Qualitative measurement of C-reactive protein in serum

Description

This code represents a laboratory test that measures the presence of C-reactive protein (CRP) in serum. Elevated levels of CRP indicate inflammation in the body, which can be associated with various medical conditions, including infections and chronic diseases.

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 GWService unrelated to hospice patient's terminal condition(8.24%)

HCPCS/CPT 90Reference laboratory services performed by an outside laboratory(4.73%)

HCPCS/CPT GAWaiver of liability statement issued per payer policy(3.56%)

HCPCS/CPT 59Distinct procedural service for non-E/M services(2.63%)

HCPCS/CPT GVAttending physician not employed by hospice provider(2.58%)

HCPCS/CPT 91Repeat clinical diagnostic laboratory test performed on the same day(2.05%)

HCPCS/CPT GZItem or service expected to be denied as not reasonable and necessary(2%)

HCPCS/CPT 26Professional component of diagnostic services(1.8%)

HCPCS/CPT Q1Routine clinical service in an approved clinical research study(1.22%)

HCPCS/CPT GYItem or service excluded from Medicare benefits(0.68%)

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)