Molecular Pathology Coding Changes for 2013
January 28, 2013Effective for services provided on or after January 1, 2013, Medicare will implement use of the CPT molecular pathology codes. Codes 83890 through 83914, which were a component of the stacking method of coding molecular pathology testing, have been deleted for 2013. The Tier 1 molecular pathology codes (81200-81383) are applicable to specific biomarkers. However, Tier 2 molecular pathology codes (81400-81408) are used to identify groups of biomarkers that require the similar levels of technical and interpretive resources required to complete the testing. Because there are multiple biomarkers represented by each of the Tier 2 codes, when billing for these codes, it will be necessary to report the specific biomarker in the claim narrative/remarks. Please report information in the narrative/remarks that provides ample information to uniquely identify the specific biomarker.
If the specific biomarker tested is not represented by a Tier 1 code and is not listed under one of the Tier 2 codes, then the testing should be reported using “unlisted” molecular pathology code 81479. A description of the testing performed is required in the narrative/remarks when using this code.