2019 CPT-4 and HCPCS Codes Subject to CLIA Edits Includes non-waived and non-PPMP tests Laboratory certification codes are for informational purposes only. CPT only copyright 2018 American Medical Association. All rights reserved CPT is a registered trademark of the American Medical Association. Applicable FARS/DFARS Apply to Government Use. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein. LABORATORY CERTIFICATION (LC) HCPCS MOD DESCRIPTION CODE G0103 Psa, screening 310 G0123 Screen cerv/vag thin layer 630 G0124 Screen c/v thin layer by MD 630 G0141 Scr c/v cyto,autosys and md 630 G0143 Scr c/v cyto,thinlayer,rescr 630 G0144 Scr c/v cyto,thinlayer,rescr 630 G0145 Scr c/v cyto,thinlayer,rescr 630 G0147 Scr c/v cyto, automated sys 630 G0148 Scr c/v cyto, autosys, rescr 630 G0306 CBC/diffwbc w/o platelet 400 G0307 CBC without platelet 400 G0328 Fecal blood scrn immunoassay 310, 400 G0416 Prostate biopsy, any mthd 610 G0416 TC Prostate biopsy, any mthd 610 G0416 26 Prostate biopsy, any mthd 610 G0432 EIA HIV-1/HIV-2 screen 140, 220 G0433 ELISA HIV-1/HIV-2 screen 140, 220 G0435 Oral HIV-1/HIV-2 screen 140, 220 G0472 Hepatitis c antibody screening, for individual at high risk and 220 other covered indication(s) G0475 Hiv combination assay 140, 220 G0476 Hpv combo assay ca screen 140 G0480 Drug test def 1-7 classes 340 G0481 Drug test def 8-14 classes 340 G0482 Drug test def 15-21 classes 340 G0483 Drug test def 22+ classes 340 G0499 Hepb screen high risk indiv 220 G0659 Drug test def simple all cl 340 G9143 Warfarin respon genetic test 220, 310 P3000 Screen pap by tech w md supv 630 P3001 Screening pap smear by phys 630 P7001 Culture bacterial urine 110 0111T Long-chain omega-3 fatty acids in red blood cell membranes 310 0001U Rbc dna hea 35 ag 11 bld grp 510 0002U Onc clrct 3 ur metab alg plp 220, 310 0003U Onc ovar 5 prtn ser alg scor 220, 310 0005U Onco prst8 3 gene ur alg 220, 310 0006U Detc ia meds 120+ analytes 340 0007U Rx test prsmv ur w/def conf 340 LABORATORY CERTIFICATION (LC) HCPCS MOD DESCRIPTION CODE 0008U Hpylori detcj abx rstnc dna 110 0009U Onc brst ca erbb2 amp/nonamp 220, 310 0010U Nfct ds strn typ whl gen seq 110 0011U Rx mntr lc-ms/ms oral fluid 340 0012U Germln do gene reargmt detcj 220, 310 0013U Onc sld org neo gene reargmt 220, 310 0014U Hem hmtlmf neo gene reargmt 400 0016U Onc hmtlmf neo rna bcr/abl1 220, 310, 400 0017U Onc hmtlmf neo jak2 mut dna 220, 310, 400 0018U MicroRNA gene analysis of thyroid nodule tissue - Effective 10/1/2017 220, 310 0019U RNA gene analysis of tumor tissue - Effective 10/1/2017 220, 310 0020U Rx test prsmv ur w/def conf - Discontinued 9/30/2018 340 0021U Onc prst8 detcj 8 autoantb - Effective 10/1/2017 220, 310 0022U Trgt gen seq dna&rna 23 gene - Effective 10/1/2017 220, 310 0023U Onc aml dna detcj/nondetcj - Effective 10/1/2017 220, 310, 400 0024U Glyca nuc mr spectrsc quan - Effective 1/1/2019 220, 310 0025U Tenofovir liq chrom ur quan - Effective 1/1/2019 220, 310 0026U Onc thyr dna&mrna 112 genes - Effective 1/1/2019 220, 310 0027U Jak2 gene trgt seq alys - Effective 1/1/2019 310, 900 0028U Cyp2d6 gene cpy nmr cmn vrnt - Discontinued 9/30/2018 220, 310 0029U Rx metab advrs trgt seq alys - Effective 1/1/2019 220, 310 0030U Rx metab warf trgt seq alys - Effective 1/1/2019 220, 310 0031U Cyp1a2 gene - Effective 1/1/2019 220, 310 0032U Comt gene - Effective 1/1/2019 220, 310 0033U Htr2a htr2c genes - Effective 1/1/2019 220, 310 0034U Tpmt nudt15 genes - Effective 1/1/2019 220, 310 0035U Neuro csf prion prtn qual - Effective 4/1/2018 310 0036U Xome tum & nml spec seq alys - Effective 4/1/2018 220, 310 0037U Trgt gen seq dna 324 genes - Effective 4/1/2018 220, 310 0038U Vitamin d srm microsamp quan - Effective 4/1/2018 310 0039U Dna antb 2strand hi avidity - Effective 4/1/2018 220 0040U Gene analysis (t(9;22)) for translocation analysis - Effective 4/1/2018 220, 310, 400 0041U B brgdrferi antb 5 prtn igm - Effective 4/1/2018 220 0042U B brgdrferi antb 12 prtn igg - Effective 4/1/2018 220 0043U Tbrf b grp antb 4 prtn igm - Effective 4/1/2018 220 0044U Tbrf b grp antb 4 prtn igg - Effective 4/1/2018 220 0045U Onc brst dux carc is 12 gene - Effective 7/1/2018 220, 310 0046U Flt3 gene itd variants quan - Effective 7/1/2018 220, 310, 410 0047U Onc prst8 mrna 17 gene alg - Effective 7/1/2018 220, 310 0048U Onc sld org neo dna 468 gene - Effective 7/1/2018 220, 310 0049U Npm1 gene analysis quan - Effective 7/1/2018 220, 310, 410 CPT only copyright 2018 American Medical Association. All rights reserved. 2 LABORATORY CERTIFICATION (LC) HCPCS MOD DESCRIPTION CODE 0050U Trgt gen seq dna 194 genes - Effective 7/1/2018 220, 310, 410 0051U Rx mntr lc-ms/ms ur 31 pnl - Effective 7/1/2018 340 0052U Lpoprtn bld w/5 maj classes - Effective 7/1/2018 310 0053U Onc prst8 ca fish alys 4 gen - Effective 7/1/2018 220, 310 0054U Rx mntr 14+ drugs & sbsts - Effective 7/1/2018 340 0055U Card hrt trnspl 96 dna seq - Effective 7/1/2018 220, 310 0056U Hem aml dna gene reargmt - Effective 7/1/2018 400 0057U Onc sld org neo mrna 51 gene - Effective 7/1/2018 220, 310 0058U Onc merkel cll carc srm quan - Effective 7/1/2018 220, 310 0059U Onc merkel cll carc srm +/- - Effective 7/1/2018 220, 310 0060U Twn zyg gen seq alys chrms2 - Effective 7/1/2018 900 0062U Ai sle igg&igm alys 80 bmrk - Effective 10/1/2018 220, 310 0063U Neuro autism 32 amines alg - Effective 10/1/2018 220, 310, 900 0064U Antb tp total&rpr ia qual - Effective 10/1/2018 210 0065U Syfls tst nontreponemal antb - Effective 10/1/2018 210 0066U Pamg-1 ia cervico-vag fluid - Effective 10/1/2018 310 0067U Onc brst imhchem prfl 4 bmrk - Effective 10/1/2018 220, 310 0068U Candida species pnl amp prb - Effective 10/1/2018 120 0069U Onc clrct microrna mir-31-3p - Effective 10/1/2018 220, 310 0070U Cyp2d6 gen com&slct rar vrnt - Effective 10/1/2018 220, 310 0071U Cyp2d6 full gene sequence - Effective 10/1/2018 220, 310 0072U Cyp2d6 gen cyp2d6-2d7 hybrid - Effective 10/1/2018 220, 310 0073U Cyp2d6 gen cyp2d7-2d6 hybrid - Effective 10/1/2018 220, 310 0074U Cyp2d6 nonduplicated gene - Effective 10/1/2018 220, 310 0075U Cyp2d6 5' gene dup/mlt - Effective 10/1/2018 220, 310 0076U Cyp2d6 3' gene dup/mlt - Effective 10/1/2018 220, 310 0077U Ig paraprotein qual bld/ur - Effective 10/1/2018 310 0078U Pain mgt opi use gnotyp pnl - Effective 10/1/2018 220, 310 0080U Oncology (lung), mass spectrometric analysis of galectin-3- 220, 310 binding protein and scavenger receptor cysteine-rich type 1 protein M130, with five clinical risk factors (age, smoking status, nodule diameter, nodule-spiculation status and nodule location), utilizing plasma, algorithm reported as a categorical probability of malignancy - Effective 1/1/2019 0081U Oncology (uveal melanoma), mRNA, gene-expression profiling 220, 310 by real-time RT-PCR of 15 genes (12 content and 3 housekeeping genes), utilizing fine needle aspirate or formalin- fixed paraffin-embedded tissue, algorithm reported as risk of metastasis - Effective 1/1/2019 CPT only copyright 2018 American Medical Association. All rights reserved. 3 LABORATORY CERTIFICATION (LC) HCPCS MOD DESCRIPTION CODE 0082U Drug test(s), definitive, 90 or more drugs or substances, 340 definitive chromatography with mass spectrometry, and presumptive, any number of drug classes, by instrument chemistry analyzer (utilizing immunoassay), urine, report of presence or absence of each drug, drug metabolite or substance with description and severity of significant interactions per date of service - Effective 1/1/2019 0083U Oncology, response to chemotherapy drugs using motility 220, 310 contrast tomography, fresh or frozen tissue, reported as likelihood of sensitivity or resistance to drugs or drug combinations - Effective 1/1/2019 17311 Mohs, 1 stage, h/n/hf/g 610 17312 Mohs addl stage 610 17313 Mohs, 1 stage, t/a/l 610 17314 Mohs, addl stage, t/a/l 610 17315 Mohs surg, addl block 610 78110 Plasma volume, single 800 78110 TC Plasma volume, single 800 78110 26 Plasma volume single 800 78111 Plasma volume, multiple 800 78111 TC Plasma volume, multiple 800 78111 26 Plasma volume multiple 800 78120 Red cell mass, single 800 78120 TC Red cell mass, single 800 78120 26 Red cell mass single 800 78121 Red cell mass, multiple 800 78121 TC Red cell mass, multiple 800 78121 26 Red cell mass multiple 800 78122 Blood volume 800 78122 TC Blood volume 800 78122 26 Blood volume 800 78130 Red cell survival study 800 78130 TC Red cell survival study 800 78130 26 Red cell survival study 800 78191 Platelet survival 800 78191 TC Platelet survival 800 78191 26 Platelet survival 800 78270 Vit B-12 absorption exam - Discontinued 12/31/2018 800 78270 TC Vit B-12 absorption exam - Discontinued 12/31/2018 800 78270 26 Vit B-12 absorption exam - Discontinued 12/31/2018 800 78271 Vit B-12 absorp exam, int fac - Discontinued 12/31/2018 800 78271 TC Vit B-12 absorp exam, int fac - Discontinued 12/31/2018 800 78271 26 Vit b-12 absrp exam int fac - Discontinued 12/31/2018 800 78272 Vit B-12 absorp, combined - Discontinued 12/31/2018 800 78272 TC Vit B-12 absorp, combined - Discontinued 12/31/2018 800 78272 26 Vit b-12 absorp combined - Discontinued 12/31/2018 800 80047 Metabolic panel ionized ca 310 80048 Metabolic panel total ca 310 80050 General health panel - Not payable by Medicare 310, 330, 400 CPT only copyright 2018 American Medical Association.