
80154
81479
81479
80100 x 12
80101
82205
82205
82205
82205
80164
80100
83840
82003
80320
82055
80100
80100
80154
82205
82646
80196
80182
80166
80102
83858
83925
80154
80100
80101 X 8
80101
80101 x 5
80101 x 10
80101 x 6
80101 x 5
80201 x 5
82520
80101
80101
80101
80101
80101
80101
80101
Test Name
HPV 16/18
HPV 16RFLX
THORAZINE
PREGRABAL S
ETH U BILL
FENTANYL U
BUTALBITAL
MORPHINE
SECOBARB
DIHYDTEST
DIAZEPAM
LORAZEPAM
MATERNT21
MATERNT21P
DIURET S U - URINE SCREEN
METHADO UR
PENTOBARB
BARB QN
AMOBARB
BUTABARB
VALPR FREE
OPIATE SC
METHADO QN
ACETAMIN
ALCOHOL
ALCOHOL
DRUG C ETH - CORD ETOH METABOLITE
ETH/SB
CLONAZEPA
PHENOBARB
HYDROCOD S
SALICYLATE
NORTRIPTL
DOXEPIN
GC ETH U
METHSUXMD
OXYCODON S
FLUNTR SCR
FLUNTR URI
PAIN MGMT DRUG PANEL
SYNTHETIC CANNABINOID UR SCR
DRUG F SCR
DRUG F S10
DRUG B SCR
ER DRUG B
ER DRUG B
COCAINE SC
ACETAMIN U
AMPHET U
BARB U
BENZO U
ETH U DET
OPIATES U
PCP U
2015 Code
87625
87624
80342
80366
80301
80354
80345
80361
80345
80327
80346
80346
81420
81420
83788
80301
80345
80345X6
80345
80345
80165
80301
80358
80329
80320
80320
80301
80320
80346
80345
80361
80329
80335
80335
80301
80339
80361
80346
80346
80301
80351
80301
80301
80301
80301
80301
80353
80302
80301
80301
80301
80301
80301
80301
Regional Medical Laboratory
4142 South Mingo Road
Tulsa, OK. 74146-3632
G Codes
N/A
N/A
G6057
82542
G0431
G6056
G6043
G6056
G6043
G6047
G6031
G6031
N/A
N/A
N/A
G0431
G6043
G6043X6
G6043
G6043
N/A
G0431
G6053
G6039
G6040
G6040
G0431
G6040
G6031
G6043
G6045
G6038
G6037
G6034
G0431
G6054
G6056
G6031
G6031
G0431
83788
G0431
G0431
G0431
G0431
G0431
G6044
G0431
G0431
G0431
G0431
G0431
G0431
G0431
2015 CPT codes changes
Listed in order of RML Test Code Numbers
Current Test
4301395
4301500
4301525
4301600
4301775
4301800
4301875
4302025
4302050
4302350
4302400
4302455
4304800
4304825
4305025
4305250
4305500
4305525
4305700
4307075
4308700
4310150
4311685
4312125
4312325
4312550
4313525
4313600
4313625
4313675
4313800
4313850
4313900
4314650
4315100
4315650
4315685
4316150
4316335
4316400
4316550
4317875
4318525
4325300
4325400
4325403
4325425
4325575
4325600
4325625
4325653
4325675
4325700
4325750
2014 Code
80101
80101
80101
80101
80101
80101
80101
80101
80101
80160
80174
80152
80104
80104
80102
80100
82145
82145
83925
80101 x 9
80101 X 11
82520
82145
80154
83887
83887
80101 X 10
80101
80101 X 12
80101 X 5
80101
80101
80101
80101
83925
80101
80101
80102
80102
80102
80102
80102
83925
80101 x 10
80101 X 9
80101 X 11
80104
82003
82055
82145
83805
80154
83925
83805
Test Name
OPI 300 UR
PROPOXY U
PROPOXY UR
THC U
TRICYCL SC
BENZ SC
ETHANOL SC
SALIC SC
ACETAM SC
DESIPRAMI
IMIPRAMIN
AMITRIPTL
DRUG ABUSE
DRUG ABUS2
THC GC/MS
UNK SUBPNL
AMPHET QNT
METHAM QNT
OPI-FR QT
DRUG BRMLK
UR DRG SC
COCAI QNU
AMPH/METAM
BENZO QN S
NICOTINE U
NICOT QN S
UDS INFANT
AMPHET UR
UDS CLIN
UDS CLIN-5
PCP UR
COCAINE UR
THC UR
ETHANOL SC
MEPERI QN
OXYCODON
BUPRENO UR
BARB CONF
BENZ CONF
GC PROPOX
GC METHD
GC PCP
OPIATE GCU
MEDTOX 4055 MECONIUM X9 (BO)
PACIFIC TOX HIGH COMPLEXITY
PACIFIC TOX PAIN BLOOD PANEL
PACIFIC TOX MODERATE COMPEXITY
ACETAMINOPHEN CONFIRMATION
XPT ETOH ALCOHOL QUANT
AMPHETAMINES QUANT
XPTB CARIS (CARISOPRODOL)
BENZODIAZEPINE QUANT
BUPRENORPHINE QUANT
CARISOPRODOL QUANT (MEPROBAMATE)
2015 Code
80301
80301
80301
80302
80301
80301
80301
80302
80302
80335
80335
80335
80030
80030
80302
80301
80324
80324
80361
80301
80301
80353
80324
80346
80323
80323
80301
80301
80301
80301
80301
80301
80302
80301
80362
80301
80301
80301
80301
80301
80301
80301
80361; 80365
80301
80301
80301
80030
80329
80320
80324
80369
80346
80361
80369
Regional Medical Laboratory
4142 South Mingo Road
Tulsa, OK. 74146-3632
G Codes
G0431
G0431
G0431
G0431
G0431
G0431
G0431
G0431
G0431
G6032
G6036
G6030
G0434
G0434
G0431
G0431
G6042
G6042
G6056
G0431
G0431
G6044
G6042
G6031
G6055
G6055
G0431
G0431
G0431
G0431
G0431
G0431
G0431
G0431
G6056
G0431
G0431
G6058
G6058
G0431
G0431
G0431
G6056X2
G0431
G0431
G0431
G0434
G6058
G6058
G6058
G6058
G6058
G6058
G6058
2015 CPT codes changes
Listed in order of RML Test Code Numbers
Current Test
4325775
4325777
4325789
4325800
4325825
4325875
4325900
4325950
4325975
4326025
4326050
4326250
4326275
4326300
4505400
5522575
5522725
5565570
5565580
8002561
8002563
2025650
2014 Code
82520
80101
83925
83925
83925
83925
83840
82646;82649
83925
83925
83925
83887
83925
80101 X 9
80101 X 10
87621
87621
87798
88798
82145
80154
82542
Test Name
COCAINE QUANT
XPTB ALPRZ ALPRAZOLAM SERUM/PLASMA
XPT HEROIN (6MAM) QUANT
FENTANYL, URINE QUANT
KETAMINE QUANT CONFIRMATION
MEPERIDINE, QUANT
METHADONE, QUANT
XPT OPIATE
OXYCODONE, URINE QUANT
PROPOXYPHENE QUANT
TRAMADOL QUANT
XPT NICO
XPT TAPENT
PTOX PAIN2
UDS INDUST 10 PANEL
HPVPAPHI
HPV ONLY
FLU A PCR
FLU B PCR
PM AMPHETAMINES CONFIRM
BILL PM BENZODIAZEPINES CONFRM
PREGRABAL S
2015 Code
80353
80301
80361
80354
80361
80362
80358
80361
80365
80367
80373
80323
80361
80301
80301
87624
87624
87801
87801
80324
80346
80366
Regional Medical Laboratory
4142 South Mingo Road
Tulsa, OK. 74146-3632
G Codes
G6058
G6058
G6058
G6058
G6058
G6058
G6058
G6058X2
G6058
G6058
G6056
G6058
G6058
G0431
G0431
N/A
N/A
N/A
N/A
G6058
G6058
82542
2015 CPT codes changes
Listed in order of 2014 CPT code
Current Test
2938975
3661000
4000805
4001400
4013100
4305250
3650775
4032025
4301000
4301050
4301100
4301150
4301210
4301300
4301350
4301395
4301500
4301525
4301600
4301775
4301800
4301875
4302025
4302050
4313600
4313800
4313850
4313900
4314650
4315650
4315685
4325777
3632070
4325400
4066450
4313525
4325300
4505400
4308700
4325403
4313625
4066250
4300075
4313675
4300050
4030005
4307075
4326300
4300075
4006900
4305025
4316150
4316335
4316400
2014 Code
80100
80100
80100
80100
80100
80100
80101
80101
80101
80101
80101
80101
80101
80101
80101
80101
80101
80101
80101
80101
80101
80101
80101
80101
80101
80101
80101
80101
80101
80101
80101
80101
80100 x 12
80101 X 9
80101 x 10
80101 X 10
80101 x 10
80101 X 10
80101 X 11
80101 X 11
80101 X 12
80101 x 5
80101 x 5
80101 X 5
80101 x 6
80101 X 8
80101 x 9
80101 X 9
80201 x 5
80102
80102
80102
80102
80102
Test Name
ETH U BILL
OPIATE SC
DRUG C ETH - CORD ETOH METABOLITE
ETH/SB
FLUNTR URI
UNK SUBPNL
METHADO UR
SYNTHETIC CANNABINOID UR SCR
ACETAMIN U
AMPHET U
BARB U
BENZO U
ETH U DET
OPIATES U
PCP U
OPI 300 UR
PROPOXY U
PROPOXY UR
THC U
TRICYCL SC
BENZ SC
ETHANOL SC
SALIC SC
ACETAM SC
AMPHET UR
PCP UR
COCAINE UR
THC UR
ETHANOL SC
OXYCODON
BUPRENO UR
XPTB ALPRZ ALPRAZOLAM SERUM/PLAS
DIURET S U - URINE SCREEN
PACIFIC TOX HIGH COMPLEXITY
DRUG F S10
UDS INFANT
MEDTOX 4055 MECONIUM X9 (BO)
UDS INDUST 10 PANEL
UR DRG SC
PACIFIC TOX PAIN BLOOD PANEL
UDS CLIN
DRUG F SCR
ER DRUG B
UDS CLIN-5
DRUG B SCR
PAIN MGMT DRUG PANEL
DRUG BRMLK
PTOX PAIN2
ER DRUG B
GC ETH U
THC GC/MS
BARB CONF
BENZ CONF
GC PROPOX
2015 Code
80301
80301
80301
80320
80346
80301
80301
80351
80302
80301
80301
80301
80301
80301
80301
80301
80301
80301
80302
80301
80301
80301
80302
80302
80301
80301
80301
80302
80301
80301
80301
80301
83788
80301
80301
80301
80301
80301
80301
80301
80301
80301
80301
80301
80301
80301
80301
80301
80301
80301
80302
80301
80301
80301
Regional Medical Laboratory
4142 South Mingo Road
Tulsa, OK. 74146-3632
G Codes
G0431
G0431
G0431
G6040
G6031
G0431
G0431
83788
G0431
G0431
G0431
G0431
G0431
G0431
G0431
G0431
G0431
G0431
G0431
G0431
G0431
G0431
G0431
G0431
G0431
G0431
G0431
G0431
G0431
G0431
G0431
G6058
N/A
G0431
G0431
G0431
G0431
G0431
G0431
G0431
G0431
G0431
G0431
G0431
G0431
G0431
G0431
G0431
G0431
G0431
G0431
G6058
G6058
G0431
2015 CPT codes changes
Listed in order of 2014 CPT code
Current Test
4316550
4317875
4304800
4304825
4325425
4302455
3611375
3611975
4001540
4013050
4312125
4325675
8002563
4302350
3656525
4006450
4302400
4006150
4004550
4000800
3622403
3622405
4000050
4325575
4000800
4325600
4305500
4305525
4311685
4325625
8002561
3608250
3609000
3651550
3653530
3653600
3653650
4003300
4300080
4310150
4325775
2025650
4004525
4325950
3609075
4325653
4325750
3801000
4325900
4007500
4312325
4312550
4326250
3602125
2014 Code
80102
80102
80104
80104
80104
80152
80154
80154
80154
80154
80154
80154
80154
80160
80164
80166
80174
80182
80196
80320
81479
81479
82003
82003
82055
82055
82145
82145
82145
82145
82145
82205
82205
82205
82205
82205
82205
82205
82520
82520
82520
82542
82646
82646;82649
82651
83805
83805
83840
83840
83858
83887
83887
83887
83925
Test Name
GC METHD
GC PCP
DRUG ABUSE
DRUG ABUS2
PACIFIC TOX MODERATE COMPEXITY
AMITRIPTL
DIAZEPAM
LORAZEPAM
CLONAZEPA
FLUNTR SCR
BENZO QN S
BENZODIAZEPINE QUANT
BILL PM BENZODIAZEPINES CONFRM
DESIPRAMI
VALPR FREE
DOXEPIN
IMIPRAMIN
NORTRIPTL
SALICYLATE
ALCOHOL
MATERNT21
MATERNT21P
ACETAMIN
ACETAMINOPHEN CONFIRMATION
ALCOHOL
XPT ETOH ALCOHOL QUANT
AMPHET QNT
METHAM QNT
AMPH/METAM
AMPHETAMINES QUANT
PM AMPHETAMINES CONFIRM
BUTALBITAL
SECOBARB
PENTOBARB
BARB QN
AMOBARB
BUTABARB
PHENOBARB
COCAINE SC
COCAI QNU
COCAINE QUANT
PREGRABAL S
HYDROCOD S
XPT OPIATE
DIHYDTEST
XPTB CARIS (CARISOPRODOL)
CARISOPRODOL QUANT (MEPROBAMAT
METHADO QN
METHADONE, QUANT
METHSUXMD
NICOTINE U
NICOT QN S
XPT NICO
FENTANYL U
2015 Code
80301
80301
80030
80030
80030
80335
80346
80346
80346
80346
80346
80346
80346
80335
80165
80335
80335
80335
80329
80320
81420
81420
80329
80329
80320
80320
80324
80324
80324
80324
80324
80345
80345
80345
80345X6
80345
80345
80345
80353
80353
80353
80366
80361
80361
80327
80369
80369
80358
80358
80339
80323
80323
80323
80354
Regional Medical Laboratory
4142 South Mingo Road
Tulsa, OK. 74146-3632
G Codes
G0431
G0431
G0434
G0434
G0434
G6030
G6031
G6031
G6031
G6031
G6031
G6058
G6058
G6032
N/A
G6034
G6036
G6037
G6038
G6040
N/A
N/A
G6039
G6058
G6040
G6058
G6042
G6042
G6042
G6058
G6058
G6043
G6043
G6043
G6043X6
G6043
G6043
G6043
G6044
G6044
G6058
82542
G6045
G6058X2
G6047
G6058
G6058
G6053
G6058
G6054
G6055
G6055
G6058
G6056
2015 CPT codes changes
Listed in order of 2014 CPT code
Current Test
3608350
4007800
4305700
4315100
4318525
4325700
4325789
4325800
4325825
4325875
4325975
4326025
4326050
4326275
2008650
1516350
1516355
5522575
5522725
5565570
5565580
2014 Code
83925
83925
83925
83925
83925
83925
83925
83925
83925
83925
83925
83925
83925
83925
84022
87621
87621
87621
87621
87798
88798
Test Name
MORPHINE
OXYCODON S
OPI-FR QT
MEPERI QN
OPIATE GCU
BUPRENORPHINE QUANT
XPT HEROIN (6MAM) QUANT
FENTANYL, URINE QUANT
KETAMINE QUANT CONFIRMATION
MEPERIDINE, QUANT
OXYCODONE, URINE QUANT
PROPOXYPHENE QUANT
TRAMADOL QUANT
XPT TAPENT
THORAZINE
HPV 16/18
HPV 16RFLX
HPVPAPHI
HPV ONLY
FLU A PCR
FLU B PCR
2015 Code
80361
80361
80361
80362
80361; 80365
80361
80361
80354
80361
80362
80365
80367
80373
80361
80342
87625
87624
87624
87624
87801
87801
Regional Medical Laboratory
4142 South Mingo Road
Tulsa, OK. 74146-3632
G Codes
G6056
G6056
G6056
G6056
G6056X2
G6058
G6058
G6058
G6058
G6058
G6058
G6058
G6056
G6058
G6057
N/A
N/A
N/A
N/A
N/A
N/A
Regional Medical Laboratory
4142 South Mingo Road
Tulsa, OK. 74146-3632
Tests with Deleted Codes
Current Test
2014 Code
Test Name
2015 Code
G Codes
4300175
80101 x 5;
80320
80201 x 5
80320
DRUG B ER
80301; 80320
G0431;G6040
ER DRUG B
ALCOHOL
80301
80320
G0431
G6040
80301; 80300
G0431; G0434
80301
80030
G0431
G0434
80301, 84311
G0431 84311
80301
84311
G0431
84311
4300075
4000800
4325375
4325400
4325425
4030010
4030005
4030030
80101 X 9;
80104
80101 X 9
80104
PACIFIC TOX PAIN3 PANEL
PACIFIC TOX HIGH COMPLEXITY
PACIFIC TOX MODERATE COMPEXITY
80101X8;
PAIN MGMT DRUG PANEL 1
82570; 83986;
84311
80101 X 8
PAIN MGMT DRUG PANEL
84311
PM OXIDANT
4014050
80101 X 11;
UDS MED PR
82570; 83896
80301
G0431
4032005
80152; 80182 PAIN MGMT TRYCYCLIC CONFIRM
80335
G6058x2
4326075
80152;80160; TRICYCLICS QUANT (5)
80166;80174;
80182
80336
G6805X5
4325787
80196;83789
80196
83789
80329;83789
80329
83789
G60038;83789
G6038
83789
4325650
82205; 80184 BARBITURATES QUANT
80184
XPT PHENOBAR
82205
XPT PENTOB ETAL
80184;80345
80184
80345
80184;G6058
80185
G6058
5568555
87631x2;
87798x2
XPT NSAID-NSAID QUANT (2)
XPT NSAID SALICYLATE
XPT NSAID ANALYTE UNSPECIFIED
VRESP PCR
87632
N/A
Note
No longer billing PH 83896 or
Creat 82570 with panels
No longer billing PH 83896 or
Creat 82570 with panels
80336 = 3-5 Tricyclics
Regional Medical Laboratory
4142 South Mingo Road
Tulsa, OK. 74146-3632
Anatomic Pathology New Codes
Related Primary Code
1st Stain
Each additional Stain
New RML
Procedure Code in
Bold
8088725
8088344
Technical Component
Multiplex Stain
8188344
8088345
88344TC
Technical Component
8388344
88365
1st Stain
8088526
Each additional Stain
8088524
Technical Component
Multiplex Stain
8088527
8088528
88366TC
Technical Component
8088529
88368
88369
1st Stain
Each additional Stain
8023445
8088531
Technical Component
8088532
Multiplex Stain
8088533
Technical Component
8088534
Surgical
Pathology
88342
Immunohistochemistry or immunocytochemistry, per specimen; each
88341
additional single antibody stain procedure (List separately in addition
to code for primary procedure)
88341TC
88344
88364
88364TC
88366
Immunohistochemistry or immunocytochemistry, per specimen; each
multiplex antibody stain procedure
In situ hybridization (eg, FISH), per specimen; each additional single
probe stain procedure (List separately in addition to code for primary
procedure)
In situ hybridization (eg, FISH), per specimen; each multiplex probe
stain procedure
Morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each additional single probe
stain procedure (List separately in addition to code for primary
procedure)
88369TC
88377
Morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex probe stain
procedure
88377TC
Prostate Biopsies for Medicare
G0416 – Surgical pathology; gross and microscopic exam for
prostate needle biopsies, any method, any number of
specimens.
Non Mecicare Continue
to Bill 88305 per biopsy.