Nonantibody immunoassay for analyte detection and quantification

Description

This code describes a laboratory test that utilizes a nonantibody immunoassay to detect and measure specific noninfectious analytes. The results are reported as positive, negative, or in a semiquantitative numerical format, indicating whether levels are normal or abnormal.

Medicare Hospital Outpatient Reimbursement (OPPS)

OPPS Payment Rate

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Patient Copayment / Coinsurance

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Top Modifiers

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HCPCS/CPT QWCLIA waived laboratory tests(38.53%)

HCPCS/CPT 59Distinct procedural service for non-E/M services(23.1%)

HCPCS/CPT 90Reference laboratory services performed by an outside laboratory(13.6%)

HCPCS/CPT LTModifier for procedures performed on the left side of the body(11.44%)

HCPCS/CPT RTRight side procedure modifier(10.9%)

HCPCS/CPT 91Repeat clinical diagnostic laboratory test performed on the same day(8.31%)

HCPCS/CPT XUUnusual non-overlapping service(3.45%)

HCPCS/CPT GWService unrelated to hospice patient's terminal condition(3.18%)

HCPCS/CPT GYItem or service excluded from Medicare benefits(2.27%)

HCPCS/CPT GAWaiver of liability statement issued per payer policy(1.51%)

Code Crosswalks

No crosswalks found.

Alternate Codes

No alternates found.

Billed With Codes

No codes found here.

Sources

We make no claims to ownership of the coding systems referenced on this platform. Codes and descriptions are produced from claims and chargemaster data available through the CMS-9915-F Transparency in Coverage Final Rule and via state or federal datasets. This service is provided solely as a reference to encourage use of these codes in our chargemaster review and automated billing tools, so that healthcare professionals can understand and correctly report these codes in their claims.

Federal and State Datasets

List of CPT/HCPCS Codes, Centers for Medicare & Medicaid Services (CMS)
I/OCE Quarterly Release Files, Centers for Medicare & Medicaid Services (CMS)
Physician Fee Schedule Relative Value Files, Centers for Medicare & Medicaid Services (CMS)
OPPS Addendum B, Centers for Medicare & Medicaid Services (CMS)
ASC Payment Addenda, Centers for Medicare & Medicaid Services (CMS)