Thursday, August 12, 2010

Billing Molecular CPT codes

Molecular Diagnostics Procedures

Molecular diagnostics procedures are coded by procedure rather than analyte using the following codes:
  • 83890 MOLECULAR DIAGNOSTICS: molecular isolation or extraction
  • 83892 MOLECULAR DIAGNOSTICS: enzyme digestion
  • 83894 MOLECULAR DIAGNOSTICS: separation
  • 83896 MOLECULAR DIAGNOSTICS: nucleic acid probe, each
  • 83898 MOLECULAR DIAGNOSTICS: amplification, e.g., PCR, each
  • 83902 MOLECULAR DIAGNOSTICS: reverse transcription
  • 83912 MOLECULAR DIAGNOSTICS: interpretation and report
New antigen-specific codes are now used to describe infectious agent antigen detection and quantification using molecular diagnostic procedures.
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Medicare physician fee schedule - Quick overview

Medicare Part B pays for physician services based on the PFS, which lists the more than 7,400 unique
covered services and their payment rates. Physicians’ services include the following:

* Office visits;
* Surgical procedures;
* Anesthesia services; and
* A range of other diagnostic and therapeutic services.


Medicare Physician Fee Schedule Payment Rates

Payment rates for an individual service are based on
three components:
1) Relative Value Units (RVU)
2) Conversion Factor (CF)
3) Geographic Practice Cost Indices (GPCI)


Medicare Physician Fee Schedule Payment Rates Formula


The Medicare PFS payment rates formula is shown below:

[(Work RVU x Work GPCI) + (PE RVU x PE GPCI) +
(MP RVU x MP GPCI)] x CF

Medicare fee schedule download