The American Medical Association CPT Editorial Board recently announced 13 new digital pathology add-on codes that will go into effect Jan. 1, 2023.
According to the College of American Pathologists (CAP), the new digital pathology Category III CPT codes will be used to report additional clinical staff work and service requirements associated with digitizing glass microscope slides for primary diagnosis. The AMA CPT will also add a new heading in the Category III section and guidelines to define digital pathology digitization procedures.
Digital pathology is a dynamic, image-based environment that enables the acquisition, management, and interpretation of pathology information generated from digitized glass microscope slides. Glass microscope slides are scanned by clinical staff, and captured images (either real-time or stored in a computer server or cloud-based digital image archival and communication system) are used for digital examination for pathologic diagnosis.
Digitization of glass microscope slides enable remote examination by the pathologist and/or in conjunction with used of artificial intelligence (AI) algorithms.
The new codes are listed below, with the following descriptors:
- 0751T– Digitization of glass microscope slides for Level II, surgical pathology, gross and microscopic examination (List separately in addition to code for primary procedure) (Use 0751T in conjunction with 88302)
- 0752T– Digitization of glass microscope slides for Level III, surgical pathology, gross and microscopic examination (List separately in addition to code for primary procedure) (Use 0752T in conjunction with 88304)
- 0753T– Digitization of glass microscope slides for Level IV, surgical pathology, gross and microscopic examination (List separately in addition to code for primary procedure) (Use 0753T in conjunction with 88305)
- 0754T– Digitization of glass microscope slides for Level V, surgical pathology, gross and microscopic examination (List separately in addition to code for primary procedure) (Use 0754T in conjunction with 88307)
- 0755T– Digitization of glass microscope slides for Level VI, surgical pathology, gross and microscopic examination (List separately in addition to code for primary procedure) (Use 0755T in conjunction with 88309)
- 0756T– Digitization of glass microscope slides for special stain, including interpretation and report, group I, for microorganisms (eg, acid fast, methenamine silver) (List separately in addition to primary procedure) (Use 0756T in conjunction with 88312)
- 0757T– Digitization of glass microscope slides for special stain, including interpretation and report, group II, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzymes constituents, or immunocytochemistry and immunohistochemistry (List separately in addition to code for primary procedure) (Use 0757T in conjunction with 88313)
- 0758T– Digitization of glass microscope slides for special stain, including interpretation and report, histochemical stain on frozen tissue block (List separately in addition to primary procedure) (Use 0758T in conjunction with 88314)
- 0759T– Digitization of glass microscope slides for special stain, including interpretation and report, group III, for enzymes constituents (List separately in addition to primary procedure) (Use 0759T in conjunction with 88319)
- 0760T– Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial single antibody stain procedure (List separately in addition to primary procedure) (Use 0760T in conjunction with 88342)
- 0761T– Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each additional single antibody stain procedure (List separately in addition to primary procedure) (Use 0761T in conjunction with 88341)
- 0762T– Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex antibody stain procedure (List separately in addition to primary procedure) (Use 0762T in conjunction with 88344)
- 0763T– Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, ER, PR), quantitative or semiquantitative, per specimen, each additional single antibody stain procedure, manual (List separately in addition to primary procedure) (Use 0763T in conjunction with 88360)
Keep in mind, Category III codes almost never receive national pricing from Medicare, but almost always receive hospital outpatient payment levels (APCs). Look for the July draft and November final hospital outpatient rulemaking this year. MAC contractors usually consolidate listings of all the locally priced Category III codes on their websites.
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