Does 89240 require prior authorization?

No, 89240 does not require prior authorization (low confidence). No active coverage policies found for this code.

What is the Medicare reimbursement rate for 89240?

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

HCPCS/CPT

No Prior Auth Required

No active coverage policies found for this code (low confidence)

Work RVU

0.00

Facility

N/A

Non-Facility

N/A

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.

Coverage and medical necessity determinations for in vitro chemosensitivity and chemoresistance assays follow the Local Coverage Determination L34554.

NORIDIAN-L37628 — In Vitro Chemosensitivity & Chemoresistance Assays

JF Part B

PALMETTO-L34554 — In Vitro Chemosensitivity & Chemoresistance Assays

JJ Part B

L34554 — In Vitro Chemosensitivity & Chemoresistance Assays

L37628 — In Vitro Chemosensitivity & Chemoresistance Assays

A56073 — Billing and Coding: In Vitro Chemosensitivity & Chemoresistance Assays

Ask Verity about documentation requirements, denial risks, or coverage in your state.