Question:
Do the NCCI updates that clarify CPT® utilization guidelines for multi-gene panel coding still remain in effect for 2022? If so, what do they specify?
Answer:
The National Correct Coding Initiative (NCCI) policy was updated for 2019, and again in 2020, to clarify CPT utilization guidelines for multi-gene panel coding. This guidance remains in effect for 2022. The NCCI specifies the requirement for sequential testing (as opposed to simultaneous testing) if reporting multiple genes with separate/individual CPT codes. This requirement has a significant impact on the billing of GSP-based methodology which utilizes DNA or RNA analytic methods that simultaneously assay multiple genes or genetic regions during a single run of the patient specimen. The NCCI updates also emphasize the requirement for physician determination of genetic analysis to be completed based on treatment and management of patient-specific medical needs.
This question was answered in our Coding Essentials for Laboratories. For more hot topics relating to laboratory services, please visit our store or call us at 1.800.252.1578, ext. 2.
CPT® copyright 2024 American Medical Association (AMA). All rights reserved.
Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
CPT is a registered trademark of the American Medical Association.
Subscribe to receive our News, Insights, and Compliance Question of the Week delivered right to your inbox.
Address: 5874 Blackshire Path, #13, Inver Grove Heights, MN 55076
Phone: (800) 252-1578
Email: support@medlearnmedia.com
Hours: 9am – 5pm CT
Copyright © 2025 MedLearn Publishing. Powered by MedLearn Media.
Unlock 50% off all 2024 edition books when you order by July 5! Use the coupon code CO5024 at checkout to claim this offer!
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24