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Urology Coding Alert

Reader Question:

Retire 86294 For NMP-22 Bladder Test Checks

Published on Sun Jan 16, 2011

Question: We perform bladder test checks in the office fairly often. Recently we have been receiving denials from Medicare for these services. How should we be reporting the test?Michigan SubscriberAnswer: Nuclear matrix protein-22 (NMP-22), also known as the Bladder Test Check, is performed to detect abnormal proteins in the urine which might suggest the presence of a bladder tumor or carcinoma in situ. This test is most often performed in the office to monitor bladder cancer between cystourethroscopic procedure intervals. Old way: In the past, you billed this services using 86294 (Immunoassay for tumor antigen, qualitative or semi-qualitative [eg, bladder tumor antigen]) with modifier QW (CLIA waived test) attached.Right now: According to a Part B Medicare notification, dated Oct. 19, 2011, you should use 88299 (Unlisted cytogenetic study) to report this test until the end of 2011. Remember to add "NMP-22" in box 19 of the CMS-1500 form or in [...]
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