Does 83884 require prior authorization?

Yes, 83884 requires prior authorization (medium confidence). Conditional coverage; review criteria to confirm PA need.

What is the Medicare reimbursement rate for 83884?

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

Verity

`83884`

HCPCS/CPT

Prior Authorization

Prior Auth Required

Conditional coverage; review criteria to confirm PA need (medium confidence)

Medicare Pricing

Work RVU

0.00

Facility

N/A

Non-Facility

N/A

Documentation Required

No documentation requirements are specified in this document chunk; required documentation should be obtained from the applicable MAC LCD.
No documentation requirements (medical records, test results, clinical notes) are specified in the provided fragment.
Documentation that the test is identified as covered in an applicable NCD, LCD or LCA and that medical necessity criteria are met.
Where CMS guidance is lacking or incomplete, documentation/evidence submitted to or referenced from the DEX Diagnostics Exchange Registry (DEX) / MolDX evaluation supporting analytical validity, clinical validity and clinical utility.

Key Coverage Criteria

Biomarkers Overview | L35062
MolDX: Pharmacogenomics Testing | L38337
MolDX: Repeat Germline Testing | L38353
Billing and Coding: MoIDX: Proteomics Testing — (Article/LCA titles present; IDs A57772, A59649, A59646, A56973 etc.)
MoIDX: Pharmacogenomics Testing — (Article/LCA titles present)
MoIDX: Repeat Germline Testing — (Article/LCA titles present)

3 Active Policies

HUMANA-GENETIC-AND-BIOMARKER-TESTING-FOR-NEURODEGENERATIVE-DISEASE-MA — Genetic and Biomarker Testing for Neurodegenerative Disease - Medicare Advantage

ANTHEM-LAB.00046 — LAB.00046 Testing for Biochemical Markers for Alzheimerâs Disease

ANTHEM-LAB.00028 — LAB.00028 Blood-based Biomarker Tests for Multiple Sclerosis

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83884