Pathology/Lab Coding Alert

Molecular Pathology:

Say Goodbye to 83912 -- And Hello to G0452

Solve physician professional pay problem. As CPT® 2013 jettisons 83912 (Molecular diagnostics; interpretation and report), you’ll need to find a new way to capture your pathologist’s professional interpretation of molecular pathology tests. You’ll also need to see what can be done -- if anything -- to capture a similar service performed by a laboratory scientist instead of a physician. That Was Then "When labs used the stacking codes to describe molecular tests, they had the option of reporting 83912-26 (… Professional component) to capture the pathologist’s interpretation," says Peggy Slagle, CPC, billing compliance coordinator at the University of Nebraska Medical Center in Omaha. Medicare paid for this service on the Physician Fee Schedule (PFS), meaning that only physicians could charge for the interpretation. CLFS paid, too: But the Clinical Laboratory Fee Schedule also paid a (lesser) fee for 83912, billed without modifier 26. Labs billed that fee when a PhD or other [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

Pathology/Lab Coding Alert

View All