Listen to the recording now.
Click here to view the Questions & Answers.
In an ongoing effort to continually improve our educational offerings, we invite you to share your feedback with us in a short 10-question survey.

Presented by: Diane Allingham-Hawkins, PhD, FCCMG, FACMG, Director of the Hayes Genetic Test Evaluation Program

Overview
Payers have struggled to make coverage decisions for molecular tests due to the lack of a specific CPT coding system. The use of so-called “stacking codes” (83890-83914) that related to procedures rather than specific tests made it difficult if not impossible for payers to identify molecular tests that were being requested. Hence, many tests were reimbursed, even though payers could not determine if the tests were being prescribed appropriately. Conversely, some appropriate tests may have been denied coverage because the payer had no way of identifying the test. This loophole in coding could be used to manufacturers’ advantage by allowing them to potentially slip tests “under the radar” of the payer.

The issuing of CPT codes for nearly 200 genetic and molecular tests by the American Medical Association (AMA) has offered clarity to both payers and providers. Hayes is providing this webinar in a hands-on approach to effectively implementing the use of these CPT codes to evaluate the appropriate utilization of these tests.

This webinar will provide payers and providers with a brief overview of the history of molecular CPT codes and a general outline of the newly implemented codes. In addition, specific examples illustrating the use of the new codes will be provided. Participants will have an opportunity to ask questions as time permits.

Target Audience:
The target audience for this webinar includes payers and providers interested in learning more about the implementation of the molecular CPT codes. These include health plan care managers, claims specialists, medical coders and coding specialists, physicians, and laboratory managers.

Overall Learning Purpose/Goal:
The purpose of this webinar is to provide an overview of the new CPT codes for molecular tests and a discussion of how these codes are intended for use.

Learning Objectives:
At the conclusion of this webinar, participants should be able to:

• Describe the rationale for the development of molecular CPT codes.
• Explain how the use of the new molecular CPT codes differs from the previous process of stacking codes.
• Give specific examples to illustrate the use of the new codes.
• List some of the benefits of using the new codes.

For more information about this webinar, please e-mail us at: educationservices@hayesinc.com.