New CPT Codes for Molecular Diagnostic Testing
Hayes, Inc. is committed to ensuring that our clients are prepared for the implementation of new CPT codes for molecular diagnostic testing. These new codes, developed by the CPT® Editorial Panel Molecular Pathology Coding Workgroup for the American Medical Association, are scheduled for implementation in January 2012. The Hayes Genetic Test Evaluation (GTE) Program is working proactively to ensure that evidence reviews are available for each of the tests or disorders covered by the new codes.
“We have completed a comprehensive review of the proposed code list and determined that the Hayes GTE Program currently has reports covering 71 of the 170 proposed codes,” says Dr. Diane Allingham-Hawkins, Director of the Hayes Genetic Test Evaluation Program. “We estimate that we can address these remaining codes with 49 additional topics in our GTE Index.”
Hayes Genetic Test Evaluation reports are evidence-based health technology assessments of genetic tests across a range of conditions and applications. Each report provides a clear, objective view of the science behind a specific genetic test, the clinical evidence supporting the test, and the use of the test in clinical practice. These reports can help to guide decisions about whether a hospital should develop or contract for specific genetic tests, based on the clinical value of the test, appropriate patient selection criteria, and the likelihood of reimbursement for each type of test. The reports also can support the development of defensible, transparent coverage policies that are based on evidence of analytical validity, clinical validity, and clinical utility of the test, as well as appropriate patient selection criteria.
We’ll continue to make updates as the implementation of the new CPT codes draws near.