Billing for Medical Genetics and Genetic Counseling Services: A National Survey
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In January 2007 the American Medical Association added a new Current Procedural Terminology® (CPT) code, 96040, for “Medical Genetics and Genetic Counseling Services.” In order to identify the impact of having this new code and to identify issues with implementation of the code, the National Society of Genetic Counselors (NSGC) CPT® Working Group surveyed NSGC members using an internet-based survey tool. The majority of respondents (94%) reported being aware of the new code and over half of the respondents (69%) said they were billing for genetic counseling. Approximately 24% of those billing reported using 96040. Many facilities are not using this code and the reported success of billing using 96040 is highly varied. Continued education may be beneficial to encourage reimbursement for 96040 and follow up is needed to assess the ongoing implementation and impact of the new CPT® code.
- American College of Medical Genetics. (2002). In M. Williams (Ed.), Manual on reimbursement for medical genetic services. Dubuque: Kendall/Hunt.
- American College of Obstetricians and Gynecologists. (2008). Ethical issues in genetic testing. ACOG committee opinion number 410. Obstetrics & Gynecology, 111, 1495–1502.
- American Medical Association. (2006). CPT® changes 2007: An insider’s view. Chicago: American Medical Association.
- American Society of Human Genetics Board of Directors, & American College of Medical Genetics Board of Directors. (1995). Points to consider: ethical, legal, and psychosocial implications of genetic testing in children and adolescents. American Journal of Human Genetics, 57(5), 1233–1241.
- Bernhardt, B. A., & Pyeritz, R. E. (1989). The economics of clinical genetics services. III. Cognitive genetics services are not self-supporting. American Journal of Human Genetics, 44(2), 288–293.
- Bernhardt, B. A., & Pyeritz, R. E. (1992). The organization and delivery of clinical genetic services. Pediatric Clinics of North America, 39(1), 1–12.
- Bernhardt, B. A., Weiner, J., Foster, E. C., Tumpsonn, J. E., & Pyeritz, R. E. (1987). The economics of clinical genetics services. II. A time analysis of a medical genetics clinic. American Journal of Human Genetics, 41(4), 559–565.
- Bernhardt, B. A., Peshkin, B. N., & Kemel, Y. (1998). Billing and record-keeping for familial cancer risk counseling: a national survey. Journal of Genetic Counseling, 7, 317–330. CrossRef
- Bernhardt, B. A., Biesecker, B. B., & Mastromarino, C. L. (2000). Goals, benefits, and outcomes of genetic counseling: client and genetic counselor assessment. American Journal of Medical Genetics, 94, 189–197. CrossRef
- Cohn, G. M., Cimaroli, T., Gould, M., Macri, C. J., Habecker-Green, J., & Miller, R. C. (1996). The usefulness of a prenatal genetic questionnaire in genetic risk assessment. Obstetrics and Gynecology, 88, 806–810. CrossRef
- Ciske, D. J., Haavisto, A., Laxova, A., Zeng, L., Rock, M., & Farrell, P. M. (2001). Genetic counseling and neonatal screening for cystic fibrosis: an assessment of the communication process. Pediatrics, 107, 699–705. CrossRef
- Frezzo, T. M., Rubinstein, W. S., Dunham, D., & Ormand, K. E. (2003). The genetic family history as a risk assessment tool in internal medicine. Genetics in Medicine, 5(2), 84–91. CrossRef
- Giardiello, F. M., Brensinger, J. D., Petersen, G. M., Luce, M. C., Hylind, L. M., Bacon, J. A., et al. (1997). The use and interpretation of commercial APC gene testing for familial adenomatous polyposis. NEJM, 336(12), 823–827. CrossRef
- Hiraki, S., Ormand, K. E., Kim, K., & Ross, L. F. (2006). Attitudes of genetic counselors towards expanding newborn screening and offering predictive genetic testing to children. American Journal of Medical Genetics, 140(21), 2312–2319.
- Katz, A., & Thompson, J. (1996). The role of public policy in health care market change. Health Affairs, 15(2), 77–92. CrossRef
- Keller, M., Jost, R., Haunstetter, C. M., Sattel, H., Schroeter, C., Bertsch, U., et al. (2008). Psychosocial outcome following genetic risk counselling for familial colorectal cancer. A comparison of affected patients and family members. Clinical Genetics, 74(5), 414–424. CrossRef
- Khatcheressian, J. L., Wolff, A. C., Smith, T. J., Grunfeld, E., Muss, H. B., Vogel, V. G., et al. (2006). American Society of Clinical Oncology 2006 update of the breast cancer follow-up and management guidelines in the adjuvant setting. Journal of Clinical Oncology, 24(31), 5091–5097. CrossRef
- McPherson, E., Zaleski, C., Benishek, K., McCarty, C. A., Giampietro, P. F., Reynolds, K., et al. (2008). Clinical genetics provider real-time workflow study. Genetics in Medicine, 10(9), 699–706. CrossRef
- Medical Malpractice: Wrongful birth, preconception torts, duty to inform of genetic risks. (1979). Akron Law Review, 13, 390–400. (Court Cases Park v. Chessin, Becker v. Schwartz, Howard v. Lecher, and Gleitman v. Cosgrove).
- Nelson, R. M., Botkjin, J. R., Kodish, E. D., Levetown, M., Truman, J. T., Wilfornd, B. S., et al. (2001). Ethical issues with genetic testing in pediatrics. Pediatrics, 107(6), 1451–1455. CrossRef
- Parrott, S., & Del Vecchio, M. (2007). Professional status survey 2006. Wallingford: National Society of Genetic Counselors, Inc.
- Pirzadeh, S. M., McCarthy Veach, P., Bartels, D. M., Kao, J., & LeRoy, B. S. (2007). A national survey of genetic counselors’ personal values. Journal of Genetic Counseling, 16(6), 763–773. CrossRef
- Pyeritz, R. E., Tumpson, J. E., & Bernhardt, B. A. (1987). The economics of clinical genetics services. I. Preview. American Journal of Human Genetics, 41, 549–558.
- Reed, S. (1955). Counseling in medical genetics. Philadelphia: Saunders.
- Resta, R. G. (2003). In memoriam: Sheldon Clark Reed, PhD, 1910–2003. Journal of Genetic Counseling, 12, 283–285. CrossRef
- StataCorp. (2007). Stata statistical software: Release 10. College Station: StataCorp LP.
- U.S. Department of Health and Human Services (2006). Coverage and reimbursement of genetic tests and services: Report of the secretary’s advisory committee on genetics,health, and society, from http://oba.od.nih.gov/oba/sacghs/reports/CR_report.pdf.
- Zahm, K. W., McCarthy Veach, P., & LeRoy, B. S. (2008). An investigation of genetic counselor experiences in peer groups supervision. Journal of Genetic Counseling, 17(3), 220–233. CrossRef
- Billing for Medical Genetics and Genetic Counseling Services: A National Survey
Journal of Genetic Counseling
Volume 19, Issue 1 , pp 38-43
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- Genetic counselor
- CPT® code
- Industry Sectors
- Author Affiliations
- 1. Genetic Services Section, Washington State Department of Health, 20435 72nd Ave S, Suite 200, Kent, WA, 98032, WA, USA
- 2. National Society of Genetic Counselors, CPT® Working Group, Chicago, IL, USA