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Medical Coding News Archives

AMA Creates New Section for MAAA Codes

 
June 29, 2012:

Wendy Gabbert, CPC, CPC-H, Clinical/Technical Editor

The American Medical Association will add a new section of codes to its CPT manual effective September 15, 2012. The three codes in the section describe multianalyte assays with algorithmic analyses (MAAA) procedures. Such procedures are usually developed and performed by just one laboratory or manufacturer.

The codes are administrative codes that describe the algorithmic analysis as well as the analytical services, such as nucleic acid stabilization, amplification, and hybridization, that make the algorithmic analysis possible. The AMA notes that procedures performed before cell lysis should be reported separately and that an unlisted code should be used to describe the service if documentation describes one of the procedures represented by one of the codes but the MAAA was not performed by the laboratory or manufacturer specified.

MAAAs are based on various assays (such as molecular pathology, fluorescent in situ hybridization, and non-nucleic acid-based assays) as well as other elements, such as age and sex of a patient. An algorithm (often proprietary) is then used on the assay data to assign a single, patient-specific value that indicates diagnosis, mitigation, treatment, or prevention of disease.

For example, instead of undergoing an invasive liver biopsy, a person with hepatitis C might have the HCV FibroSURE blood test to assess fibrosis and necroinflammatory activity in his liver. A grade of A0 corresponds to no activity, A1 to minimal activity, A2 to moderate activity, and A3 to severe activity. The physician can then use that “score” to tailor treatment and develop a more accurate prognosis of the disease’s progression.

Below are the three new codes that will populate the new CPT code section. An assay was included if it was generally available for patient care; the AMA is careful to point out that inclusion does not indicate clinical utility. Note that each code description includes eight elements: disease type, materials analyzed, number of markers, methodology, number of functional domains (if applicable), specimen type, algorithm result type, and report, such as risk score:

  • 0001M Infectious disease, HCV, six biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, and haptoglobin) utilizing serum, prognostic algorithm reported as a scores for fibrosis and necroinflammatory activity in liver [HCV FibroSURE, LabCorp]
  • 0002M Liver disease, ten biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, haptoglobin, AST, glucose, total cholesterol and triglycerides) utilizing serum, prognostic algorithm reported as quantitative scores for fibrosis, steatosis and alcoholic steatohepatitis (ASH) [ASH FibroSURE, LabCorp]
  • 0003M Liver disease, ten biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, haptoglobin, AST, glucose, total cholesterol and triglycerides) utilizing serum, prognostic algorithm reported as quantitative scores for fibrosis, steatosis and nonalcoholic steatohepatitis (NASH) [NASH FibroSURE, LabCorp]

Some MAAA procedures have already been assigned a Category I code and will not be included in this new section.

 

 
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