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2022 CPT updates for pathology consults

The following are 2022 Current Procedural Terminology (CPT) coding updates for pathology consultations. When talking with your billers, make sure they have added these new codes in their systems and your fee schedules.

CPT 80500 and 80502 will be deleted in 2022.

80500 (Clinical pathology consultation; limited, without review of patient’s history and medical records)

80502 (… comprehensive, for a complex diagnostic problem, with review of patient’s history and medical records)

There will now be four new codes to differentiate pathology clinical consults in more detail than the previous two CPT codes (80500 and 80502).

Effective January 1, 2022: The following new codes will be replacing the 80500 and 80502.

80503 – Pathology clinical consultation; for a clinical problem, with limited review of patient’s history and medical records and straightforward medical decision making. When using time for code selection, 5-20 minutes of total time is spent on the date of the consultation.

80504 – … for a moderately complex clinical problem, with review of patient’s history and medical records and moderate level of medical decision making. When using time for code selection, 21-40 minutes of total time is spent on the date of the consultation.

80505 – … for a highly complex clinical problem, with comprehensive review of patient’s history and medical records and high level of medical decision making. When using time for code selection, 41-60 minutes of total time is spent on the date of the consultation.

+80506 – … prolonged service, each additional 30 minutes (List separately in addition to code for primary procedure).

  • These four new codes will allow the pathologist to use time for code selection. This option was not previously available with CPTs 80500/80502.

To use codes 80503-+80506, you need to meet certain criteria.  To use these new codes, you must have documentation of the following facts:

  • A physician or qualified healthcare professional requested the pathology clinical consultation

 

  • The request is related to a laboratory finding and relevant clinical information that requires extra medical judgement beyond a simple interpretation of results.

 

  • The pathologist renders the medical judgement and reports back to the requesting clinician.

Interested in learning more about coding audits or improving your overall revenue cycle management? Contact us today for a free consultation.

 

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