Download Lab Test Panels (LO#1) Slide 1. Hello. Reporting a pathology panel

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Lab Test Panels (LO#1)
Slide 1. Hello. Reporting a pathology panel may not be a simple as it looks, but
these are used quite often, so let’s discuss them.
Slide 2.
PANELS
When you turn to the Pathology and Laboratory section of the CPT book, you will
notice that many codes include a long list of elements within the code’s
description. These groupings of tests commonly performed at the same time are
called panels.
Slide 3.
EXAMPLE
80076 Hepatic function panel
This panel must include the following:
Albumin (82040)
Bilirubin, total (82247)
Bilirubin, direct (82248)
Phosphatase, alkaline (84075)
Protein, total (84155)
Transferase, alanine amino (ALT)(SGPT) (84460)
Transferase, aspartate amino (AST)(SGOT)(84450)
The example shows you that in order for code 80076 to be the most accurate
code, the lab must have performed all 7 tests: Albumin; Bilirubin, total; Bilirubin,
direct; Phosphatase, alkaline; Protein, total; Transferase, alanine amino
(ALT)(SGPT); and Transferase, aspartate amino. And in this case, you will report
this one code to represent all 7 tests.
The lab performs fewer than all 7 tests listed in a panel, you must code the
tests separately; you are not permitted to use the panel code.
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Slide 4.
When all the included tests of a panel are performed, you must use the panel
code. Coding the tests individually is considered unbundling. Remember that
unbundling is unethical and illegal. If fewer tests are performed, using a panel
code with the modifier 52 Reduced Services is not permitted. You must code the
tests individually.
Slide 5.
Again, the CPT book will help you. Should you have to code any of the tests
separately, the individual test code is given in parentheses right next to the name
of the test listed there. From our example, next to Albumin, you will notice the
number 82040. Turn to code 82040, and you will see that it is the code for testing
albumin alone.
82040 Albumin; serum, plasma or whole blood
Notice that there are actually five different codes for testing albumin but this is
the only one that is using blood as the specimen. Another detail to which you
must pay attention…. What test was performed AND what was the specimen?
Slide 6.
Let’s say, instead of doing fewer tests than those listed in a panel, the lab
performs more. The guidelines state that you are to code those additional tests
separately and additionally. For example, a hepatic function panel and a CBC,
then you would report the code for the panel and a separate code for the CBC.
80076 Hepatic function panel
85025 Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC, and
platelet count) and automated differential WBC count
Slide 7.
Additional explanation can be found in the guidelines within the Pathology and
Laboratory section, directly under the subhead Organ or Disease-Oriented
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Panels in your CPT book. You can always use these guidelines to help support
your learning here and as a memory booster later
Slide 8.
Experience and practice will help you learn the elements easily. After working at
a lab or for a facility with a lab, you will recognize the lab tests that are typically
performed together and, consequently, probably have a panel code grouping
them. Should a test not be in a panel, the alphabetic index will direct you to the
correct individual code for that test.
Do you have questions? Please ask your instructor.