Billing News

Calendar Year (CY) 2012 Annual Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment

The annual update to the local clinical laboratory fees for CY 2012 is 0.65 percent.

Molecular Pathology Procedure Test Codes

Beginning January 1, 2012, there will be 101 additional Molecular Pathology Procedure test codes established by the AMA. For payment purposes under the Clinical Laboratory Fee Schedule (CLFS), these test codes will be assigned a "B" indicator ñ "Payment for covered services are always bundled into payment for other services not specified. There will be no RVUs or payment amounts for these codes and no separate payment is ever made.

As of January 1, 2012, Medicare requests that Medicare claims for Molecular Pathology Procedures reflect both the existing CPT "stacked" test codes that are required for payment and the new single CPT test code that would be used for payment purposes if the new CPT test codes were active. While the allowed charge amount will be $0.00 for the new Molecular Pathology Procedure test codes that carry the "B" indicator, Medicare requests that Medicare claims also reflect a charge for the non-payable service.

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