Molecular Codes Placed on CLFS

On November 1st, CMS announced that the 101 new molecular CPT codes will be placed on the CLFS.  CAP helped develop these codes and supported their placement in the Professional Fee Schedule, but CMS disagreed.  CMS cited differences of opinions amongst professionals in the community on if these codes required a physician interpretation.  CMS did, however, provide a new G-code for use by pathologists, for instances where interpretation of these tests is medically necessary. That code is G0452.  Payment amounts for the codes were not published, as reimbursement for 2013 will be set by the gap filling method.  If you have any additional questions about this topic, please contact your Account Representative.