Unlisted molecular pathology procedure

Description

This code is used to report a molecular pathology procedure that lacks a specific CPT code. It serves to document unique tests or analyses that are not categorized under existing codes, ensuring proper billing and clinical tracking.

Medicare Hospital Outpatient Reimbursement (OPPS)

OPPS Payment Rate

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Patient Copayment / Coinsurance

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Top Modifiers

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HCPCS/CPT 90Reference laboratory services performed by an outside laboratory(36.14%)

HCPCS/CPT 59Distinct procedural service for non-E/M services(15.08%)

HCPCS/CPT GZItem or service expected to be denied as not reasonable and necessary(11.31%)

HCPCS/CPT GYItem or service excluded from Medicare benefits(9.98%)

HCPCS/CPT GAWaiver of liability statement issued per payer policy(8.2%)

HCPCS/CPT 91Repeat clinical diagnostic laboratory test performed on the same day(5.54%)

HCPCS/CPT GWService unrelated to hospice patient's terminal condition(4.88%)

HCPCS/CPT XUUnusual non-overlapping service(3.99%)

HCPCS/CPT 76Repeat procedure or service by same physician or qualified healthcare professional(1.55%)

HCPCS/CPT GVAttending physician not employed by hospice provider(1.55%)

Code Crosswalks

No crosswalks found.

Alternate Codes

No alternates found.

Billed With Codes

No codes found here.

Sources

We make no claims to ownership of the coding systems referenced on this platform. Codes and descriptions are produced from claims and chargemaster data available through the CMS-9915-F Transparency in Coverage Final Rule and via state or federal datasets. This service is provided solely as a reference to encourage use of these codes in our chargemaster review and automated billing tools, so that healthcare professionals can understand and correctly report these codes in their claims.

Federal and State Datasets

List of CPT/HCPCS Codes, Centers for Medicare & Medicaid Services (CMS)
I/OCE Quarterly Release Files, Centers for Medicare & Medicaid Services (CMS)
Physician Fee Schedule Relative Value Files, Centers for Medicare & Medicaid Services (CMS)
OPPS Addendum B, Centers for Medicare & Medicaid Services (CMS)
ASC Payment Addenda, Centers for Medicare & Medicaid Services (CMS)