Molecular Diagnostics Update:
Capture Pay for Each Nucleic Acid Sequence -- Here's How
Published on Thu Aug 03, 2006
Net $$ for cell lysis and primer extension too Confused about how many units of service to charge for multiplex reactions or how to get paid for unlisted steps in your molecular diagnostics procedures? Your answer is here -- in the form of revised and new codes for CPT Codes 2006.
Prior to the changes, labs didn't code for certain molecular diagnostics procedures such as cell lysis because CPT provided no code for the service, according to Diana Voorhees, MA, CLS, MT(ASCP)SH, CLCP, principal with DV and Associates Inc. in Salt Lake City. That's why learning how to use the revised codes can keep your billing accurate -- and help your bottom line. Add Up Steps for Molecular Diagnostics Study When labs perform molecular diagnostics techniques to analyze nucleic acids, you should use 83890-83914 to report the service. -Each code describes a separate technique, such as nucleic acid extraction or gene amplification, and you should report each step using the appropriate code,- explains Elizabeth Sheppard, HT(ASCP), marketing manager for Ventana Medical Systems in Tucson, Ariz.
CPT 2006 adds five codes and revises two in this code range. Physicians order molecular diagnostic testing to diagnose and direct treatment relating to infectious agents and disease markers, inherited disorders and oncology. Clarify Unit of Service
New language in CPT 2006 updates 83898 (Molecular diagnostics; amplification of patient nucleic acid, each nucleic acid sequence) to remove the terminology single primer pair. -Although the change doesn't alter how you use the code, the new definition clarifies that you should code once for each nucleic acid sequence, rather than for a primer pair that is used to -flag- each sequence,- Voorhees says.
Technical note: -Amplification- involves duplicating one or more nucleic acid sequences from patient DNA to make more copies for testing. -The larger sample acquired through amplification improves the quality of testing,- Voorhees says.
CPT also clarifies the unit of service for multiplex reactions -- procedures that -amplify- more than one nucleic acid sequence in a single tube. Rather than using one unit of 83901 for each multiplex reaction, as you did prior to CPT 2006, you should now report multiplex reactions using the following new and revised codes:
- 83900 -- Molecular diagnostics; amplification of patient nucleic acid, multiplex, first two nucleic acid sequences
- +83901 -- Molecular diagnostics; amplification of patient nucleic acid, multiplex, each additional nucleic acid sequence (list separately in addition to code for primary procedure). -The code change spells out that the unit of service for multiplex amplification is the nucleic acid sequence,- Voorhees says. The new [...]
