US-based Interpace Diagnostics has announced its medicare administrative carrier (MAC), Novitas Solutions has assigned a new molecular current procedural terminology (CPT) code, 81479 to its PancraGen test.
Previously, the PancraGen test was covered under the miscellaneous chemistry code 84999, which is used to bill a range of tests across the laboratory industry and does not differentiate between technologies with different features.
Interpace Diagnostics interim CEO Jack Stover said: "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.
"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 will have a positive impact on the way claims are submitted and remittances are received from both Medicare and commercial payers.
PancraGen is an integrated molecular pathology test to determine the risk of cancer in pancreatic cysts by using a small sample of a thick or viscous pancreatic cyst fluid.
According to clinical studies, PancraGen is claimed to be 90% accurate, enabling effective risk stratification of patients.
Image: A diagnostic image of pancreatic pseudocyst. Photo: courtesy of James Heilman, MD / Wikipedia.