Laboratory Question for the Week of July 17, 2017

Laboratory Compliance Question of the Week

Question:

Can a physician’s interpretation of a molecular pathology procedure (such as in the CPT® code range 81161–81408) be reported with CPT code 88291 (cytogenetics and molecular cytogenetics, interpretation and report)?

Answer:

A physician’s interpretation of a molecular pathology procedure can be reported with HCPCS code G0452 when medically reasonable and necessary. It should not be reported with CPT code 88291 (cytogenetics and molecular cytogenetics, interpretation, and report).

Reporting requirements related to G0452 can be found in NCCI Manual for Medicare Services, Chapter X, Section L (Medically Unlikely Edits) at https://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/index.html.

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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.