Antibody to smooth muscle actin (ASMA) test, serum

Description

This test detects antibodies to smooth muscle actin (ASMA) in serum, which is useful in diagnosing autoimmune hepatitis. The presence of ASMA indicates that the immune system is attacking liver cells, leading to chronic liver inflammation. A common method for this test is an enzyme-linked immunosorbent assay (ELISA).

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 90Reference laboratory services performed by an outside laboratory(37.5%)

HCPCS/CPT 91Repeat clinical diagnostic laboratory test performed on the same day(4.55%)

HCPCS/CPT GWService unrelated to hospice patient's terminal condition(3.98%)

HCPCS/CPT 59Distinct procedural service for non-E/M services(3.41%)

HCPCS/CPT GAWaiver of liability statement issued per payer policy(2.27%)

HCPCS/CPT 26Professional component of diagnostic services(1.14%)

HCPCS/CPT Q4Service exemption for laboratory services by ordering/referring physician(1.14%)

HCPCS/CPT GYItem or service excluded from Medicare benefits(1.14%)

HCPCS/CPT POOutpatient services at off-campus provider-based departments(0.57%)

HCPCS/CPT XSSeparate structure service on distinct organ or structure(0.57%)

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)