Billing and Coding: Genetic Testing in Oncology: Specific Tests

UroVysion Bladder Kit services must be billed using CPT 88120 or 88121 with 'UroVysion' indicated in the claim narrative or attachment; laboratories reporting only the technical component must append the -TC modifier. Testing should be ordered only when the ordering clinician manages the patient's cancer or there is a substantiated suspicion of cancer, must follow LCD L39365 for coverage, and the medical record must document diagnosis/suspicion, counseling, how results will affect management, and provider signatures.

"Report UroVysion Bladder Kit services using CPT 88120 or 88121 as appropriate and include 'UroVysion' in the claim narrative (Loop 2400 NTE02 or SV101-7 for 5010A1 837P) or on an attachment for pap..."

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