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Notice to Readers Changes in CPT Code for Hepatitis Panel Causing Delayed Reports of Acute Hepatitis

Current Procedural Terminology (CPT) codes are standardized codes developed and maintained by the CPT Board of the American Medical Association for reporting medical services. The Health Care Financing Administration requires use of these codes in the Common Procedure Coding System when services are reported to Medicare and Medicaid for reimbursement. Effective January 1, 1998, the CPT Board changed the hepatitis serology panel (CPT#80059) to exclude the tests for IgM antibody to hepatitis A virus (IgM anti-HAV) and IgM antibody to hepatitis B core antigen (IgM anti-HBc). These two tests specifically identify recent infection with HAV and HBV, respectively. Many providers may be unaware that these tests are not part of the standard hepatitis panel, and diagnoses of cases of acute viral hepatitis are likely to be delayed by the need to perform additional testing. As a result, reporting of cases to health departments may be delayed, and CDC has received reports of instances of insufficient time to provide postexposure prophylaxis to prevent transmission of HAV or HBV to susceptible contacts of the case-patient.

The CPT Board has revised the hepatitis serology panel to include both IgM tests that were deleted. However, these modifications will not be implemented until the next CPT code manual is issued on January 1, 2000. Until this change takes effect, health departments should notify health-care practitioners and/or laboratories of the need to order individual tests for IgM anti-HAV (CPT#86709) and IgM anti-HBc (CPT#86705) for accurate determination of the cause of illness in patients with signs and/or symptoms of acute viral hepatitis and for timely prophylaxis of contacts.

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