84999
HCPCS/CPT
Prior Authorization
No Prior Auth Required
No active coverage policies found for this code (low confidence)
Medicare Pricing
Documentation Required
- The patient's medical record must include the ordering provider's assessment as it relates to the patient's complaint for that visit.
- Include relevant medical history in the medical record that supports the need for GlycoMark® testing.
- Document results of pertinent tests and procedures; for diagnostic tests report the result if known, otherwise report the symptoms prompting the performance of the test.
- All services ordered or rendered to Medicare beneficiaries must be signed and include a signed and dated office visit record or operative report.
- When using modifier -GA, a signed ABN (Form CMS‑R‑131) should be on file; for Part A MAC claims include occurrence code 32 and the date of the ABN.
- For a voluntarily issued ABN append claims with modifier -GX; to indicate a statutorily excluded service append with modifier -GY.
Key Coverage Criteria
- Bill GlycoMark® testing using CPT code 84378 or, if appropriate, CPT 84999.
- No clinical coverage indications are specified in this billing/coding guidance; clinical coverage criteria for GlycoMark® testing are defined in Local Coverage Determination L36761.
- GlycoMark testing for assessment of glycemic control (use when local coverage determination authorizes GlycoMark testing).
- Serum thallium testing is covered for beneficiaries with documented industrial thallium exposure and unexplained ataxia.
- Serum tin testing is covered for beneficiaries with documented industrial tin exposure.
- Serum aluminum testing is covered for beneficiaries on chronic dialysis with evidence suggesting aluminum toxicity or for beneficiaries with documented chronic industrial aluminum exposure.
20 Active Policies
L35074 — Heavy Metal Testing
J06
A56767 — Billing and Coding: Heavy Metal Testing
J06
CGS-L36906 — GlycoMark® Testing for Glycemic Control
J18 MAC Part B
NORIDIAN-L37628 — In Vitro Chemosensitivity & Chemoresistance Assays
JF Part B
NORIDIAN-L36864 — GlycoMark Testing for Glycemic Control
JF Part B
NORIDIAN-L36846 — Measurement of Salivary Hormones
JF Part B
PALMETTO-L36761 — GlycoMark® Testing for Glycemic Control
JJ Part B
PALMETTO-L34554 — In Vitro Chemosensitivity & Chemoresistance Assays
JJ Part B
NGS-L35074 — Heavy Metal Testing
JK MAC Part B
A57237 — Billing and Coding: GlycoMark Testing for Glycemic Control
L36846 — Measurement of Salivary Hormones
L36864 — GlycoMark Testing for Glycemic Control
L36906 — GlycoMark Testing for Glycemic Control
L37628 — In Vitro Chemosensitivity & Chemoresistance Assays
A56872 — Billing and Coding: GlycoMark Testing for Glycemic Control
A56465 — Billing and Coding: GlycoMark Testing for Glycemic Control
A57238 — Billing and Coding: GlycoMark Testing for Glycemic Control
L36761 — GlycoMark Testing for Glycemic Control
CIGNA-EN0086 — Complementary and Alternative Medicine - (EN0086)
MED207.128 — Salivary Testing
Related Codes
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