Billing and Coding: Cystatin C Measurement

Coverage for cystatin C measurement is determined by the reasonable and necessary criteria in LCD L37561; services not meeting the LCD are not billable to Medicare and should be billed with the appropriate modifier when non-covered. Detailed documentation is required, including legible records with patient identifiers, provider signature, medical record support for the ICD-10-CM code, accurate CPT/HCPCS coding, and a physician requisition stating the diagnosis that warrants testing.

"Cystatin C measurement is covered when it meets the reasonable and necessary requirements specified in Local Coverage Determination L37561."

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