2017 Payment Schedule Test Updates

The table below reflects Records of Decision associated with laboratory tests under the Laboratory Services Act in BC.

LSA ROD #

Approvals Granted

LSA2017-039

Amendment of fee item titles for Chlamydia and Gonorrhea testing using Nucleic Acid Amplification Test (NAAT) for specimens collected by swabs in the Outpatient Laboratory Services Payment Schedule.

Effective January 1, 2018, the Ministry of Health has amended the title for fee item 90652 from “Chlamydia trachomatis using NAAT – urogenital swab” to “Chlamydia trachomatis using NAAT – swab”, and the title for fee item 90654 from “Gonorrhea by NAAT – urogenital swab” to “Gonorrhea by NAAT – swab”, in the Outpatient Laboratory Services Payment Schedule.

LSA2017-034

Amendment of billing notes for three antinuclear antibodies tests.

Effective January 1, 2018, the Ministry of Health (MOH) has approved the amendment of billing notes for antinuclear antibodies by sensitive EIA (FI 90281), antinuclear antibodies, specific detection by multiplex immunoassay (FI 90121), and antinuclear antibodies, immunofluorescence screen (FI 90280) on the Laboratory Services Outpatient Payment Schedule.

LSA2017-035

Addition of a new Provisional (P) fee item P91163, IgG anti-deamidated gliadin peptide (anti-DGP) antibodies, to the Outpatient Laboratory Services Payment Schedule; and amendment of limits and conditions to existing fee item 91162, anti-tissue transglutaminase antibodies (anti-TTG), IgA.

Effective January 1, 2018, the Ministry of Health (MOH) has approved the addition of IgG anti-deamidated gliadin peptide (anti-DGP) antibodies testing on a provisional basis (P) for a one year period. Anti-DGP IgG testing is available to patients up to 36 months of age and patients who are IgA deficient, and is restricted to referrals by paediatricians and gastroenterologists. See payment schedule for specific details.

LSA2017-036

Approval of the Standard Outpatient Laboratory Requisition for Maternity Care.

In accordance with Section 36(1) of the Laboratory Services Act (LSA), the Standard Outpatient Laboratory Requisition for Maternity Care has been approved, and is effective December 1, 2017.

LSA2017-030

Removal of provisional status for 4 laboratory services outpatient fee items.

Effective November 1, 2017, the provisional status (P) of the following four fee items is removed:

  1. 90831 – Hepatitis B virus (HBV) identification by nucleic acid amplification, direct – quantification;
  2. 90832 – BK polyma virus identification by nucleic acid amplification, direct – quantification;
  3. 90833 – Cytomegalovirus Viral (CMV) identification by nucleic acid amplification, direct – quantification;
  4. 91162 – Anti-tissue transglutaminase antibodies (anti-TTG), IgA.

All existing billing notes associated with the fee items are maintained.

LSA2017-011

Extension of provisional status for 11 fee for service laboratory medicine fee items.

Effective August 1, 2017, the provisional (P) status of the following 11 fee items is extended to July 31, 2018:

a) 90656 - C. difficile toxin, real time PCR

b) 90751 - Molecular identification, stool isolate

c) 90784 - Trichomonas Antigen Test

d) 90831 - Hepatitis B virus (HBV) identification by nucleic acid amplification, direct – quantification

e) 90832 - BK polyoma virus identification by nucleic acid amplification, direct – quantification

f) 90833 - Cytomegalovirus Viral (CMV) identification by nucleic acid amplification, direct – quantification

g) 91162 - Anti-tissue transglutaminase antibodies (anti-TTG), IgA

h) 91761 - Helicobacter pylori stool antigen (HPSA)

i) 93051 - Cytogenetic analysis/fluorescence in situ hybridization, single probe  

j) 93052 - Cytogenetic analysis/fluorescence in situ hybridization, subtelomeric probe

 k) 93053 - Cytogenetic analysis/fluorescence in situ hybridization (FISH), uncultured amniotic fluid.

LSA2017-025

Removal of neonatal alloimmune thrombocytopenia (NAIT) and hemolytic disease of the fetus and newborn (HDFN) genetic testing on amniotic fluid from the BC Children’s and Women’s Hospital laboratory test menu.

Effective July 1, 2017, the Ministry of Health (MOH) has approved the removal of NAIT and HDFN testing from the BC provincial test menu. Request for testing may be forwarded to the MOH out-of-province/out-of-country program for consideration.

LSA2017-001

Addition of new Provisional (P) fee item P90811 – Gastrointestinal pathogen multiplex panel and selective culture, and amendment to billing rules/notes of existing fee items 90800 – Stool examination, concentration method and 90810 – Stool examination, search for amoebae and/or permanent stain smear to the Laboratory Services Outpatient Payment Schedule. 

Effective July 31, 2017 (amended from June 1, 2017), a new Provisional fee item P90811 Gastrointestinal pathogen multiplex panel (GPMP) and selective culture (SC) was added to the laboratory services outpatient payment schedule. The cost per test was set at $105.04, with the following billing notes: “i) Restricted to Victoria General Hospital Laboratory and Royal Jubilee Hospital Laboratory at Vancouver Island Health Authority (VIHA)” and “ii) For VIHA only, P90811 not payable with: 90630, 90655, P90656, 90725, 90745, 90750 & 90751.” 

Fee item 90800 – Stool examination, concentration methods wasamended by adding a new note, it reads “Within Vancouver Island Health Authority, 90800 testing restricted to children under 13 years old, returning travellers, immigrants from outside of Canada and the United States of America, and immunocompromised hosts.”

Fee item 90810 – Stool examination, search for amoebae and/or permanent stain smear was amended by adding a new note, it reads “Within Vancouver Island Health Authority, 90810 testing restricted to children under 13 years old, returning travellers, immigrants from outside of Canada and the United States of America, and immunocompromised hosts.”

LSA2017-022

Amendment of billing notes for fee items 91210 – Aspartate aminotransferase (AST) and 91065 – Alanine aminotransferase (ALT) 

Effective August 1, 2017, the following billing notes were added to fee items 91210 – Aspartate aminotransferase (AST) and 91065 – Alanine aminotransferase of the laboratory services outpatient payment schedule:

“Note i) Fee item 91065 Alanine aminotransferase (ALT) is the preferred liver function test and is a superior marker of hepatocellular damage compared to the 91210 Aspartate aminotransferase (AST) test” and “Note ii) In addition, measurement of AST 91210 in conjunction with ALT 91065 rarely adds clinical value and should not be co-billed, unless clinically indicated.” 

For fee item 91210 (AST), an additional note was added, it reads:

“Note iii) 91210 AST should only be requested to evaluate liver fibrosis or steatohepatitis.”

LSA2017-007

Addition of new Provisional (P) fee item to the Laboratory Services Outpatient Payment Schedule: fee item P91022 in support of Muscle-specific Tyrosine Kinase Antibody testing.  

Effective June 1, 2017, the Ministry of Health has approved the addition of a new Provisional fee item P91022 Muscle-specific Tyrosine Kinase Antibody testing. Testing will be restricted to UBC Diagnostic Services Laboratory and requires consultation with a Laboratory Medicine physician before test can be requested.

LSA2017-008

Addition of new Provisional (P) fee item to the Laboratory Services Outpatient Payment Schedule: fee item P91861 in support of Voltage-gated Calcium Channel Antibody testing. 

Effective June 1, 2017, the Ministry of Health has approved the addition of a new Provisional fee item P91861 Voltage-gated Calcium Channel Antibody testing. Testing will be restricted to UBC Diagnostic Services Laboratory and requires consultation with a Laboratory Medicine physician before test can be requested.