Laboratory/Pathology CPT Code Update

In June 2013, MHCP added coverage for the following lab codes effective January 1, 2013: Molecular Pathology Codes 81200-4, 81225-7, 81240-1, 81245, 81257, 81261-8, 81270, 81291-81301, 81310, 81317-9, 81330-2, 81340-2, 81355,81370-81383, 82777 and 84145. Providers will need to replace laboratory claims where these services may have denied.

The system change to allow pathology facility charges claimed on the 837I without the TC modifier to pay the TC rate will be effective for dates of service beginning October 1, 2013. The following services do not require the TC modifier when claimed on the 837I: 88104-88125, 88160-88162, 88172, 88173, 88177, 88182, 88300-88319, 88323, 88331-88362, 88365-88368, 88380-88388. For dates of service before October 1, 2013, MHCP will continue to pay the global rate when the above services are claimed on the 837I unmodified.