UCR 090: UTI – PCR UPDATE Part 2, Modifier -22

April 1, 2022

Mark, Scott, and Ray discuss an update on the MolDx guidelines for PCR billing set to take effect April 17th, 2022.  They also talk about Modifier -22; should you use it and what it takes.


The following Medicare Administrative Contractors (MAC) aka Carriers, have issued a proposed multi-jurisdictional Local Coverage Decision (LCD) for Multiplex Nucleic Acid Amplification Test (NAAT) PANELS FOR INFECTIOUS DISEASE Testing, Wisconsin Physician Services Insurance Corporation, CGS Administrators, LLC., Noridian Healthcare Services, LLC., and Palmetto GBA.

Each has also issued an associated Local Coverage Article (LCA) with coding instructions and limitations on coverage. Each of these states participate in the MolDX program administered by Palmetto GBA. The coverage change takes effect April 17, 2022 in all states within each jurisdiction...


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