CPC - Radiology, Pathology and Laboratory, and Medicine - Section 2.2

Assign CPT pathology and laboratory codes, including panels, the rules against unbundling a panel into its component tests, and molecular and surgical pathology levels.

Code laboratory services accurately, reporting an organ- or disease-oriented panel with a single panel code rather than billing the component tests separately, and selecting the correct level of surgical pathology (88300 to 88309) by specimen complexity. Distinguish quantitative from qualitative testing and recognise the molecular pathology and drug-testing structures.

Pathology and Laboratory sectionLaboratory panelsSurgical pathology levelsUnbundling

Practice question for this objective

Free sampleRadiology, Pathology and Laboratory, and Medicinemedium

CPT organ or disease-oriented panels, such as the basic metabolic panel 80048, list a fixed set of component tests. When a laboratory performs every test named in a panel on one date of service, how does CPT direct the coder to report the work?

80048 Basic metabolic panel
component example: 82947 Glucose, 84520 Urea nitrogen, 82565 Creatinine
  • AReport each component test with its individual code and append modifier 59 to show the tests were distinct.
  • BReport the panel code and also report each component test individually to capture the full laboratory work.
  • CReport the single panel code, because CPT lists the panel code once every named component test is performed on that date. Correct
  • DReport the component test carrying the highest relative value and list the remaining tests as add-on codes.
When all listed component tests of a CPT panel are performed on one date, report the single panel code rather than the individual components. CPT organ or disease-oriented panels are defined as a bundle: performing every named component on the same date triggers the panel code itself, and separately reporting the components is unbundling, which CPT and payer edits disallow.

Why A is wrong: This looks correct because modifier 59 does separate bundled services, but billing the components individually to unbundle a completed panel is exactly what CPT panel rules forbid.

Why B is wrong: Reporting both double counts the same tests; the panel code already includes every component, so adding them again is duplicate billing, not fuller capture.

Why C is correct: Correct: CPT panel definitions require the panel code when all listed components are performed, which prevents unbundling and reflects the intended bundled reimbursement.

Why D is wrong: Panel components are not structured as a primary test plus add-on codes, so this misapplies add-on logic and would omit the correct single panel code.

See more CPC practice questions with worked answers.

More in this domain

Back to all Radiology, Pathology and Laboratory, and Medicine objectives, or the CPC cert hub.

Examworthy is not affiliated with or endorsed by AAPC. Original, blueprint-aligned practice material only.