CPT® 2021 Code Updates: Second and Third Quarters

The American Medical Association (AMA) has released updates for the second and third quarters of CPT® 2021. These changes, including new, revised, and deleted codes, will be implemented in AAPC’s Codify system as they become effective. Practices should also update their CPT® 2021 code books and electronic health record (EHR) software accordingly.

Proprietary Laboratory Analyses (PLA) Code Changes (Effective April 1)

Appendix O, which covers Multianalyte Assays with Algorithmic Analyses and PLA, includes several new codes, deletions, and one revision.

New Codes:

• • $0242U$: Targeted genomic sequence analysis panel, solid organ neoplasm, cell-free circulating DNA analysis of 55-74 genes, interrogation for sequence variants, gene copy number amplifications, and gene rearrangements.
  • $0243U$: Obstetrics (preeclampsia), biochemical assay of placental-growth factor, time-resolved fluorescence immunoassay, maternal serum, predictive algorithm reported as a risk score for preeclampsia.
  • $0244U$: Oncology (solid organ), DNA, comprehensive genomic profiling, 257 genes, interrogation for single-nucleotide variants, insertions/deletions, copy number alterations, gene rearrangements, tumor-mutational burden and microsatellite instability, utilizing formalin-fixed paraffin-embedded tumor tissue.
  • $0245U$: Oncology (thyroid), mutation analysis of 10 genes and 37 RNA fusions and expression of 4 mRNA markers using next-generation sequencing, fine needle aspirate, report includes associated risk of malignancy expressed as a percentage.
  • $0246U$: Red blood cell antigen typing, DNA, genotyping of at least 16 blood groups with phenotype prediction of at least 51 red blood cell antigens.
  • $0247U$: Obstetrics (preterm birth), insulin-like growth factor-binding protein 4 (IBP4), sex hormone-binding globulin (SHBG), quantitative measurement by LC-MS/MS, utilizing maternal serum, combined with clinical data, reported as predictive-risk stratification for spontaneous preterm birth.

Deleted Codes:

• • $0098U$
  • $0099U$
  • $0100U$

Category III Code Changes (Effective July 1)

Category III codes are temporary codes for emerging technologies, services, procedures, and service paradigms. Payers typically do not cover these services, and the codes are primarily for reporting purposes.

New Codes:

• • $0640T$ – $0670T$ (Detailed list as provided in the original text).

Revised Code:

• • $0493T$: Contact near-infrared spectroscopy studies of lower extremity wounds (eg, for oxyhemoglobin measurement).

CPT® 2021 Errata and Technical Corrections (Effective January 1, 2021)

The AMA also published errata and technical corrections on December 1, 2020, for Category I codes, which are used to report professional services.

Category I Code Changes:

• • Revised parenthetical note under complex chronic care service code $99489$.
  • Deleted code $98969$.