Forum - Questions & Answers

Apr 7th, 2010 - ASTOUGH 15 

BRAC testing

I have a patient that has a personal history of breast cancer and our physician would like her to have the BRAC testing done (the genetic screening). I am unsure as to which codes to use for the office portion of this test which involves the doctor reviewing her history with her and a swab of the mouth. I usually use V10.3 for personal history of malignancy of the breast and as per our Myriad representative (for BRAC testing) I also use the CPT code 99401. These were the only codes that I used for this patient and I would like your opinion on if these are correct of if there is something else that I should be using for the CPT. Thank You!

Apr 7th, 2010 -

Sounds right

There are two choices- you can bill it out as you are doing or let Myriad bill it out. The test is $3,500 and if the insurance denies it you are at risk for the cost if you bill it. I would not risk it- I would bill the E&M for the counseling and let the lab bill it out. The other option is to refer to a genetic counselor for the counseling and testing. That is actually the best option as they are trained to interpret the test and explain the results and counsel on who needs to be notified- family, etc as there is a liability involved with this test.



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