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MEDICARE CPT CODES AND FEE SCHEDULE UPDATE.
Effective March 1, 1999 a new Medicare fee schedule will be in place. A few changes affect lab fees and CPT codes. Please check the updated Fee Schedule for prices and CPT codes.

The largest changes in the new Fee Schedule are for Anatomic Pathology billing. Currently one charge is billed. Beginning March 1, 1999 billing will include two components, the technical and professional components. The fee itself does not change much but two bills will be sent.

TECHNICAL COMPONENT-The non-physician technical tissue preparation component. Clinics/Physicians-The technical component must be billed directly to Medicare for all Medicare patients. Non-Medicare patients may be billed to your facility, the patient or the insurance provider.

Hospitals-The technical component must be billed to Hospitals for all Medicare patients. Non-Medicare patients may be billed to your facility, the patient or the insurance provider.

PROFESSIONAL COMPONENT-The physician (pathologist) tissue interpretation component. Hospitals/Clinics/Physicians-The professional component will be billed directly to Medicare, Medicaid, the patient or the insurance provider.

Medicare now requires differentiation between screening and diagnostic PAP smears, due to statutory limitations on the frequency of screening PAP smears. There are now four CPT/HCPCS codes for Gyn PAP smears.

Diagnostic PAP smear (Technical component)-is performed because there are signs and symptoms of disease and is reported using all numeric CPT codes.

Diagnostic PAP smear with pathologist interpretation (Professional component)-is performed because there are signs and symptoms of disease requiring interpretation by a physician (pathologist) and is reported using all numeric CPT codes.

Screening PAP smear (Technical component)-is performed in the absence of signs and symptoms of disease and is reported using alphanumeric HCPCS codes.

Screening PAP smear with pathologist interpretation (Professional component)-is performed because upon screening by a cytotechnologist, abnormalities are noted which require an interpretation by a physician (pathologist).

NOTE: The PAP code selection is always based on the reason the test was performed, regardless of results. The pathology requisition must include a diagnosis or ICD-9 code. For specific CPT codes and prices contact your Avera Laboratory Network lab. (Avera St. Luke's has sent this information to it's accounts. If you have not received a packet, please contact Avera St. Luke's client services.)

SPRING INTO THE MILLENNIUM.
The spring 1999 SDSCLS/CLMA convention will be held May 5-7 in Rapid City, SD. Program listings

and registration forms will be arriving soon. The program offerings cover a wide range of topics, from cord blood storage to Y2K readiness. If you would like to attend and don't receive a packet, contact your Avera Laboratory Network laboratory of call Pam Keiffer at (605) 341-8092.

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NEW TESTING OFFERED AT AVERA QUEEN OF PEACE.
Avera Queen of Peace recently began offering Legionella urinary antigen, Mycoplasma IgM antibody, and H. pylori testing. Tests are run daily, specimens must be received by 0930 for the daily run. Legionella urinary antigen is intended to aid in the presumptive diagnosis of infection by pneumonophilia serogroup 1. Specimen required: random urine. Stability: 14 days a t 2-8C.

Mycoplasma IgM antibody is intended to aid in the diagnosis of recent Mycoplasma pneumoniae infections. Specimen required: Serum. Stability: 72 hrs at 2-8, specimen should be frozen for longer storage.

H. pylori has been indicated as a cause of peptic ulcers. Specimen: Serum or plasma (EDTA or heparin).

Stability: 5 days at 2-8C, longer storage requires freezing.

H. pylori is also performed at Avera McKennan and Avera St. Luke’s. Legionella urinary antigen and Mycoplasma IgM are performed at Avera McKennan.

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Question: What hepatitis testing need to be done for an employed needle stick?

Answer: Each facility will differ in policy for employee needle sticks. Generally, the employee will need to be tested for hepatitis B surface antibody (HBSAB) and in some facilities, hepatitis C antibody. If the source is known, he/she will be tested for hepatitis B surface antigen (HBSAG). Remember that consent must be obtained before sample collection.