Multiplex molecular identification of pathogens from cultured blood specimens

Description

This procedure involves the amplification and identification of DNA or RNA targets from a previously cultured blood specimen. It specifically detects at least six genetic markers to accurately identify pathogenic organisms and assess their resistance to medications.

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 59Distinct procedural service for non-E/M services(15.69%)

HCPCS/CPT 26Professional component of diagnostic services(9.8%)

HCPCS/CPT 91Repeat clinical diagnostic laboratory test performed on the same day(7.84%)

HCPCS/CPT GZItem or service expected to be denied as not reasonable and necessary(5.88%)

HCPCS/CPT 90Reference laboratory services performed by an outside laboratory(5.88%)

HCPCS/CPT GWService unrelated to hospice patient's terminal condition(3.92%)

HCPCS/CPT GVAttending physician not employed by hospice provider(1.96%)

HCPCS/CPT Q1Routine clinical service in an approved clinical research study(1.96%)

HCPCS/CPT Q4Service exemption for laboratory services by ordering/referring physician(1.96%)

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)