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Transcript
Pathology/Laboratory CPT Code Change Applications February 2017 CPT® Editorial Panel Meeting Pathology/Laboratory CPT Code Change Applications that have been submitted for consideration by the CPT Editorial Panel at its February 2017 meeting are listed below. These applications will be included in the proposed Panel agenda that will be posted to the AMA website on December 9, 2016. This listing includes the code application names, code(s) affected, and a description of the request. The Code numbers and Request Descriptions detailed in this document are extracted from Code Applications submitted for discussion at this meeting. Until such time as the CPT Editorial Panel acts on these requests, the following information is provided for informational purposes only, giving interested individuals the information to help determine whether or not to attend the meeting and provide comment on a given topic(s). This listing of Pathology/Laboratory applications is being posted ahead of the full February Panel meeting agenda in order to provide the Molecular Pathology Advisory Group (MPAG) and the Pathology Coding Caucus (PCC) sufficient time to review comments from interested stakeholders individuals who wish to comment prior to making their recommendations to the CPT Editorial Panel. Codes that contain an ‘X’ (e.g., 1002X4, 234X2X, 0301XT) below are placeholder codes that are intended, through the first three digits, to give readers an idea of the proposed placement in the code set of the potential code changes. These codes are not used for claims reporting and will be removed and not retained when the final CPT Datafiles are distributed on August 31st of each year. To report the services for “X” codes listed on this form, please refer to the actual codes as they appear in the CPT Datafiles publication distributed on August 31st of each year. Upon review of these applications, if the reviewer believes that they will need to provide comment on an issue, they should send a request for a copy of the application and associated materials to Judy Connelly. This request for review of the agenda materials should contain the identity of the interested party seeking such and a brief summary of the basis for the request (e.g., associated vendor/ industry representative). Any interested parties wishing to provide written comments on any agenda items should be aware of the following relevant deadlines for provision of written comments on the agenda to ensure comment review by all parties. Additional verbal comments on any issue can be provided in person at the Panel meeting following a statement of conflict of interest. The applicant(s) who submitted the original code change application is automatically considered an interested party and are notified by AMA staff of any request for review submitted by another party. *Interested party requests will not be processed until the interested party submits a signed confidentiality agreement and Updated November 11, 2016 disclosure of interest form. Interested party requests will be processed within 5 days of receipt of the requested forms. Written comments for these requests are due within 10 days upon receipt of materials. However, based upon receipt of these materials the deadline for written comments may vary. Please follow the instructions in the correspondence provided by AMA staff. Updated November 11, 2016 Issues Molecular Pathology Pathology/Laboratory (Other than Molecular Pathology) Written Comment Deadlines Comments Deadline Tabs (Noon, CDT) 17, 18, 19, 20, 21, 22, December 2, 2016 23, 24, 25 26, 27, 28, 29, 30 December 16, 2016 During the time between now and the Panel meeting, the agenda will, most likely, be modified to reflect changes – additions, deletions or updates. Please check back frequently for the most up to date information. Outcomes on these actions will be found in the CPT Editorial Panel Summary of Actions for the February 2017 meeting, which will be published on or before March 9, 2017 to the CPT home page of the AMA website http://www.ama-assn.org/go/panel-actions. Tab # Name Code # 16 Drugs of Abuse-Editorial Revision 17 Tier 1 ASXL1 Leukemia 18 Tier 1 BRCA1 BRCA2-Revise 81211 81162 19 Tier 1 RUNX1 Leukemia 813XX Add 813XX for a Molecular Pathology Tier 1 code for RUNX1 gene analysis for acute myeloid leukemia 20 Tier 2-KAL1-ANOS1 Revision 81406 Revise the KAL1 gene test descriptor in Tier 2 code 81406 to be consistent with the Hugo Gene Nomenclature Committee reassignment of KAL1 to ANOS1 Updated November 11, 2016 80305, 80306, 80307 Request-Description 81X04 81211, 81162 Revise 80305, 80306, and 80307 to more accurately describe the procedures performed Add 81X04 for full gene sequence or targeted sequence analysis for ASXL1 Revise code 81211 to specify analysis primarily by Sanger or capillary sequencing methods; revise 81162 to specify analysis with sequencing primarily by massively parallel methods Tab # Name Code # 21 GSP Hereditary Breast Cancer Disorders-Revise 81432 22 GSP Multiple Cancer Syndromes 23 GSP Panethnic Genetic Carrier Screening Panel 81X43 Add 81X43 for panethnic genetic carrier screening panel of severe inherited conditions 24 MAAA Kidney Transplant Rejection Risk 81X15 Add 81X15 to report gene expression profiling bt real-time quantitative PCR of 17 genes using peripheral whole blood with an algorithm reported as rejection risk score 25 MAAA Prostate Cancer Gene Expression 81X41 Add 81X41 for RNA expression of 46 genes, utilizing formalin-fixed paraffin imbedded tissue with algorithm reported as a risk score 26 Albumin Urine Testing Updated November 11, 2016 81432 Request-Description 81X56, 81X57 82042, 82043, 82044 Revise 81432 to include sequencing of at least ten genes always including BRCA1 and BRCA2, and typically including ATM, BRIP1, CDH1, MLH1, MSH2, MSH6, PALB2, PTEN, RAD51C, STK11, and TP53, and to remove NBN Add 81X56 for targeted germline hereditary cancer panel spanning multiple cancer syndromes; add 81X57 for duplication/deletion and large rearrangement gene panel Revise 82042 by deleting urine as a specimen, and revising 82043, and 82044 by making microalbumin an example by adding "eg" to the descriptors Tab # Name Code # Request-Description 27 Drug Interaction Assessment 82XXX 28 Respiratory Syncytial Virus Antigen Detection by Nucleic Acid 876XX 29 Human Papillomavirus 87625, 87X43 Add 87X43 to report testing of high-risk HPV genotype 30 Zika Virus Detection 876XX, 867XX Add 876XX for Zika virus detection by nucleic acid and 867XX for Zika virus IgM antibody detection Updated November 11, 2016 Add 82XXX for reporting drug/drug and drug/substance identification and interaction of 120 or more drugs by definitive mass spectrometry including assessment and risk severity score Add 876XX for nucleic acid detection of respiratory syncytial virus, types A and B