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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.
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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.
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