Next Generation Sequencing Coding and Billing Guidelines

NGS testing platforms allow identification of somatic and/or germline alterations in multiple genes at the same time. This guideline focuses on two main types of somatic, tumor tissue-based, testing panels.  Germline panels will be addressed in another article as needed. To bill for targeted NGS services, review CPT codes 81445, 81450 and 81455. Base the selected code on the number of genes in your laboratory’s NGS panel and the test indication for solid organ and hematolymphoid neoplasms. The UOS for the NGS panel is one. Individual gene tests performed in the NGS panel should NOT be registered and reported with multiple CPT Tier 1 and/or Tier II codes. 

INDUSTRY NEWS TAGS: MolDX Jurisdictions, California JE A/B MAC, Nevada JE A/B MAC, Hawaii JE A/B MAC, Guam JE A/B MAC, American Samoa JE A/B MAC, Northern Marianas JE A/B MAC, Noridian Healthcare Solutions, Oregon JF A/B MAC, Washington JF A/B MAC, Idaho JF A/B MAC, Montana JF A/B MAC, Wyoming JF A/B MAC, Nevada JF A/B MAC, Arizona JF A/B MAC, North Dakota JF A/B MAC, South Dakota JF A/B MAC, Alaska JF A/B MAC, Aleutian Islands JF A/B MAC, North Carolina JM A/B MAC, South Carolina JM A/B MAC, Virginia JM A/B MAC, West Virginia JM A/B MAC, Palmetto GBA, Ohio J15 A/B MAC, Kentucky J15 A/B MAC, CGS Administrators LLC, Iowa J5, Kansas J5, Missouri J5, J5 Nebraska, Indiana MAC J8, MAC J8 Michigan, WPS

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