Billing and Coding: Genetic Testing for Cardiovascular Disease

Per LCD L39084, genetic testing for cardiovascular disease is not currently covered because no genes meet the LCD/ClinGen evidence standards; CPT 81406 is not appropriate for cardiovascular genetic testing. Billing of non-covered services must use the appropriate modifier and all LCD limitations apply. Extensive medical-record documentation is required to support coding, demonstrate the ordering clinician's role, document pre- and post-test counseling, disease phenotyping, and clinical actionability if testing is performed.

"No genes currently meet the coverage criteria under LCD L39084 for genetic testing for cardiovascular disease, therefore genetic testing for cardiovascular disease is not covered."

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