83698
HCPCS/CPT
Prior Authorization
No Prior Auth Required
No active coverage policies found for this code (low confidence)
Medicare Pricing
Work RVU
0.00
Facility
N/A
Non-Facility
N/A
Documentation Required
- The submitted medical record must support the selected ICD-10-CM code(s), and the submitted CPT/HCPCS code must accurately describe the service performed.
- The medical record must include the legible signature of the physician or non-physician practitioner responsible for and providing the care.
- When billing CPT 84999 for the listed tests, include a note identifying the specific test in the Remarks (Part A) or Narrative (Part B) area of the claim.
- All documentation must be maintained in the patient's medical record, be legible, include patient identification (e.g., complete name) and dates of service, and be made available to the contractor upon request.
Key Coverage Criteria
- For tests that currently lack specific CPT codes (functional intracellular analysis and total antioxidant function), bill using CPT 84999 and add a note identifying which test was performed in the Remarks area for Part A claims and the Narrative area for Part B claims.
- Coverage and reasonable/necessary determinations for assays for vitamins and metabolic function are governed by LCD L34914 and claims must meet that LCD's requirements to be covered.
- No clinical indications are specified in this article; coverage indications are determined by the referenced LCD L36362 (MolDX: Biomarkers in Cardiovascular Risk Assessment).
- This article contains billing and coding guidance only and does not itself define clinical indications; refer to MolDX: Biomarkers in Cardiovascular Risk Assessment LCD L36139 for covered clinical indications.
- Targeted single vitamin assays are covered when reasonable and necessary for diagnosis or treatment of a specific suspected vitamin deficiency documented by history and focused physical exam.
- Laboratory testing for a specific vitamin deficiency is covered when specific clinical findings suggest that deficiency (e.g., signs/symptoms or physical exam findings consistent with that vitamin deficiency).
17 Active Policies
L36523 — MolDX: Biomarkers in Cardiovascular Risk Assessment
J05
A57559 — Billing and Coding: MolDX: Biomarkers in Cardiovascular Risk Assessment
J05
L34914 — Assays for Vitamins and Metabolic Function
J12
A56416 — Billing and Coding: Assays for Vitamins and Metabolic Function
J12
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