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Alternative Code for BRCA Genetic Testing

  1. #1
    Salisbury, MD
    Default Alternative Code for BRCA Genetic Testing
    Medical Coding Books
    Does anyone know what an alternative code(s) to S3818-S3820 (BRCA Genetic Analysis) would be to use with a patient undergoing the BRCA genetic (Breast CA) testing where S-Codes are not allowable/billable? Not necessarily the test is not allowable but S-codes in general are not allowable/billable?


  2. #2
    Default 88299?
    88299 looks like the closest code I can find for this......

    Any other suggestions?



  3. Default
    I posted this same question on the Path and Lab discussion forum! I had the same instance where I needed to find something other than the 'S' code with Medicaid. I called my lab to ask them about this and someone found me a print out on AMA. A lot of codes come up for BRCA, but only one came up for BRCA TESTING and that is reads Molecular diagnositcs; isolation or extraction of highly purified nucleic acid. So, that says nothing about BRCA specifically, but that's according to our lab. I've thought about calling Labcorp or Quest and see what they use.

    Amanda, CPC
    Urology coder

  4. #4
    Salisbury, MD
    Thanks you guys! Very helpful.

  5. Default
    Below is the series of CPT codes we bill for the BRAC testing, these codes were obtained from the reference lab doing the test.

    COMP BRAC ANALYSIS 83891, 83898 x81, 83904 x81, 83909 x81, 83912
    BRAC1 (Single Site) 83891, 83898, 83904, 83909, 83912
    BRAC2 (Single Site) 83891, 83898, 83904, 83909, 83912

  6. #6
    Greeley, Colorado
    Are you all doing the actual test in your office or are they going to an outside lab?
    Lisa Bledsoe, CPC, CPMA

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