Chemistry Panels
In 1998 at HCFA’s urging, the American Medical Association’s CPT editorial board abolished the automated chemistry profile codes 80002-80019 and replaced them with four smaller disease/organ panels containing tests on Medicare’s national roster of automated procedures. HCFA has steadily tightened requirements for panels, in particular stipulating that for a panel to be reimbursed, all of its component tests must be medically justified. Not surprisingly, the CPT 2000 manual once again contained significant changes to the organ/disease panels that laboratories had to implement on April 1, 2000.
ChemistryTests |
Comprehensive Metabolic |
Renal Function |
Basic Metabolic |
ElectrolytePanel |
Hepatic Function |
Sodium |
X |
X* |
X |
X |
|
Potassium |
X |
X* |
X |
X |
|
Chloride |
X |
X* |
X |
X |
|
CO2 |
X |
X* |
X |
X |
|
Anion Gap |
X* |
X* |
X |
X |
|
BUN |
X |
X* |
X |
|
|
Creatinine |
X |
X* |
X |
|
|
Glucose |
X |
X* |
X |
|
|
Calcium |
X |
X* |
X* |
|
|
Phosphate |
|
X* |
|
|
|
Albumin |
X |
X* |
|
|
X |
Total Protein |
X |
|
|
|
X* |
ALP |
X |
|
|
|
X |
AST |
X |
|
|
|
X |
ALT |
X* |
|
|
|
X |
D. Bilirubin |
|
|
|
|
X |
T. Bilirubin |
X |
|
|
|
X |
|
|
|
|
|
|
# Tests |
14 |
10 |
8 |
4 |
7 |
2000 CPT |
80053 |
80069 |
80048 |
80051 |
80076 |
1999 CPT |
80054 |
80049,82310,82040, 84100 |
80049 |
80051 |
80058 |
* New tests added April 2000
If a physician decides that other automated tests, which are not included in one of these panels, are medically necessary for a patient, the additional tests should be ordered individually.If two panels are ordered that contain overlapping tests, duplicate tests must be eliminated prior to billing. All claims for physician office lab testing must contain an ICD-9 diagnosis code as medical justification for the tests. Patient records and chart notes should include supporting documentation.