Billing Beat

Public Meeting to Discuss the Laboratory Payment of New Clinical Tests in 2012

June 15, 2011

The Public Meeting for the Laboratory Payment for New Clinical Test for 2012 as well as an information session to discuss new genetic testing codes will be held on July 18, 2011 at the CMS Services Auditorium in Baltimore, MD.

The meeting is open to the general public to make recommendations on the assignment of payment levels for new codes to be included in the 2012 Medicare Clinical Laboratory Fee Schedule. The meeting is intended to provide expert input on the nature of the new test codes and receive recommendations to either crosswalk or gap-fill for payment.

The following New Test Codes for 2012 will be discussed as well as codes that are eligible for reconsideration.

Immunology

1. 863XX Nuclear Matrix Protein 22 (NMP22), qualitative

 

Microbiology

1. 873XX HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies, single result

 

 

Reconsideration Requests

  1. G0434 Drug screen, other than chromatographic; any number of drug classes, by CLIA waived test or moderate complexity test, per patient encounter
  2. G0435 Infectious agent antibody detection by rapid antibody test, HIV-1 and/or HIV-2, screening (SHORT DESCRIPTOR: Oral HIV-1/HIV-2 screen)
  3. 83861 Microfluidic analysis utilizing an integrated collection and analysis device; tear osmolarity
  4. 86481 Tuberculosis test, cell mediated immunity antigen response measurement; enumeration of gamma interferon producing T-cells in cell suspension
  5. 87906 Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, other region (e.g., integrase, fusion)

Immediately following the Laboratory Public Meeting on Payment for New Clinical Laboratory Tests for 2012, CMS will host a separate information session aimed at discussing new genetic testing codes.

 To register for the meeting, individuals should complete the internet registration form by July 8, 2011, at www.cms.hhs.gov/ClinicalLabFeeSched/.

Sign up for Billing Beat