Billing and Coding: In Vitro Chemosensitivity & Chemoresistance Assays

Coverage and medical necessity for in vitro chemosensitivity and chemoresistance assays are determined by LCD L34554. Claims seeking a CSRA denial must report the applicable CPT code(s); ABNs are not required for statutorily excluded services, but if a voluntary ABN is issued append modifier GX, and use modifier GY to identify statutorily excluded services.

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

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