Detection of gastrointestinal pathogens using nucleic acid amplification

Description

This laboratory test identifies 12 to 25 types or subtypes of gastrointestinal pathogens, including Clostridium difficile and E. coli, through advanced nucleic acid amplification techniques. The method may involve multiplex reverse transcription and amplified probe techniques for accurate pathogen detection.

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 GZItem or service expected to be denied as not reasonable and necessary(18.76%)

HCPCS/CPT 90Reference laboratory services performed by an outside laboratory(17.37%)

HCPCS/CPT GAWaiver of liability statement issued per payer policy(13.97%)

HCPCS/CPT 59Distinct procedural service for non-E/M services(7.98%)

HCPCS/CPT GWService unrelated to hospice patient's terminal condition(4.39%)

HCPCS/CPT XUUnusual non-overlapping service(1.8%)

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

HCPCS/CPT GYItem or service excluded from Medicare benefits(1%)

HCPCS/CPT 91Repeat clinical diagnostic laboratory test performed on the same day(0.8%)

HCPCS/CPT AQService rendered in a health professional shortage area(0.6%)

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)