HCPCS Code Frequency Limit and ‘Do Not Report’ Update

Effective for dates of service on or after December 1, 2014, providers are not required to report HCPCS code G0461 (immunohistochemistry or immunocytochemistry, per specimen; first single or multiplex antibody stain) with CPT code 88342 or HCPCS code G0462 (…each additional single or multiplex antibody stain) with CPT code 88343.

Also, effective for dates of service on or after December 1, 2014, reimbursement for CPT code 81507 (fetal aneuploidy [trisomy 21, 18, and 13] DNA sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy) is limited to once a year for any provider. CPT code 81287 (MGMT, [0-6 methylguanin-DNA methyltransferase] methylation analysis) is limited to once a lifetime for any provider.

Source: General Medicine | October 2014 | Bulletin 484