Interpace Diagnostics Group has announced that its Medicare Administrative Carrier (MAC), Novitas Solutions, has assigned a new molecular CPT code (Current Procedural Terminology), 81479 to its PancraGen™ test for pancreatic cysts.
Prior to this coding change, the test was covered under a miscellaneous chemistry code, 84999, which is used for billing a wide range of tests across the laboratory industry and does not effectively differentiate between technologies that have significantly different features and offer unique benefits to patients with specific diseases.
"The CPT coding change represents further confirmation from payers that PancraGen is a clinically comprehensive and robust molecular test that provides novel insights to physicians and patients dealing with this life altering disease," said Jack Stover, Interim Chief Executive Officer.
"The new coding enables both Interpace Diagnostics and those hospitals that bill Medicare directly to use a molecular code when billing for PancraGen, which could result in incremental reimbursement above the established Diagnosis-Related Group ("DRG") payment for this condition."
The new code is expected to streamline and positively impact the way claims are submitted and remittances are received from both Medicare and Commercial payers.