Wiki Billing for Unlisted code 84179

[sdduck]

Hi All

Does anyone have experience with billing the code 81479, The Current Procedural Terminology (CPT) code 81479 as maintained by American Medical Association, is a medical procedural code under the range - Tier 2 Molecular Pathology Procedures? We are particularly looking for payers that have the code in the fee schedule.
Please let me know any help is appreciated

 

[chetanemerson]

code 81479

Hi All

Does anyone have experience with billing the code 81479, The Current Procedural Terminology (CPT) code 81479 as maintained by American Medical Association, is a medical procedural code under the range - Tier 2 Molecular Pathology Procedures? We are particularly looking for payers that have the code in the fee schedule.
Please let me know any help is appreciated

we have experience in billing 81479, would be glad to help with payers

 

[TThivierge]

CPT 81479 Out of Sequence Path Lab Code

Hi All

Does anyone have experience with billing the code 81479, The Current Procedural Terminology (CPT) code 81479 as maintained by American Medical Association, is a medical procedural code under the range - Tier 2 Molecular Pathology Procedures? We are particularly looking for payers that have the code in the fee schedule.
Please let me know any help is appreciated

Hi
Ok this is a out of sequence code which CPT manual tells you to view other CPT 81400 to 81450 which lab is close to what doc needs regarding genetic testing. I would use one of those CPT in the range of CPT codes close to what doc is doing. Read the CPT descriptions of 81400 to 81471 This is for genetic testing for differ diseases...which depends on physician documentation and selected dx. code. Check with your payer see if covers it. I am sure Medicare has more descriptions and fee ranges.

I hope this info helps you.

Lady T

 

[danachock]

Billing for Unlisted procedure code 81479

Hi, I will provide instructions on how our facility has billed this procedure out for as long as I can recall from when I was a laboratory coder. This is an unlisted procedure - we have this procedure purposely "hard stopped" on both the HB & PB HARs to add the necessary "procedure description" on what is being tested. When I google 81479 in our facilities laboratory catalog there is several possibilities that this procedure could represent (https://essentiahealth.testcatalog.org/search?q=81479). I'm not brought in often to review/or work denials very often, so I am unsure if adding that procedure description actually satisfies a possible denial or not. However, if a denial specialist asked me my opinion on this I would provide the test that was conducted and the reason(s) why... to suffice medical necessity to utilize an appeal.
I wish you success battling any denials!
Thanks,
Dana Chock, RHIT, CPC, CANPC, CHONC, CPMA, CPB
Coding Analyst