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CodeMap Compliance Briefing: 10/22/04


Editor's Welcome

Both Medicare and the American Medical Association (AMA) are continuing to respond to the many new genetic tests with new codes and coverage decisions. As molecular diagnostics continues to evolve, expect more new codes, rules and coverage decisions. Today's introduction to the new genetic testing CPT code modifiers will surely be followed by updates as more information and instructions from CMS are published. As always, feel free to email us your compliance questions and suggestions.

Sincerely,

Charles B. Root, Ph.D.

New Genetic Testing CPT Code Modifiers

The AMA has published new CPT code modifiers for use with molecular diagnostic and cytogenetic procedures related to genetic testing. These modifiers are found in Appendix I (page 438) of the 2005 CPT. They are to be used in conjunction with both CPT and HCPCS codes to provide diagnostic detail regarding the disease and specific genes being determined using molecular diagnostic techniques.

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