Molecular and genetic testing uses complex multi-tiered CPT codes with stacking rules and component billing requirements.
Genetic tests require extensive medical necessity documentation including family history, clinical indications, and genetic counseling.
Most genetic and molecular tests require prior authorization with detailed clinical justification and supporting documentation.
Each payer has unique coverage policies, testing criteria, and reimbursement rates for genetic tests.
Multi-gene panels require proper bundling of individual genes versus comprehensive panel codes.
Hereditary cancer and disease testing has strict clinical criteria that must be met for coverage approval.
Our team includes certified coders with specialized training in molecular diagnostics and genetic testing billing.
Comprehensive review of test orders against payer-specific medical necessity criteria before claim submission.
Dedicated PA team with expertise in genetic testing authorizations and payer requirements.
Continuous monitoring of payer coverage policies and testing criteria for all genetic and molecular tests.
Expert billing for multi-gene panels including hereditary cancer, cardiac, and neurology panels.
Specialized billing for molecular testing including PCR, sequencing, and chromosomal analysis.
Complete billing for oncology molecular testing including tumor profiling and liquid biopsies.
Expert billing for hereditary disease and carrier screening with proper documentation.
Medtransic's genetic testing billing expertise has been invaluable for our molecular lab. Their understanding of complex CPT codes and payer policies has increased our revenue by 55% while virtually eliminating our authorization and denial issues.
Contact Medtransic today for expert genetic testing billing services. Call 888-777-0860 or visit https://medtransic.com/contact for a free consultation.