Avoid CERT errors related to genetic testing codes

Cahaba has noted recent errors related to genetic testing codes for CERT reviewed claims (CPT codes: 81225, 81226, 81240, 81241, 81291, 81350, 81400, 81401, 81402, 81403). Insufficient documentation to support medical necessity of the service accounted for the vast majority of the errors at 77%. Eleven percent of the errors were due to a missing valid physician order. The final two error categories were: service was not medically necessary (7%) and missing laboratory results (5%). (To learn more about how to avoid these errors, read Comprehensive Error Rate Testing (CERT) Program Compliance: Avoiding CERT Errors for Genetic Testing Codes on the Cahaba website.)