89240
HCPCS/CPT
Prior Authorization
No Prior Auth Required
No active coverage policies found for this code (low confidence)
Medicare Pricing
Work RVU
0.00
Facility
N/A
Non-Facility
N/A
Documentation Required
- To receive a CSRA denial, the claim must include the appropriate CPT code for the specific in vitro chemosensitivity/chemoresistance assay.
- For a voluntarily issued ABN, append modifier GX to the claim.
- If a voluntary ABN is issued, append the GX modifier to the CPT code on the claim.
- To indicate a statutorily excluded service on the claim, append the GY modifier to the CPT code.
Key Coverage Criteria
- Coverage and medical necessity determinations for in vitro chemosensitivity and chemoresistance assays follow the Local Coverage Determination L34554.
9 Active Policies
A56071 — Billing and Coding: In Vitro Chemosensitivity & Chemoresistance Assays
A56871 — Billing and Coding: In Vitro Chemosensitivity & Chemoresistance Assays
L34554 — In Vitro Chemosensitivity & Chemoresistance Assays
L37628 — In Vitro Chemosensitivity & Chemoresistance Assays
A56073 — Billing and Coding: In Vitro Chemosensitivity & Chemoresistance Assays
Related Codes
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