The following are the new codes for 2015 for gene-specific and genomic procedures.
Molecular pathology coding guidelines include all analytical services performed in the test. This includes cell lysis, nucleic acid stabilization,extraction,digestion, mplification, and detection. Any procedures required prior to cell lysis such as microdissection (88380, 88381) are reported separately.
AMA instructs coders to use 87149-87153, 87470-87801, and 87900-87904 for any molecular testing done for microbial identification. This means molecular testing for infectious agents, such as HPV are NOT reported in the molecular pathology coding guidelines section of the code book. You should look to the Microbiology section for those codes.
For in situ hybridization, use the 88271-88275 (when interpreted by scientist instead of pathologist) and88365-88368 when interpreted by a pathologist.
MOLECULAR PATHOLOGY TIER 1 MOLECULAR PATHOLOGY PROCEDURES
81246 FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis;tyrosine kinase domain (TKD) variants (eg, D835, I836)
81288 MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposiscolorectal cancer, Lynch syndrome) gene analysis; promoter methylation analysis
81313 PCA3/KLK3 (prostate cancer antigen 3 [non-protein coding] / kallikrein-related peptidase 3 [prostate specific antigen]) ratio (eg, prostate cancer)
Molecular pathology coding guidelines Tier 1 code 81246 has been established for reporting analysis of the FLT3 gene for the testing of acute myeloid leukemia and indicates the testing is specifically for tyrosine kinase domain variants (TKD).
MLH1 gene analysis (code 81288) is testing of colorectal cancer variants specifically for the promoter methylation analysis method.
The PCA3/KLK3 (code 81313) is for the prostate specific antigen testing for prostate cancer, common testing in the current laboratories .