Question 1

A young woman goes to her doctor's office to have a urine pregnancy test performed. They can do this test by visual color comparison only at the office. What is the correct CPT code for this test?

Accepted Answer

81025 is the correct code for a urine pregnancy test done by using visual color comparison methods.
Codes 81000, 81005, and 81015 are all incorrect because they all refer to codes for urinalysis instead of a pregnancy test.

Question 2

A patient with a family history of breast cancer has a BRCA1 gene analysis ordered. The physician wants the full sequence analysis and common duplication/deletion variants to be assessed. What is the correct CPT code for this test?

Accepted Answer

81214 is the correct code for BRCA1 gene analysis with full sequence analysis and common duplication/deletion variants.
Code 81211 is incorrect because this code is for both BRCA1 and BRCA2 gene analysis. Code 81212 is incorrect because this code is for both BRCA1 and BRCA2 with additional specific variants. Code 81216 is incorrect because this code is for BRCA2 only.

Question 3

A patient's physician has had a hard time finding the correct drug to put the patient on. Thinking that it has to do with the way the patient's body metabolizes the drug, she orders a CYP2C19 gene analysis. What is the correct CPT code for this test?

Accepted Answer

81225 is the correct code for the CYP2C19 gene analysis test.
Code 81220 is incorrect because this code is for CFTR gene analysis. Code 81226 is incorrect because this code is for CYP2D6 gene analysis and code 81227 is incorrect because this code is for CYP2C9 gene analysis.

Question 4

Due to a previous child having some fetal congenital abnormalities, the OB/GYN ordered a biochemical assay of four analytes (AFP, uE3, hCG, DIA) to assess for fetal congenital abnormalities of pregnancy #3. This is done by using the mother's blood and is reported with a risk score for the provider to interpret. What is the correct CPT code for this test?

Accepted Answer

81511 is the correct code for the test for fetal congenital abnormalities including AFP, uE3, hCG, and DIA.
Code 81508 is incorrect because this code is for the testing of the biochemical assay of two proteins (PAPP-A, hCG). Code 81509 is incorrect because it is also testing for proteins, but involves three proteins instead of just the two above. This code tests for PAPP-A, hCG, and DIA). Code 81510 is incorrect because this code is for the testing of three analytes, including AFP, uE3, hCG, but does not include the fourth analyte listed above, the DIA.

Question 5

A 19 year old was given a lab slip to have a biochemical assay performed of seven analytes to assess for type 2 diabetes. What code should be used for this test?

Accepted Answer

81506 is the correct code for an endocrinology (type 2 diabetes) biochemical assay of seven analytes.
Code 81504 is incorrect because this code refers to oncology testing. Code 81507 is incorrect because this code is for a fetal aneuploidy DNA sequence analysis. Code 81508 is incorrect because this code is assessing for specific fetal congenital abnormalities.

Question 6

A patient needs to have an oncology biochemical assay of five proteins performed to assess for ovarian cancer. These proteins include CA-125, apolipoprotein A1, beta-2 microglobulin, transferring, and pre-albumin.

Accepted Answer

81502 is the correct code for ovarian oncology biochemical assay of five proteins, including CA-125, apolipoprotein A1, beta-2 microglobulin, transferring, and pre-albumin.
Code 81500 is incorrect because, although this code is for ovarian oncology, it is only assessing two proteins, which include CA-125 and HE4. Code 81504 is incorrect because this code is for oncology of a specific tissue of origin, including a microarray gene expressing profiling. Code 81506 is incorrect because this code is specific for an endocrinology biochemical assay.

Question 7

A mother is going to have alpha-fetoprotein (AFP) testing done, using the amniotic fluid. What is the correct CPT code for this specific test?

Accepted Answer

82106 is the correct code for AFP test using amniotic fluid.
Codes 82103 and 82104 are both incorrect because these codes are for alpha-1-antitrypsin tests. Code 82105 is incorrect because this code is for AFP using serum instead of amniotic fluid.

Question 8

A patient with a history of low B-12 needs to have this lab test repeated. What is the correct CPT code for Vitamin B-12 testing, which is also known as cyanocobalamin?

Accepted Answer

82607 is the correct code for the lab test cyanocobalamin (Vitamin B-12).
Code 82608 is incorrect because, although this is a test for Vitamin B-12, it is using the unsaturated binding capacity. Code 82610 is incorrect because this code is for Cystatin C and code 82615 is incorrect because this code is for cysteine and homocystine using urine.

Question 9

A patient needs to have a specific clotting factor tested for von Willebrand disease. He needs factor VIII, multimetric analysis testing performed. What is the correct CPT code for this laboratory test?

Accepted Answer

85247 is the correct code for factor VIII, von Willebrand factor, multimetric analysis.
Code 85210 is incorrect because this code is for clotting factor II, prothrombin specific. Code 85245 is incorrect because this is for factor VIII, von Willebrand factor ristocetin cofactor and 85246 is incorrect because this is specific for factor VIII, von Willebrand factor antigen. It is important to know the specific test ordered. In this case the physician had ordered the multimetric analysis of factor VIII von Willebrand factor.

Question 10

A patient's physician ordered a clot lysis time, involving whole blood dilution. What is the correct CPT code for this test?

Accepted Answer

85175 is the correct code for whole blood dilution clot lysis time.
Code 85170 is incorrect because this code is for clot retraction. Code 85210 is incorrect because this code is for prothrombin clotting factor II. Code 85300 is incorrect because this code is for clotting inhibitors or anticoagulants for antithrombin III activity.

Question 11

A patient's physician ordered an erythrocyte sedimentation rate (ESR) and requested that it be automated. What is the correct CPT code for this laboratory test?

Accepted Answer

85652 is the correct code for automated erythrocyte sedimentation rate.
Code 85635 is incorrect because this code is for the reptilase test. 85651 is incorrect because this code is for a non-automated erythrocyte sedimentation rate. Code 85660 is incorrect because this is for sickling of red blood cells.

Question 12

A patient needs to have a high sensitivity C-reactive protein test performed. What is the correct CPT code for this laboratory test?

Accepted Answer

86141 is the correct code for high sensitivity C-reactive protein.
Code 86140 is incorrect because this code is for C-reactive protein, but not the high sensitivity version. Code 86146 is incorrect because this code is for Beta 2 Glycoprotein I antibody and code 86147 is incorrect because this code is for Cardiolipin (phospholipid) antibody.

Question 13

A patient has an order for an Islet cell antibody laboratory test. What is the correct CPT code for this particular test?

Accepted Answer

86341 is the correct code for Islet cell antibody.
Code 86336 is incorrect because this code is for Inhibin A. Code 86337 is incorrect because this code is for insulin antibodies and 86340 is incorrect because this code is for intrinsic factor antibodies.

Question 14

A patient has an order for an absolute CD4 T-cell count. What is the correct CPT code for this test?

Accepted Answer

86361 is the correct code for absolute CD4 T-cell count.
Code 86359 is incorrect because this is the code for total T-cell count. Code 86360 is incorrect because this is for the absolute CD4 and CD8 T-cell count including ratio. Code 86367 is incorrect because this code is for stem cell total count.

Question 15

A patient needs to have serologic blood typing performed for ABO. What is the correct laboratory code for this test?

Accepted Answer

86900 is the correct code for ABO serologic blood typing.
Code 86890 is incorrect because this code is for autologous blood or component collection processing and storage. Code 86901 is incorrect because this is for Rh typing and code 86902 is incorrect because this is antigen testing of donor blood using reagent serum.

Question 16

A patient needs to have an antihuman globulin test (Coombs test) performed, which needs to be done as a qualitative indirect test on each reagent red cell. What is the correct CPT laboratory code for this specific test?

Accepted Answer

86885 is the correct code for indirect qualitative antihuman globulin test (Coombs test) for each reagent red cell.
Code 86880 is incorrect because this code is for the direct antihuman globulin test (Coombs test). Code 86886 is incorrect because this code is for the indirect testing of the antihuman globulin test (Coombs test), each antibody titer. Code 86890 is incorrect because this code is for autologous blood or component collection processing and storage.

Question 17

What is the correct CPT code for splitting of blood or blood products per unit?

Accepted Answer

86985 is the correct code for splitting of blood or blood products for each unit. If more than one unit was needed to be split, then this code would be multiplied by however many units were required for the patient.
Code 86965 is incorrect because this code is for pooling of platelets or other blood products. Code 86975 is incorrect because this code is for pretreatment of serum for use in RBC antibody identification using incubation with drugs. Code 86999 is incorrect because this code is for unlisted transfusion medicine procedure, but there was a specific code available for the splitting of blood or blood products.

Question 18

A patient needs to have a culture done of his stool looking for Salmonella and Shigella. This will be performed as an aerobic stool sample with isolation and preliminary examination. What is the correct CPT code for this laboratory test?

Accepted Answer

87045 is the correct code for aerobic stool culture with isolation and preliminary examination for Salmonella and Shigella species.
Code 87040 is incorrect because this code is for blood bacterial culture. Code 87046 is incorrect because, even though this is an aerobic stool culture, it is for additional pathogens with identification of isolates. Code 87070 is incorrect because this code is for culture of any other source except for urine, blood or stool.

Question 19

A patient needs to have a stool sample done, looking for ova and parasites. What is the correct CPT code for this laboratory test involving direct smears for concentration and identification?

Accepted Answer

87177 is the correct code for direct smear for concentration and identification of ova and parasites.
Code 87169 is incorrect because this code is for macroscopic examination for parasites. Code 87172 is incorrect because this is for a pinworm exam. Code 87181 is incorrect because this code is for an antimicrobial susceptibility study.

Question 20

A patient needs to have a culture done for chlamydia. What is the correct code for this laboratory testing?

Accepted Answer

87110 is the correct code for a chlamydia culture from any source.
Code 87109 is incorrect because this code is for a culture for mycoplasma. Code 87116 is incorrect because this code is for tubercle or other acid-fast bacilli culture with isolation and presumptive identification of isolates. Code 87118 is incorrect because this code is for mycobacterial culture with definitive identification.

Quiz 9: Laboratory and Pathology