Navigating Coding Structures Using Next Generation Sequencing to Determine Reimbursement

Innovative technologies and major revisions to the CPT coding system have made the reimbursement landscape more challenging for the diagnostic industry. Next generation sequencing (NGS) has recently been introduced and adopted for diagnostic and genetic testing, replacing the limited and costly traditional technologies such as Sanger sequencing. NGS technologies can assist in delivering large amounts of information at a reasonable cost and has been supported by many within the academic and life science industry. As the diagnostic market continues to grow it is imperative that reimbursement payment plans align, and in order to assist payers in making coverage decisions, it is necessary for the AMA to incorporate NGS into the current CPT coding system.

TOPICS TO BE COVERED

Overview of CPT and NGS

Proposed AMP framework: reactions and timelines

Coding guidance in current environment

Discussing the reasoning behind current coding changes

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