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One Genetic Test CPT Code Earns ‘Fraudomatic’ Title

Medicare claims paid under this code soared from 5,817 in 2017 to more than 146,000 in 2019

CEO SUMMARY: Several genetic testing companies have noticed that some of the nation’s Medicare Administrative Contractors (MAC) pay about $2,000 for test claims billed with CPT code 81408. From 2018 through and 2019, the number of 81408 claims rose dramatically at just two of these federal contractors: Novitas Solutions and First Coast Service Options. This …

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