Question:
We encountered a low-frequency MAAA test listed in Appendix O and questioned whether the listing indicates the procedure has been reviewed for clinical utility. What guidance does CPT® provide regarding Appendix O listings and the use of code 81599?
Answer:
The MAAA codes are listed in two different locations within the CPT manual. The Category I codes (81490–81596 and 81599) are published within the listing of the CPT codes. The second category is identified as the Administrative Code list and is found in Appendix O of the CPT manual. The administrative codes represent low-frequency analyses that, at this time, were not determined to justify the assignment of a Category I code. The inclusion of a procedure in Appendix O does not mean that the procedure has been reviewed for clinical utility. To qualify for a listing in Appendix O, the procedure must be available for request in order to be utilized in patient care. There is an unlisted MAAA code, 81599, and this code must be assigned when a procedure meets the definition of an algorithmic analysis and another more accurate code is not available.
This question was answered in our annual Laboratory Coding Update webcast. For more hot topics relating to laboratory services, please visit our store or call us at 1.800.252.1578, ext. 2.
