Q&A Modifiers OB and OA

[susan sayers]

Hi all. was doing a practice test and came across this question."
Which modifier would you use to report with code 88239 if the test was looking for hereditary cancer?"
I cant even find these modifiers in my book(CPT prof edition) the answer sheet reports to look in Appendix I under sub category Cytogenetic studies.Thanks ....sue

 

[Lori Woods]

Hello I am a coding student & haven't used these modifiers before I see the list in Appendix I genetic testing code modifiers the first section is neoplasia (solid tumor excluding sarcoma & lymphoma) there seem to be 5 that mention hereditary, but I agree how do you chose on just that information?
GENETIC TESTING CODE MODIFIERS - Neo plasia - 0A - 0M

This listing of modifiers is intended for reporting with molecular laboratory procedures related to genetic
testing. Genetic test modifiers should be used in conjunction with CPT and HCPCS codes to provide
diagnostic granularity of service to enable provider to submit complete and precise genetic testing
information without altering test descriptors. These modifiers are categorized by mutation. The first
(numeric) digit indicates the disease category and the second (alpha) digit denotes gene type. Introductory
guidelines in the molecular diagnostic and molecular cytogenetic code sections of CPT provide further
guidance in interpretation and application of genetic test modifiers.
Neoplasia (solid tumor)

0A BRCA1 (Hereditary breast/ovarian cancer)
0B BRCA2 (Hereditary breast cancer)
0C Neurofibromin (Neurofibromatosis, type 1)
0D Merlin (Neurofibromatosis, type 2)
0E c-RET (Multiple endocrine neoplasia, types 2A/B,
familial medullary thyroid carcinoma
0F VHL (Von Hippel Lindau disease)
0G SDHD (Hereditary paraganglioma)
0H SDHB (Hereditary paraganglioma)
0I Her-2/neu
0J MLH1 (HNPCC)
0K MSH2 (HNPCC)
0L APC (Hereditary polyposis coli)
0M Rb (Retinoblastoma)
1Z Solid tumor, not otherwise specified

 

[susan sayers]

YEAAA. I,m not going crazy. These codes no longer in 2013. I went back to 2010(first CPT pulled off shelf) and found them easily.Teach me to use old tests.But now i am curious, are the genetic Testing modifiers in any of out reference books for 2013.

 

[Ruth Sheets]

This question was reviewed in the November 2013 Q&A Webinar. Appendix I does not exist anymore. For more up-to-date info on molecular coding check:
http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/cpt/about-cpt/mopath-codes.page.

If you missed the webinar, you can join the CCO Club, and get access to webinar transcripts and Answer Sheets, and for months where they are available (since May 2013), you can also get access to a webinar CEU quiz.