Molecular Pathology Procedure, Physician Interpretation and Report G0452

January 14, 2013

New in 2013, CMS created CPT code G0452 (molecular pathology procedure; physician interpretation and report), which will be a clinical laboratory interpretation service paid off of the Physician Fee Schedule.  While reimbursement on this code is cross-walked to 83912-26 from the 2012 fee schedule, 83912-26 has been deleted from the CPT books.   We highly recommend your billing company and coders are aware of this new code, are aware of payer-specific requirements for submitting claims for this new code and to monitor payments from commercial carriers to ensure your claims for CPT G0452 are being properly paid.

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