Laboratory Question for the Week of February 27, 2017

Laboratory Compliance Question of the Week

Question:

What is the difference between the Tier 1 and Tier 2 molecular pathology CPT codes?

Answer:

The Tier 1 CPT—CPT 81161 through 81383—describe frequently performed gene assays and HLA typing, which have been assigned to a unique procedure-specific CPT. The next series—81400 through 81408—are referred to as Tier 2 and describe nine levels of complexity for other procedures that are less frequently performed. Within each level there are groups of procedures that are considered to be similar in complexity. This is much like the CPT codes used for coding of surgical histology—where each level is defined by a group of tissues that have a similar work value assigned.

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.