jeudi 21 août 2014

Molecular Pathology - HCPCS G0452

Can anyone clarify when multiple units of G0452 - physician interpretation and report of molecular pathology procedures - may be reported for Tier 2 molecular pathology codes. Per NCCI manual chapter X, Pathology/Laboratory Services, pg 18:

?One UOS may be reported for each physician interpretation for each separately listed molecular pathology procedure for each distinct source of a specimen. For Tier 2 molecular pathology CPT codes, a physician should not report more than one UOS for each listed molecular pathology procedure on a specimen from a single source?.


For example:


Description CPT

HBA1/HBA2 DUP/DEL ANALYSIS 81404

HB HBB DUP/DEL ANALYSIS 81403

HBB FULL GENE SEQ 81404

PF-MOLECULAR PATH INTERP G0452


In the above example there are three Tier 2 procedures (HBA1/HBA2 and HBB). Assuming medical necessity and all other requirements for reporting are met; if an interpretation is done on each of the three procedures, can the physician charge G0452 x 3 even though it is from the same source? There are three distinct molecular pathology procedures from this single source (2.5ml of blood).






Molecular Pathology - HCPCS G0452

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