AMA CPT® Assistant - 2017 Issue 4 (April)

Pathology and Laboratory: Molecular Pathology (Q&A) (April 2017)

April 2017 page 10a Pathology and Laboratory: Molecular Pathology Question: For gene sequencing of 11-25 exons, is it appropriate to report code 81406 when the gene is not specifically mentioned in the code descriptor, but matches the procedure definition? Answer: No, if the analyte tested is not specifically listed under a Tier 2 code, the Tier 2 code should not be reported. Tier 2 codes cannot be reported for tests other than those listed in the code. When reporting the testing of an analyte that isn't listed under one of the Tier 2 codes, it would be appropriate to...

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CPT® Assistant content is the official source for CPT® coding guidance. It is an instrumental tool when appealing insurance denials and validating coding to auditors. Monthly issues and an extensive archive provide comprehensive guidance on proper CPT® coding for past, present and upcoming code set releases. Archives date back to 1990 for historical use of codes, changes, rationales, coding tips and trends in the industry.

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