Laboratory Question for the Week of July 17, 2017

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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