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CodeMap® Compliance Briefing: December 21, 2016


Editor's Welcome:

Since 2013, the Medicare Physician Fee Schedule has included a HCPCS code (G0452) and payment for a physician's interpretation of a molecular pathology procedure. Just like other physician interpretation services, a provider may not bill for this code unless specific criteria are fulfilled, most importantly an order from the attending physician as well as the production of a written report.

Until recently, nobody paid much attention to HCPCS code G0452. However, during 2016, the OIG for the Department of Health and Human Services settled numerous cases against physician practices and clinics for inappropriately submitti....

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