This year there has been considerable code changes in every practice that has taken the healthcare industry by storm. Molecular pathology too underwent significant changes and new CPT codes. But many payers as well as CMS did not have fee schedule payments. This will be done April onwards and failing to meet the terms of the new changes can lead to delay in claim processing and claim rejection.
Some of the 2013 CPT code changes include medical lab procedures that deal with analysis of nucleic acids that detects variants in genes that indicates germline or somatic disease or tests for histocompatibility antigens. It does not include diseases causing infections or in situ hybridization analyses that are only found in Microbiology and anatomic pathology section.
Some of the deleted codes include stacking codes 83890 – 83914, 88384-88386 that are array based evaluation codes, a few genetic testing modifiers. A new code 81479 is to be used for unlisted molecular pathology procedure. Some Tier 1 molecular pathology codes like 81200-81383 are relevant to few biomarkers. Tier 2 molecular pathology codes in the range 81400-81408 are used to refer groups of biomarkers that will need the same level of interpretive and technical resources that is necessary to finish the test.
If one is reporting a particular biomarker and not providing the complete descriptor that is there in the parenthetical CPT examples will be considered to be sufficient. But sometimes it will be important to provide the abbreviated information that will be essential to identify the service that has been provided.
For instance, The CPT code 81404 indicates “level 5” biomarker tests. CPT has identified an huge list of biomarkers that needs to be reported using code 81404. While billing for “frataxin” reporting it as FXN will be sufficient.
When a particular biomarker that has been tested is not represented by a Tier 1 code as well as not listed in Tier 2 codes, then it is best to report the test as “unlisted” using molecular pathology code 81479. However, it needs to have a description in the narrative or remarks section when this code is used.
If descriptions are provided for Tier 2 and unlisted codes it will immensely affect in claims being processed on time and failing this will only result in claim denial or delay in processing of claim.
If you are looking for online medical coding training conferences, AudioEducator is the place where you can choose a wide range webinars that provide training on 2013 CPT code changes and you can get familiar with the 2013 ICD 9 code changes and stay compliant.
Some of the 2013 CPT code changes include medical lab procedures that deal with analysis of nucleic acids that detects variants in genes that indicates germline or somatic disease or tests for histocompatibility antigens. It does not include diseases causing infections or in situ hybridization analyses that are only found in Microbiology and anatomic pathology section.
Some of the deleted codes include stacking codes 83890 – 83914, 88384-88386 that are array based evaluation codes, a few genetic testing modifiers. A new code 81479 is to be used for unlisted molecular pathology procedure. Some Tier 1 molecular pathology codes like 81200-81383 are relevant to few biomarkers. Tier 2 molecular pathology codes in the range 81400-81408 are used to refer groups of biomarkers that will need the same level of interpretive and technical resources that is necessary to finish the test.
If one is reporting a particular biomarker and not providing the complete descriptor that is there in the parenthetical CPT examples will be considered to be sufficient. But sometimes it will be important to provide the abbreviated information that will be essential to identify the service that has been provided.
For instance, The CPT code 81404 indicates “level 5” biomarker tests. CPT has identified an huge list of biomarkers that needs to be reported using code 81404. While billing for “frataxin” reporting it as FXN will be sufficient.
When a particular biomarker that has been tested is not represented by a Tier 1 code as well as not listed in Tier 2 codes, then it is best to report the test as “unlisted” using molecular pathology code 81479. However, it needs to have a description in the narrative or remarks section when this code is used.
If descriptions are provided for Tier 2 and unlisted codes it will immensely affect in claims being processed on time and failing this will only result in claim denial or delay in processing of claim.
If you are looking for online medical coding training conferences, AudioEducator is the place where you can choose a wide range webinars that provide training on 2013 CPT code changes and you can get familiar with the 2013 ICD 9 code changes and stay compliant.
Thanks for sharing the information.
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