Coding and Billing of Molecular Pathology and Genetic Testing

Why This Topic Matters

Molecular diagnostic testing changes quickly and can create coding, billing, and compliance risk when services are reported incorrectly. Understanding the structure of the relevant code families and the broader reimbursement environment helps reduce denials, administrative burden, and payment errors.

Article Sections

1. Overview of molecular pathology and genetic testing

   Introduces the growth of genetic testing and the general coding and billing challenges associated with molecular diagnostic and laboratory-developed testing services.

2. CPT molecular pathology code structure

   Summarizes the organization of the CPT molecular pathology code families and the broad types of services they represent.

3. Billing, compliance, and reimbursement considerations

   Discusses general issues affecting coding accuracy, payer review, authorization, coverage, and administrative burden in genetic testing.