Billing and Coding: B-Type Natriuretic Peptide (BNP)

BNP testing is covered when it meets the reasonable and necessary clinical criteria of LCD L33267 and is performed in allowed places of service (POS 11, 21, 22, 23, 20, 81) with immediate availability of results. Billing requires complete, legible medical record documentation that supports ICD-10-CM and CPT/HCPCS coding, an order from the treating physician/NPP per 42 CFR 410.32(a), and retention of test result documentation when the performing provider differs from the ordering provider; non-covered services must be billed with the appropriate modifier.

"B-Type Natriuretic Peptide (BNP) testing is covered when performed in an allowed place of service (office POS 11, inpatient hospital POS 21, outpatient hospital POS 22, emergency room – hospital PO..."

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