|2012 Molecular Pathology Code Sets not Recognized|
The American Medical Association (AMA) has announced the creation of new molecular pathology codes effective January 1, 2012. These codes are intended to replace the historic “stacked codes” used for molecular testing.
Although the Specialty Society RVS Update Committee (RUC) suggested Relative Value Units (RVUs) for these codes, the Centers for Medicare and Medicaid Services (CMS) has decided not to recognize the codes and the RVU recommendations because resources and costs have not been determined.
As a result of the CMS decision, Wellmark will not recognize the new codes at this time. Claims submitted with the new molecular pathology CPT codes 81200–81408 will be denied.
Please continue to use CPT codes 83890–83914 when billing the individual steps or components of a molecular service. These codes are often referred to as “stacking codes.”