The Concert Coding Engine (v1.2)

v1.2 – January 2024:
This version contains clarifications to the coding algorithm, updated data, and implementation results. The previous version can be accessed here. 

Amidst the rapid growth in the genetic testing market, one persistent challenge has been ambiguity and inconsistency in how genetic test claims are coded. Variation in coding leads to administrative burden, error, waste.

Concert developed a novel solution in 2019 – the Concert Coding Engine – which translates each genetic test into a single code or code combination. Since the launch of this solution, many health plans have instituted requirements for labs to code according to the Concert coding standards for reimbursement, leading to outcomes that benefit plans, labs, and most importantly, health consumers.

This paper describes the Coding Engine, including the guiding principles, data inputs, underlying logic, and results of implementation.