April is the time to celebrate laboratory professionals and honor their invaluable contributions to our complex healthcare system. Laboratory professionals are a critical component of our ever-evolving medical system, performing more than 14 billion tests annually. According to the American Clinical Laboratory Association, laboratory services contribute over $140 billion to the U.S. economy, supported by an estimated workforce of more than 668,000 professionals. Without their expertise and dedication, modern healthcare would not be possible.
“Medical laboratory science professionals make patient care possible in ways many people never get to see,” said Robin Miller Zweifel, BS, MT (ASCP) “Every day, they produce the accurate, timely test results clinicians rely on to diagnose disease, monitor treatment, and support preventive measures—and it’s often cited that roughly 70% of medical decisions are informed by laboratory data. The laboratory team includes the phlebotomists who put patients at ease while expertly collecting specimens, as well as MLTs, MLSs, pathologists, and other specialists who process, analyze, and interpret results from behind the scenes. Together, they keep critical information moving through the healthcare system 24 hours a day, seven days a week. During Lab Week, we’re proud to recognize their skill, training, and commitment to quality, and to thank them for being a dependable backbone of healthcare.” As part of Lab Week, MedLearn is offering exclusive professional tips on 2026 coding changes, which are essential for accurate reporting and full reimbursement.
A series of new codes were added for 2026:
| CPT Code | CPT Description | Revenue Code |
|---|---|---|
| 87182 | Susceptibility studies, antimicrobial agent; carbapenemase enzyme detection (eg, Klebsiella pneumoniae carbapenemase [KPC], New Delhi metallo-beta-lactamase [NDM], Verona integron-encoded metallo-beta-lactamase [VIM]), multiplex immunoassay, qualitative, per isolate | 0300, 0306, 0309 |
| 87183 | Susceptibility studies, antimicrobial agent; carbapenem resistance genes (eg, blaKPC, blaNDM, blaVIM, blaOXA-48, blaIMP), amplified probe technique, per isolate | 0300, 0306, 0309 |
| 87494 | Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis and Neisseria gonorrhoeae, multiplex amplified probe technique | 0300, 0306, 0309 |
| 87627 | Infectious agent detection by nucleic acid (DNA or RNA); joint space pathogens and drug resistance genes, multiplex amplified probe technique, 26 or more targets | 0300, 0306, 0309 |
| 87812 | Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) and influenza virus types A and B | 0300, 0306, 0309 |
Why were CPT® Category I codes 87182 and 87183 created? These codes were established to detail specificity in susceptibility study testing, rather than reporting by methodology. Code 87182 covers resistance-associated enzymes and uses a multiplex immunoassay to simultaneously screen for different carbapenemase enzymes, with results reported as either positive or negative. Code 87183 encompasses resistance-associated genes and utilizes polymerase chain reaction (PCR) methodology to detect the nucleic acid sequences of common carbapenemase gene families from an actively growing pure culture of a bacterial isolate.
New code 87494 was established for reporting multiplex detection procedures for Chlamydia trachomatis and Neisseria gonorrhoeae pathogens in a single test.
This code carries some unique nuances compared to the others. Coders should note that 87494 may not be reported in conjunction with CPT codes 87491 [Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique] or 87591 [Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique] during the same encounter.
Reporting the code may mean some extra work compared to most codes. Professionals may need to review test order sets to ensure compliance. Our experts advise that laboratories should monitor updates to payer coding and reimbursement policies, which may provide bundling guidelines when performing a panel that includes three or more pathogens.
CPT code 87627 is designed for reporting infectious agent detection of joint-space pathogens and drug-resistant genes. Imperative to reporting, coders should understand that the test utilizes a multiplex PCR technique designed to simultaneously detect 26 or more targets, including pathogens and resistance genes. Finally, code 87812 was established for reporting SARS-CoV-2 as well as influenza A and B with direct optical observation as a single multiplex panel test.
Professionals are advised to refer to the parentheticals and exclusionary notes in the CPT manual regarding the new codes above.
The following PLA codes related to microbiology were deleted for 2026:
| CPT Code | CPT Description | Revenue Code |
|---|---|---|
| 0240U | Infectious disease (viral respiratory tract infection), pathogen-specific RNA, 3 targets (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2], influenza A, influenza B), upper respiratory specimen, each pathogen reported as detected or not detected | 0300, 0309, 0310, 0319 |
| 0241U | Infectious disease (viral respiratory tract infection), pathogen-specific RNA, 4 targets (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2], influenza A, influenza B, respiratory syncytial virus [RSV]), upper respiratory specimen, each pathogen reported as detected or not detected | 0300, 0309, 0310, 0319 |
| 0369U | Infectious agent detection by nucleic acid (DNA and RNA), gastrointestinal pathogens, 31 bacterial, viral, and parasitic organisms and identification of 21 associated antibiotic-resistance genes, multiplex amplified probe technique | 0300, 0309, 0310, 0319 |
| 0370U | Infectious agent detection by nucleic acid (DNA and RNA), surgical wound pathogens, 34 microorganisms and identification of 21 associated antibiotic-resistance genes, multiplex amplified probe technique, wound swab | 0300, 0309, 0310, 0319 |
| 0373U | Infectious agent detection by nucleic acid (DNA and RNA), respiratory tract infection, 17 bacteria, 8 fungus, 13 virus, and 16 antibiotic-resistance genes, multiplex amplified probe technique, upper or lower respiratory specimen | 0300, 0309, 0310, 0319 |
| 0374U | Infectious agent detection by nucleic acid (DNA or RNA), genitourinary pathogens, identification of 21 bacterial and fungal organisms and identification of 21 associated antibiotic-resistance genes, multiplex amplified probe technique, urine | 0300, 0309, 0310, 0319 |
Originally created for reporting SARS-CoV-2, PLA codes 0240U and 0241U were deleted as of July 1, 2025. Report code 0240U using the existing CPT® Category I code 87636, and report code 0241U using CPT® code 87637. PLA codes 0369U, 0370U, 0373U, and 0374U were also deleted effective July 1, 2025, but first appeared as deleted in the CPT manual for 2026. However, these codes have no direct single replacements.
For additional details on the PLA code set, refer to Appendix O of the CPT Manual. For the latest PLA updates, go to https://www.ama-assn.org/practice-management/cpt/cpt-pla-codes.
🧬 To celebrate Lab Week, MedLearn Publishing is offering an exclusive Laboratory All-Access Pass giveaway from April 13 through April 23, 2026, with the winner announced on the morning of April 24.
The Laboratory All-Access Pass is designed to support compliant coding, billing, and documentation practices through comprehensive, expert-led education. This subscription provides unlimited, 24/7 access to a robust library of laboratory resources for one low annual fee, including:
💡 Valued at $1,076, the All-Access Pass is available for $632 per year and delivers ongoing education to help laboratory teams stay compliant, reduce errors, and protect revenue.
As part of this offering, MedLearn Publishing is introducing a new webcast: “Back to Basics: Laboratory Coding Essentials,” presented by Robin Miller Zweifel, BS, MT(ASCP). This session is designed to strengthen coding accuracy, improve clean claim rates, and reduce costly denials. Attendees will gain practical guidance on CPT® and ICD-10 coding fundamentals, charge capture best practices, and effective denial management strategies—all aimed at simplifying complex laboratory coding processes and supporting a healthy revenue cycle.
The webcast is included at no additional cost with the Laboratory All-Access Pass subscription, providing subscribers with even greater value and access to essential training.
https://www.acla.com/economic-impact-of-clinical-labs/
The 30th Annual Compliance Institute for the Health Care Compliance Association (HCCA) is scheduled to take place in Orlando next week. If you are there,
Sometimes you want to be contacted by the US Department of Health and Human Services (HHS) Office of Inspector General (OIG). I realize that
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Breast biopsy procedures may be clinically straightforward but accurately translating them into compliant billing can be anything but. In this focused webcast, Shawn Blackburn, CPC, CPMA, CIC, CRC, CCS-P breaks down how imaging guidance, lesion count, laterality, and payer expectations all impact how these procedures should be reported. Through clear explanations and real-world scenarios, you’ll gain practical insight into aligning clinical workflows with billing requirements, avoiding common pitfalls, and ensuring your documentation supports accurate reimbursement and compliance.
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Uncover critical guidance on the ICD-10-CM/PCS code updates. Kay Piper reviews and explains ICD-10-CM/PCS coding guidelines in the AHA’s fourth quarter 2026 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
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In this timely session, Stacey Shillito, CDIP, CPMA, CCS, CCS-P, CPEDC, COPC, breaks down the complexities of Medical Decision Making (MDM) documentation so providers can confidently capture the true complexity of their care. Attendees will learn practical, efficient strategies to ensure documentation aligns with current E/M guidelines, supports accurate coding, and reduces audit risk, all without adding to charting time.
Join Ronald Hirsch, MD, FACP, CHCQM for The PEPPER Returns – Risk and Opportunity at Your Fingertips, a practical webcast that demystifies the PEPPER and shows you how to turn complex claims data into actionable insights. Dr. Hirsch will explain how to interpret key measures, identify compliance risks, uncover missed revenue opportunities, and understand new updates in the PEPPER, all to help your organization stay ahead of audits and use this powerful data proactively.
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