2022 CPT Update: Clinical Pathology Consults

June 17, 2022

CPT 80500 and 80502 will be deleted in 2022.

80500 (Clinical pathology consultation; limited, without review of patient’s history and medical records)

80502 (… comprehensive, for a complex diagnostic problem, with review of patient’s history and medical records)

There will now be four new codes to differentiate pathology clinical consults in more detail than the previous two CPT codes (80500 and 80502).

Effective January 1, 2022: The following new codes will be replacing the 80500 and 80502.

80503 – Pathology clinical consultation; for a clinical problem, with limited review of patient’s history and medical records and straightforward medical decision making. When using time for code selection, 5-20 minutes of total time is spent on the date of the consultation

80504 – … for a moderately complex clinical problem, with review of patient’s history and medical records and moderate level of medical decision making. When using time for code selection, 21-40 minutes of total time is spent on the date of the consultation

80505– … for a highly complex clinical problem, with comprehensive review of patient’s history and medical records and high level of medical decision making. When using time for code selection, 41-60 minutes of total time is spent on the date of the consultation

+80506 – … prolonged service, each additional 30 minutes (List separately in addition to code for primary procedure)

  • These four new codes will allow the pathologist to use time for code selection. This option was not previously available with CPTs 80500/80502.

To use codes 80503-+80506, you need to meet certain criteria. To use these new codes, you must have documentation of the following facts:

  • A physician or qualified healthcare professional requested the pathology clinical consultation
  • The request is related to a laboratory finding and relevant clinical information that requires extra medical judgement beyond a simple interpretation of results.
  • The pathologist renders the medical judgement and reports back to the requesting clinician.

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