Does 85397 require prior authorization?

No, 85397 does not require prior authorization (high confidence). Code is covered without prior authorization.

What is the Medicare reimbursement rate for 85397?

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

- von Willebrand factor antigen (VWF:Ag), VWF activity measures (RCoF, collagen binding), VWF multimer analysis where available
- VWF pro-peptide (VWFpp) in some studies
- Routine TMA/TTP-related laboratory data: platelet count, LDH, haptoglobin, peripheral smear (schistocytes), creatinine/renal function, coagulation studies
- Clinical documentation of signs/symptoms consistent with TTP/TMA (e.g., thrombocytopenia, microangiopathic hemolytic anemia, neurological signs, renal impairment)

Covered diagnoses (ICD-10) if selection criteria are met: M31.19 Other thrombotic microangiopathy.
Covered diagnoses (ICD-10) if selection criteria are met: M31.10 Thrombotic microangiopathy, unspecified.
Monitoring renal function following kidney transplantation (ADAMTS13 association with creatinine/GFR) (investigational)
Assessment of ADAMTS13 and VWF in acute cholangitis severity (investigational)
Evaluation/recognition of TMA after acute pancreatitis (including TPE decision support in reported cases) (investigational)
Research/associations of ADAMTS13 (genetic mutations or expression) in melanoma and other cancers (investigational)

AETNA-CPB-0780 — ADAMTS13 Assay for Thrombotic Thrombocytopenic Purpura (TTP)

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