TECHNICAL NOTICE T HE MEDICAL FOU N D ATION Your Laboratory Experts A listing of the 2015 changes to Current Procedural Terminology, or CPT, for tests that are offered by The Medical Foundation appears below. Please update documents and records within your facility to reflect these changes. Test No. Test Description 2015 CPT 4445417-Ketosteroids, Urine 82570; 83586 44973 1p/19q Deletion by FISH 88368; 88369 448795-a-Dihydrotestosterone, Serum 82541 31041Acetaminophen, Serum or Plasma80304 46086Acetaminophen, Urine 80329 46001Acetaminophen, Whole Blood 80329 46077Acetazolamide, Serum or Plasma 80375 35452 Acute Myeloid Leukemia Panel (NPM1 and FLT3), PCR 81245; 81246; 81310 23006Alcohol, Ethyl, Blood80301 23023Alcohol, Ethyl, Urine80301 36176ALK Gene Rearrangement by FISH88374 44485Alprazolam, Serum or Plasma 80346 45501 Amitriptyline and Nortriptyline, Serum or Plasma 80335 29080Amphetamines Screen, Urine80301 44753Amphetamines, Quantitative, Meconium 80326 47155 Amphetamines, Quantitative, Serum or Plasma 80326 47156Amphetamines, Quantitative, Urine 80326 46109Amphetamines, Quantitative, Whole Blood 80326 46017 Antidepressants Panel, Urine 80332; 80337; 80338 47112 Aripiprazole and Metabolite, Serum or Plasma 80342 29081Barbiturates Screen, Urine80301 45449Barbiturates, Quantitative, Meconium80345 44961Barbiturates, Quantitative, Serum or Plasma 80345 47141Barbiturates, Quantitative, Urine 80345 46067Bath Salts Panel, Urine 80371 29082Benzodiazepines Screen, Urine80301 45450Benzodiazepines, Quantitative, Meconium80347 47157 Benzodiazepines, Quantitative, Serum or Plasma 80347 47087Benzodiazepines, Quantitative, Urine 80347 46016Benzodiazepines, Quantitative, Whole Blood 80347 44910 Buprenorphine and Metabolites, Quantitative, Serum or Plasma 80348 47158 Buprenorphine and Metabolites, Quantitative, Urine 80348 44135Bupropion, Serum or Plasma 80338 36365Burkitt Lymphoma Panel by FISH, Tissue88374 44538Butalbital, Serum or Plasma 80345 44757Cannabinoid Metabolite, Quantitative, Meconium80349 44339 Cannabinoid Metabolite, Quantitative, Serum or Plasma 80349 47144Cannabinoid Metabolite, Quantitative, Urine 80349 THE MEDICAL FOUNDATION 5 3 0 N . L afa y ette Bo u le va rd • South B e nd, IN 46601 • (574) 234-4176 E lk h a rt (5 74) 293-8441 • (800) 544-0925 Ro b e rt J . Tome c , M .D . • Me dic al D ire c tor Test No. Test Description 2015 CPT 46015 Cannabinoids Panel, Quantitative, Whole Blood 80349 29085Cannabinoids Screen, Urine80301 44608 Carisoprodol and Metabolite, Serum or Plasma 80369 46012Carisoprodol and Metabolite, Urine 80369 36338 CCND1/IGH t(11;14) Translocation by FISH, Tissue 88374 47101CEBPA Mutation Detection 81479 44089Chlorpromazine, Serum or Plasma80342 46087Clobazam, Serum or Plasma 80339 46088Clobazam, Urine 80339 46089Clobazam, Whole Blood 80339 44152 Clomipramine and Metabolite, Serum or Plasma 80335 46000Clonazepam and Metabolite, Urine 80346 44018Clonazepam, Serum or Plasma 80346 44963 Clorazepate (Assayed as Nordiazepam), Serum or Plasma 80346 29083Cocaine and Metabolites Screen, Urine80301 44755 Cocaine and Metabolites, Quantitative, Meconium 80353 46110 Cocaine and Metabolites, Quantitative, Whole Blood 80353 47040 Cocaine Metabolite, Quantitative, Serum or Plasma 80353 47142Cocaine Metabolite, Quantitative, Urine 80353 36268 Colorectal Carcinoma Mutation Analysis Panel (BRAF, KRAS, and NRAS) with Microsatellite Instability Assessment81445 31171Cotinine Screen, Blood80302 31101Cotinine Screen, Urine80302 46100D/L Amphetamines, Urine 80374 45505Desipramine, Serum or Plasma80335 44964 Diazepam and Nordiazepam, Serum or Plasma 80346 46002Diphenhydramine, Serum or Plasma 80375 46003Diphenhydramine, Whole Blood 80375 46098 Diuretics Confirmation, Urine (Reflex Orders Only) 80377 46097 Diuretics Screen with Confirmation if Indicated, Urine 80304 45507Doxepin and Metabolite, Serum or Plasma80335 47182 Drug Detection Panel by High-Resolution Time-of-Flight Mass Spectrometry, Umbilical Cord Tissue 80301; 80304x2 31232Drug Screen 10, Urine80301 31156 Drug Screen 10, Urine, Alere Triage Meter 80300 31230 Drug Screen 10, with Confirmation/Quantitation if Indicated, Urine 80301 31231 Drug Screen 10, with Creatinine Ratio, Urine 80301; 82570 31164 Drug Screen 11, Urine, Alere Triage Meter 80300 31174 Drug Screen 5, Urine, Alere Triage Meter 80300 29062 Drug Screen 6, Serum 80301; 80302x2 THE MEDICAL FOUNDATION 5 3 0 N . L afa y ette Bo u le v ard • South B e nd, IN 46601 • (574) 234-4176 E lk h a rt (5 74) 293-8441 • (800) 544-0925 R o b ert J . Tome c , M .D . • Me dic al D ire c tor Test No. Test Description 2015 CPT 29074Drug Screen 8 plus Alcohol, Urine80301 29072Drug Screen 8, Urine80301 31233 Drug Screen 8, with Confirmation/Quantitation if Indicated, Urine 80301 29068 Drug Screen 8, with Creatinine Ratio, Urine 80301; 82570 29076 Drug Screen 8, with Creatinine Ratio, Urine (Includes Expanded Opiates/Opioids)80301; 82570 45448 Drug Screen 9, with Confirmation/Quantitation if Indicated, Meconium 80301 44646 Drug Screen 9, with Confirmation/Quantitation if Indicated, Serum or Plasma 80301 29069 Drug Screen 9, with Creatinine Ratio, Urine 80301; 82570 29077 Drug Screen 9, with Creatinine Ratio, Urine (Includes Expanded Opiates/Opioids) 80301; 82570 31163 Drug Screen with Volatiles, Blood 80301; 80304x3; 80320 31165 Drug Screen, Comprehensive, Body Fluid 80301; 80304x3 31161 Drug Screen, Comprehensive, Urine 80301; 80304x3 31007 Drug Screen, Gastric Aspirate 80301; 80304x3 31166 Drug Screen, Substance Analysis 80301; 80304x3 46072 Ephedrine, Urine 80324 47178 Ethyl Glucuronide and Ethyl Sulfate Confirmation, Urine 80321 47179 Ethyl Glucuronide Screen with Confirmation if Indicated, Urine 80302 44543Felbamate, Serum or Plasma80339 45853 Fentanyl and Metabolite, Quantitative, Serum or Plasma 80354 47143 Fentanyl and Metabolite, Quantitative, Urine 80354 46025 Fentanyl and Metabolite, Quantitative, Whole Blood 80354 47094FLT3 Mutation Detection, PCR 81245; 81246 46107 Flunitrazepam and Metabolites Confirmation, Urine (Reflex Orders Only) 80346 46103 Flunitrazepam and Metabolites Screen with Confirmation if Indicated, Urine 80304 44092 Fluoxetine and Metabolite, Serum or Plasma 80332 44090Fluphenazine, Serum or Plasma80342 46033 Gamma-Hydroxybutyric Acid Confirmation, Serum or Plasma (Reflex Orders Only) 83921 46108 Gamma-Hydroxybutyric Acid Confirmation, Urine (Reflex Orders Only) 83921 46032 Gamma-Hydroxybutyric Acid Screen with Confirmation if Indicated, Serum or Plasma 80304 46104 Gamma-Hydroxybutyric Acid Screen with Confirmation if Indicated, Urine 80304 25228 Global Charge - HER2 (ERBB2) Analysis by FISH, Paraffin Block 88374 26106 Global Charge - Immunohistochemistry (including tissue immunoperoxidase), each additional antibody88341 THE MEDICAL FOUNDATION 5 3 0 N . L afa y ette Bo u le va rd • South B e nd, IN 46601 • (574) 234-4176 E lk h a rt (5 74) 293-8441 • (800) 544-0925 Ro b e rt J . Tome c , M .D . • Me dic al D ire c tor Test No. Test Description2015 CPT 38553 HER2 (ERBB2) Analysis by FISH, Paraffin Block 88374 43508 Human Papillomavirus (HPV) DNA, High and Low Risk, Anal/Rectal 87624 43507 Human Papillomavirus (HPV) DNA, High Risk, Anal/Rectal 87624 36392 Human Papillomavirus (HPV) DNA, High Risk, Cervical, SurePath® 87624 36391 Human Papillomavirus (HPV) DNA, High Risk, Cervical, ThinPrep® 87624 44593 Human Papillomavirus (HPV) High Risk, in situ Hybridization, Paraffin 88366 44594 Human Papillomavirus (HPV) Low Risk, in situ Hybridization, Paraffin 88366 45618 Human Papillomavirus (HPV) Type-Detect 2.0®, Bio-Plex Analysis, with HPV-16 Risk Assessment Status if Indicated 87624 46028 Hydrocodone, Free (Unconjugated), Serum or Plasma 80361 47180 Hypoglycemia Panel, Sulfonylureas Qualitative, Serum or Plasma 80377 45708Ibuprofen, Serum or Plasma 80329 36364 IGH/BCL2 t(14;18) Translocation by FISH, Tissue 88374 45504 Imipramine and Desipramine, Serum or Plasma 80335 45924 Inosine Triphosphate (ITPA) and Interleukin 28 B (IL28B)-Associated Variants, 4 SNPs 81400; 81479 46035 Ketamine and Metabolite Confirmation, Urine (Reflex Orders Only) 80357 46036 Ketamine and Metabolite Screen with Confirmation if Indicated, Urine 80304 45899Lacosamide, Serum or Plasma 80339 46091Levamisole, Serum or Plasma 80375 46092Levamisole, Urine 80375 46093Levamisole, Whole Blood 80375 45997 Librium and Nordiazepam, Serum or Plasma 80346 47181 Liver Fibrosis, Chronic Viral Hepatitis (Echosens FibroMeter) 81599 44541Lorazepam, Serum or Plasma 80346 43503LSD (Lysergic Acid Diethylamide), Urine 80323 46039 MDPV Stimulant Designer Drug Test, Urine 80371 36270 Melanoma Mutation Analysis Panel (BRAF, KIT, and NRAS) 81445 44912 Meperidine and Metabolite, Quantitative, Serum or Plasma 80362 47145 Meperidine and Metabolite, Quantitative, Urine 80362 44437Mephobarbital, Serum or Plasma 80345 44962Meprobamate, Serum or Plasma 80369 45451 Methadone and Metabolite, Quantitative, Meconium 80358 44347 Methadone and Metabolite, Quantitative, Serum or Plasma 80358 47146 Methadone and Metabolite, Quantitative, Urine 80358 46111 Methadone and Metabolite, Quantitative, Whole Blood 80358 31258Methadone Screen, Urine80301 46105Methaqualone, Urine 80368 44146 Methsuximide and Normethsuximide, Serum or Plasma 80339 44353 Methylphenidate and Metabolite, Serum or Plasma 80360 THE MEDICAL FOUNDATION 5 3 0 N . L afa y ette Bo u le v ard • South B e nd, IN 46601 • (574) 234-4176 E lk h a rt (5 74) 293-8441 • (800) 544-0925 R o b ert J . Tome c , M .D . • Me dic al D ire c tor Test No. Test Description 2015 CPT 45734Methylphenidate and Metabolite, Urine 80360 38520 Mismatch Repair (MMR) Analysis by Immunohistochemistry (IHC) 88342; 88341x3 45890Mitochondrial Disorders (mtDNA) Sequencing 81460 45891 Mitochondrial Disorders Panel (mtDNA and 108 Nuclear Genes) Sequencing and Deletion/Duplication 81404x12; 81405x25; 81406x19; 81407; 81460; 81465; 81479 45888 Mitochondrial Genome (mtDNA and 108 Nuclear Genes) Deletion/Duplication 81404x3; 81405x2; 81406; 81465; 81479 47186 MLH1 Promoter Methylation, Paraffin 81288; 88381 45595 Mucopolysaccharides Screen - Electrophoresis and Quantitation, Urine 82664; 83864 46046Naproxen, Urine 80329 44552 Nicotine and Metabolites, Quantitative, Serum or Plasma 80323 44352 Nicotine and Metabolites, Quantitative, Urine 80323 36269 Non-Small Cell Lung Carcinoma Mutation Analysis Panel (BRAF, EGFR, and KRAS) with ALK, RET, and ROS1 by FISH if Indicated 81445 36299 Non-Small Cell Lung Carcinoma Panel by FISH 88374x3 45502Nortriptyline, Serum or Plasma80335 44019Olanzapine, Serum or Plasma 80342 29084Opiates Screen, Urine80301 44756 Opiates, Quantitative, Meconium 80356; 80361; 80365 47041 Opiates, Quantitative, Serum or Plasma 80356; 80361; 80365 47017 Opiates, Quantitative, Urine 80356; 80361; 80365 46112 Opiates, Quantitative, Whole Blood 80356; 80361; 80365 31234 Opiates/Opioids Screen, with Confirmation/Quantitation if Indicated, Urine 80301 47150 Pain Management Drug Panel with Interpretation, LC-TOF/MS and EIA, Urine 80301; 80302x3; 80304 47149 Pain Management Drug Panel, LC-TOF/MS and EIA, Urine 80301; 80302x3; 80304 31472 Pain Management Panel A (14 Drugs), Urine 80301; 80302x3 31473 Pain Management Panel A (14 Drugs), with Confirmation/Quantitation if Indicated, Urine 80301; 80302x3 31474 Pain Management Panel B (10 Drugs), Urine 80301; 80302x3 31475 Pain Management Panel B (10 Drugs), with Confirmation/Quantitation if Indicated, Urine 80301; 80302x3 45751 PCA3 - Prostate Cancer Biomarker by Transcription-Mediated Amplification 81313 31077Pentobarbital, Serum80345 29086Phencyclidine (PCP) Screen, Urine80301 37365 Professional Component Charge - HER2 (ERBB2) Analysis by FISH, Paraffin Block 88374-26 37020 Professional Component Charge - Immunohistochemistry (including tissue immunoperoxidase), each additional antibody 88341-26 THE MEDICAL FOUNDATION 5 3 0 N . L afa y ette Bo u le v ard • South B e nd, IN 46601 • (574) 234-4176 E lk h a rt (5 74) 293-8441 • (800) 544-0925 R o b ert J . Tome c , M .D . • Me dic al D ire c tor Test No. Test Description 2015 CPT 45452 Propoxyphene and Metabolite, Quantitative, Meconium 80367 47169 Propoxyphene and Metabolite, Quantitative, Serum or Plasma 80367 47170Propoxyphene and Metabolite, Quantitative, Urine80367 29087Propoxyphene Screen, Urine80301 44870Protriptyline, Serum or Plasma 80335 45104Quetiapine, Serum or Plasma 80342 46084Ranitidine, Urine 80375 36278RET Gene Rearrangement by FISH88374 44157 Risperidone and Metabolite, Serum or Plasma 80342 36277ROS1 Gene Rearrangement by FISH88374 45894Rufinamide, Serum or Plasma 80339 29151Salicylate, Serum80302 46090Salicylate, Whole Blood 80329 44570Sertraline, Serum or Plasma 80332 29091SJRMC Serum Drug Sceern CLAB80301 29090 SJRMC Serum Drug Screen Onsite 80301; 80302x2 36271 Solid Tumor Mutation Analysis Panel (BRAF, EGFR, KIT, KRAS, and NRAS) 81445 45630Sulfonylurea Screen, Urine 80377 46059 Synthetic Cannabinoid Metabolites Confirmation (Qualitative), Urine (Reflex Orders Only) 80352 46058 Synthetic Cannabinoid Metabolites Screen with Confirmation if Indicated, Urine 80302x2 45812 Tapentadol and Metabolite, Quantitative, Serum or Plasma 80372 45811 Tapentadol and Metabolite, Quantitative, Urine 80372 26365 Technical Component Charge - HER2 (ERBB2) Analysis by FISH, Paraffin Block 88374-TC 26343 Technical Component Charge - Immunohistochemistry (including tissue immunoperoxidase), each additional antibody 88341-TC 44639Thiothixene, Serum or Plasma 80342 44914 Tramadol and Metabolites, Quantitative, Serum or Plasma 80373 44915 Tramadol and Metabolites, Quantitative, Urine 80373 44058Trazodone, Serum or Plasma 80338 46061Trazodone, Urine 80338 47073 Tricyclic Antidepressants Panel, Quantitative, Serum or Plasma 80337 29140Tricyclic Antidepressants, Qualitative, Serum80301 29075Valproic Acid, Free80165 29160Vanillylmandelic Acid, Urine, 24-Hour84585 45193 Venlafaxine and Metabolite, Serum or Plasma 80338 31035Volatiles, Blood80320 45111Ziprasidone, Serum or Plasma80342 THE MEDICAL FOUNDATION 5 3 0 N . L afa y ette Bo u le va rd • South B e nd, IN 46601 • (574) 234-4176 E lk h a rt (5 74) 293-8441 • (800) 544-0925 Ro b e rt J . Tome c , M .D . • Me dic al D ire c tor
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