Pathology and Laboratory: Molecular Pathology (Q&A) (September 2016)

September 2016 page 10a Pathology and Laboratory: Molecular Pathology Question: What is the appropriate CPT code to report the next generation sequencing (NGS) and analysis of data described in the following scenario? A patient sample has been extracted and prepared for exome sequencing through a next-generation sequencer that will produce genetic data for over 3,000 targeted clinical genes. The output is analyzed for NGS artifacts (false positives), coverage (accuracy), and sensitivity (false negatives). A clinical test is ordered for a subset of 300 genes within the total of 3,000 genes, in which the Guanidinoacetate N-Methyltransferase (GAMT) gene...

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Note:  The following article synopsis was NOT provided by the AMA. It was created by Find-A-Code/innoviHealth.

Article Overview

This article explains a molecular pathology coding question centered on a next-generation sequencing workflow involving large-gene-panel data review and variant curation. It is useful for pathology, laboratory, and medical coding professionals who need to understand how the service is characterized in CPT terms and how unlisted molecular pathology reporting is addressed in the context of the example provided.

Why This Topic Matters

The article helps coders and laboratory staff recognize when a molecular pathology service does not align cleanly with a specific CPT code and therefore requires review of unlisted reporting considerations. It is relevant for accurate claim preparation and supporting documentation in advanced sequencing workflows.

Article Sections

  1. Question

    Presents a molecular pathology coding scenario involving next-generation sequencing, data analysis, and gene-level review. The question frames the service in terms of laboratory workflow and code selection.

  2. Answer

    Provides the coding response for the scenario and notes the need for supporting documentation when an unlisted molecular pathology service is reported. The section focuses on how the service is categorized for CPT reporting.

What You Will Learn

  • How a next-generation sequencing molecular pathology service is framed for CPT reporting.
  • How unlisted molecular pathology reporting is discussed in a laboratory coding context.
  • What type of supporting documentation is associated with reporting an unlisted procedure.
  • How a complex gene-panel workflow is described at a high level in a coding Q&A.

Who Should Read This

  • Pathology coders
  • Laboratory billing staff
  • Clinical laboratory managers
  • Medical coding professionals
  • Molecular pathology specialists

Codes Discussed


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