Does 88356 require prior authorization?

No, 88356 does not require prior authorization (high confidence). Code is covered without prior authorization.

What is the Medicare reimbursement rate for 88356?

Medicare facility rate: $223.79. Non-facility rate: $223.79. Work RVU: 2.73.

HCPCS/CPT

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Work RVU

2.73

Facility

$223.79

Non-Facility

$223.79

Pathological analysis of intra-epidermal nerve fiber density for the diagnosis of small-fiber neuropathy is consideredmedically necessarywhenbothof the following conditions are met:
Individual presents with painful sensory neuropathy;and
No evidence of large-fiber neuropathy is present on the following:Physical examination (for example, reduced or absent muscle-stretch reflexes or reduced proprioception and vibration sensation);andElectromyography and nerve-conduction studies.
Physical examination (for example, reduced or absent muscle-stretch reflexes or reduced proprioception and vibration sensation);and
Electromyography and nerve-conduction studies.

ANTHEM-CG-LAB-13 — CG-LAB-13 Skin Nerve Fiber Density Testing

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