BC Advantage - 2021 Issue 11

Coding and Billing of Molecular Pathology and Genetic Testing

Genetic testing has grown exponentially over the last decade.  The elimination of patent protection on human genes, the proliferation of next-generation sequencing (NGS) technology, and the rapid discovery of gene-disease connections have all contributed to this trend. *The rapidly evolving areas of molecular diagnostic testing and laboratory-developed testing present coding and billing challenges. These challenges may lead to incorrect coding and improper billing to account for the unique characteristics of these tests.  Prenatal and Hereditary cancer tests account for the highest spend.Prior to January 1, 2013, each step of the process of a molecular diagnostic test...

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