Does 83721 require prior authorization?

No, 83721 does not require prior authorization (high confidence). Code is covered without prior authorization.

What is the Medicare reimbursement rate for 83721?

Medicare facility rate: N/A. Non-facility rate: N/A. Work RVU: 0.00.

HCPCS/CPT

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Work RVU

0.00

Facility

N/A

Non-Facility

N/A

The medical record must document and satisfy the criteria required for any NCCI-associated modifier that is reported.
Claims must follow NCCI coding guidelines and applicable code-combination rules prior to billing Medicare.
Documentation supporting that tests meet 'reasonable and necessary' criteria and applicable frequency limits must be maintained per Novitas LCD L35099.
Claims should be supported with documentation consistent with LCD L36129; this article provides billing and coding guidelines that complement that LCD and should be used alongside the LCD when submitting claims.

Laboratory tests are covered when they meet the reasonable and necessary clinical criteria and frequency limitations specified in Novitas LCD L35099.
Procedure codes are covered for the ICD-10-CM diagnoses listed as covered in the Medicare NCDs referenced at the CMS NCD ICD-10 laboratory list.
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.
A laboratory service is reasonable and necessary only when ordered by a physician who uses the test result in the management of the beneficiary's specific medical problem.
A laboratory result must be reported promptly to the ordering physician and the physician must use that result prior to ordering a similar subsequent laboratory test to qualify for separate payment.

L36523 — MolDX: Biomarkers in Cardiovascular Risk Assessment

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A57559 — Billing and Coding: MolDX: Biomarkers in Cardiovascular Risk Assessment

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L35099 — Frequency of Laboratory Tests

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A56420 — Billing and Coding: Frequency of Laboratory Tests

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CGS-L36139

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