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Interpace Pancreas Test Reimbursement Code Changed

This article has been updated from a previous version to clarify that the Interpace test was assigned a different, existing CPT code.

NEW YORK (GenomeWeb) – Interpace Diagnostics announced today that its Medicare administrative carrier Novitas Solutions has assigned a different molecular CPT code to the molecular diagnostic firm's PancraGen test for pancreatic cysts, which is expected to improve reimbursement.

The CPT, or Current Procedural Terminology, code is widely used to report medical procedures and services to health insurance programs. Previously, the PancraGen test was covered by Novitas under a miscellaneous chemistry code used for a range of tests, Interpace said.

The new code designates a molecular pathology procedure and "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 payment for this condition," Interpace Interim CEO Jack Stover said in a statement.

The fee paid by Medicare remains unchanged at $3,100, but the new code is expected to streamline the reimbursement process for hospital clients and positively impact the way remittances are received from both Medicare and commercial payors, the company said.