CPT^® 81220, Under Genetic Analysis Procedures

The Current Procedural Terminology (CPT^®) code 81220 as maintained by American Medical Association, is a medical procedural code under the range - Genetic Analysis Procedures.

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Summary

The lab analyst performs the technical lab test to detect the presence of changes in the gene for cystic fibrosis transmembrane conductance regulator, also known as CFTR. The test evaluates the CFTR mutations such as those identified by the American College of Medical Genetics/American College of Obstetricians guidelines most commonly associated with CF, currently a panel of 23 mutations.

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81220 & 81420

CMS NCCI policy bundles 81220 into 81420, which is why it would be denied. I believe the general source of the CCI policy is this CMS policy below, which prohibits duplicate, confirmatory testing for... [ Read More ]

Cystic Fibrosis Profile

[QUOTE="Revenuecycle, post: 262318, member: 20615"] Do we code cystic fibrosis profile with 81220? Is this reimbursed? I dont see it on BC/BS or Medicare's Lab fee schedule, does anyone know? Thanks ... [ Read More ]

81220 & 81420

Hey everyone, I am getting denials relating to code 81220 being inclusive to procedure 81420. Does anyone know why the carrier would deny this way?... [ Read More ]

81220 & 81420

Can anyone help answer why UHC would be denying stating that 81220 is inclusive to 81420 and therefore is an unbundled code?... [ Read More ]

Pricing lab components for panels

Our office now uses lab corp for some panels but we pay lab corp a fee rather than them billing patients. The fee for this needs to be added to the pricing on our end. My question is do I enter the fe... [ Read More ]

Cystic Fibrosis Profile

Do we code cystic fibrosis profile with 81220? Is this reimbursed? I dont see it on BC/BS or Medicare's Lab fee schedule, does anyone know? Thanks... [ Read More ]

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