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Billing and Coding: Lab: Bladder/Urothelial Tumor Markers
A55028
Effective: November 6, 2025
Updated: December 31, 2025
Policy Summary
Noridian covers bladder/urothelial tumor marker FISH testing when performed using validated assays (currently UroVysion) on urine specimens for patients with hematuria suspected of bladder cancer and for surveillance of previously diagnosed bladder cancer. Billing must be submitted by a CLIA-certified laboratory using CPT 88120 or 88121 (1 unit per test), append the TC modifier for technical-only reporting, and physicians must personally perform and document any professional interpretive component.
Coverage Criteria Preview
Key requirements from the full policy
"FISH bladder tumor marker testing using a validated assay (e."
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