Happy New Year!  Our New 2013 Molecular Pathology CPT Codes are now in effect.  Please visit our website at www.dnatesting.uchicago.edu to obtain a listing of our new codes and tests.

Recently, there have been a number of inquiries regarding the G0452 HCPCS Level II Code.  In the final rule, the Center for Medicare & Medicaid Services (CMS) announced that it would establish a G code (G0452 – molecular pathology procedure; physician interpretation and report) for physician interpretation and report of a molecular pathology service.  To the best of our current knowledge and understanding, G0452 is only being used when interpretation and report by a physician is medically necessary and is not duplicative of laboratory reporting paid under the Clinical Laboratory Fee Schedule (CLFS). Therefore, this code should not be used to bill for interpretation and report by a PhD level professional for molecular pathology testing, even though PhD’s usually perform many of the molecular pathology interpretations.   We will continue to review the rulings of CMS to learn, if in the future, there will be an interpretative code for non-physician interpretation of a molecular pathology service. 

If you have any questions/comments about the UCGS utilization of the new 2013 Molecular CPT codes, please feel free to contact us at youtlaw@bsd.uchicago.edu.


Yulanda Outlaw, MPA, CPC

Billing Manager