Incorrect Billing of Certain Molecular Biomarker Codes for Mar. 2017

National Government Services has seen an increase in claims incorrectly coded with individual codes for molecular biomarkers when five or more gene tests are completed for lung cancer. Correct coding requires that when a panel code applies it should be billed rather than the individual test codes. Thus, CPT code 81445 should be billed when five or more gene tests for molecular biomarkers for lung cancer are completed. Providers are reminded that individual CPT codes 81210, 81235, 81275, 81276, 81479 for ERBB2, 88341 and 88366 should not be individually coded on the claim when five or more gene tests for molecular biomarkers are completed. Panel CPT code 81445 should be billed in place of the individual test codes when five or more gene tests for molecular biomarkers are completed.

Source: https://www.ngsmedicare.com/ngs/portal/ngsmedicare/newngs/home-lob/news-alerts/news-articles/!ut/p/a1/rVJbT8IwGP0tPPjY9LoLj4XB0CVDYxZZX0zpulndymWN6L93oCYoESShb9_pOSffd3KggDMorHw1lXRmYWW9nYX_yPj1COMhSqZJhhFPyIim8ZCgLOgI-Q8CnYaIs_Egiu5uaTwgv_TDEe--o9RP-RhPkfelR388jk7pH6CAQlm3dE8wt1Xb6MIoudZqYZ22zurNFdqDP2e9aYG0BZC1Xrv2G1g7o2rdbg2XyhQwl3PCPKL7oCT9OWCKMSAVQkAFBS419QuK2UEABxueCHB3wIkId4QjGeXdDsGeQzjp4CTijKcxjScU3p951HHDPrm0ITrb8OYfxTTPq5XgXT22XXhzcHaZfiybLGtC-g5eyjQFch4i6tVVr_cBxGReXw!!/dl5/d5/L2dBISEvZ0FBIS9nQSEh/