Last week, the American Medical Association (AMA) published 13 new add-on CPT digital pathology codes. The College of American Pathologists (CAP), which worked closely with the AMA to advocate for the inclusion of these codes, first shared the news. As the CAP explains, the new Category III codes will be “used to report additional clinical staff work and service requirements associated with digitizing glass microscope slides for primary diagnosis.” They go into effect on January 1, 2023.
The creation of new CPT codes – even Category III codes for which there is not yet additional compensation – doesn’t happen every day. I view this development with extraordinary enthusiasm, and here’s why you should, too.
The new codes are listed below, with their following descriptors:
- 0751T– Digitization of glass microscope slides for Level II, surgical pathology, gross and microscopic examination (List separately in addition to code for primary procedure) (Use 0751T in conjunction with 88302)
- 0752T– Digitization of glass microscope slides for Level III, surgical pathology, gross and microscopic examination (List separately in addition to code for primary procedure) (Use 0752T in conjunction with 88304)
- 0753T– Digitization of glass microscope slides for Level IV, surgical pathology, gross and microscopic examination (List separately in addition to code for primary procedure) (Use 0753T in conjunction with 88305)
- 0754T– Digitization of glass microscope slides for Level V, surgical pathology, gross and microscopic examination (List separately in addition to code for primary procedure) (Use 0754T in conjunction with 88307)
- 0755T– Digitization of glass microscope slides for Level VI, surgical pathology, gross and microscopic examination (List separately in addition to code for primary procedure) (Use 0755T in conjunction with 88309)
- 0756T– Digitization of glass microscope slides for special stain, including interpretation and report, group I, for microorganisms (eg, acid fast, methenamine silver) (List separately in addition to primary procedure) (Use 0756T in conjunction with 88312)
- 0757T– Digitization of glass microscope slides for special stain, including interpretation and report, group II, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzymes constituents, or immunocytochemistry and immunohistochemistry (List separately in addition to code for primary procedure) (Use 0757T in conjunction with 88313)
- 0758T– Digitization of glass microscope slides for special stain, including interpretation and report, histochemical stain on frozen tissue block (List separately in addition to primary procedure) (Use 0758T in conjunction with 88314)
- 0759T– Digitization of glass microscope slides for special stain, including interpretation and report, group III, for enzymes constituents (List separately in addition to primary procedure) (Use 0759T in conjunction with 88319)
- 0760T– Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial single antibody stain procedure (List separately in addition to primary procedure) (Use 0760T in conjunction with 88342)
- 0761T– Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each additional single antibody stain procedure (List separately in addition to primary procedure) (Use 0761T in conjunction with 88341)
- 0762T– Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex antibody stain procedure (List separately in addition to primary procedure) (Use 0762T in conjunction with 88344)
- 0763T– Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, ER, PR), quantitative or semiquantitative, per specimen, each additional single antibody stain procedure, manual (List separately in addition to primary procedure) (Use 0763T in conjunction with 88360)
Paving the way for added reimbursement
Today, laboratories in the US report on all diagnostic reads using the same CPT codes, regardless of whether that read was made under the microscope or using a digital pathology system. This means that payors have not distinguished the use of digital pathology when it comes to reimbursement because they are unable to do so.
This is changing. By enabling laboratories to specifically report when they’ve made a diagnosis using digital pathology, the new CPT codes will provide payors with the data they need to directly understand the utilization of digital pathology and its impact. In turn, laboratories will be one big step closer to seeing additional reimbursement for digital reads. Payors will finally be equipped to independently assess the increased value, and this is exciting.
Unleashing the next wave of adoption
Let’s jump to another big step forward – this one for the industry.
The adoption of digital pathology has already been accelerating in the US even without additional compensation as other barriers have been broken down; cloud storage has become much more affordable, scanners have higher throughput, the experience of digital pathology platforms has improved, and FDA approvals have been granted.
Now, the new CPT codes are working to chip away at one of the final blockers that remain: reimbursement. Consider that in many European countries, where there have been payment structures or reimbursement pathways specifically for digital pathology in place for years, adoption is nearing 100%. It’s easy to see why the new codes could help to unleash a new surge in demand here in the US.
A big congratulations to the CAP and the AMA on this significant industry milestone. It’s an exciting time for digital pathology, and I look forward to all that’s ahead.
