The AMA revised the molecular pathology codes in the CPT® Manual in 2012, but at that time CMS did not adopt the codes as it was still debating whether and how to change the reimbursement system for these services going forward. For CY 2013, CMS elected to recognize the codes, which meant it had to finalize how to pay for them. While CMS did not change pamyent for these services under the Clinical Laboratory Fee Schedule (CLFS) despite industry pressure, its change to the new codes means a change in the payments providers can expect this year and in the future.
CMS corrected edit 84, added five APCs to the I/OCE, deleted two APCs, and changed the description of another as part of the April updates to the I/OCE. In addition, CMS deleted all of the genetic testing modifiers, retroactive to January 1.
Our experts answer questions about modifiers for diagnostic interventional procedures, Medicare recognition of CPT® code 9066, reporting add-on code for psychotherapy with interactive complexity, reporting G0378 for all payers, and wound care coding.
The federal government has been pushing hospitals to reduce the number of preventable readmissions. Now it's putting some money behind the initiative by adding two new CPT codes that will allow physicians to bill for care that may help keep patients out of the hospital.
If the October 1, 2014, implementation date for ICD-10-CM and ICD-10-PCS is not altered by the time this is published, there will be 18 months left until the transition.
