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Provide INPUT

Download the AMP Proposal

Submitted to the AMA's CPT Editorial Panel in March 2013

Submit comments to AMP

Via email no later than April 15, 2013 to NGScomments@amp.org

View the press release from AMP on this proposal.

 

 

 

Association for Molecular Pathology

CPT Coding for Genomic Sequencing Assays

Request for Input on CPT Coding for Genomic Sequencing Assays

The AMP Economic Affairs Committee (EAC) invites you to contribute your input to the AMA's CPT Editorial Panel regarding the proposed coding for genomic sequencing assays (GSAs). AMP submitted a proposal, developed by the EAC, to the Panel in March 2013.

Your comments are welcome and encouraged. Please submit your feedback to AMP via email at NGScomments@amp.org no later than April 15, 2013. The feedback will be compiled and forwarded to the AMA CPT Editorial Panel for its consideration.

 

QUICK LINKS

 

Background

In 2009, the AMP Economic Affairs Committee released its report (AMP Proposal for CPT Coding Reform in Molecular Diagnostics). Many of the concepts in that report served as the basis for discussion by the AMA CPT Editorial Panels Molecular Pathology Working Group which developed the new coding scheme for molecular diagnostic tests. In the ensuing years, the working group endeavored to implement the new coding scheme for all extant molecular diagnostic tests, an effort which will continue through the MPAG and PCC. The AMP EAC has been an active participant in those activities with AMP members frequently performing yeoman's work in understanding the many Tier 2 assigned tests.

During that time massively parallel sequencing technologies continued to evolve and the ranks of early adopters have swelled. Foreseeing that tests performed using these new technologies might not be readily accommodated by the new coding system, the AMP EAC initiated a discussion of how one might develop CPT codes for these tests. The challenges in doing were not small. The committee had many wide ranging and often passionate discussions in trying to understand what these tests offered that distinguished them from traditional testing methodologies and how they could be classified in a manner that remained true to CPT tenets ensuring appropriate reimbursement for technical and professional work, and still offer the transparency needed by payers and other stakeholders who use CPT codes.

A summary of the Committee's efforts was submitted to the AMA's CPT Editorial Panel in March 2013. We offer the summary in the spirit of candid discussion for all parties to consider. It is not intended to define how the new sequencing based tests will be coded but rather as a possible framework for further discussion. In our committee's discussions over the past year it became clear to us that we could not possibly address all the details (and there are many) that will need to resolved. We sought, instead, to develop some insights into how these tests are likely to be used clinically and how they distinguish themselves from existing procedures and offer some informed guidance to the discussion that will need to occur. While the ultimate decisions regarding CPT coding for genomic tests will come from the AMA CPT Editorial Panel, we are interested in hearing what our members think. We are setting up a specific website to collect those ideas and, hopefully, generate further discussion.

Finally, we wish to recognize the important contributions of Dr. Jeffrey A. Kant in developing this document. His insight and leadership in this effort cannot be overstated. We dedicate this work to his memory.

Sincerely,

Jan Nowak and Aaron Bossler

Economic Affairs Committee co-Chairs

Download the full proposal.

Email your comments and input to NGScomments@amp.org no later than April 15, 2013.