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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