Bladder Tumor Marker FISH Billing and Coding Guidelines

This article introduces two CPT Codes to report in situ hybridization (e.g., FISH) testing for bladder tumor markers: 88120 and 88121. Palmetto GBA will only cover these tests when performed using validated assays such as the UroVysion Bladder Cancer Kit, an assay performed on urine specimens from persons with hematuria who are suspected of having bladder cancer. It also serves as an aid for initial diagnosis of bladder carcinoma and subsequent monitoring for tumor recurrence in patients previously diagnosed with bladder cancer. This article also contains claim information for billing services for the UroVysion Bladder Kit. Medicare Part A and Part B MAC for Jurisdiction 11; comprised of North Carolina, South Carolina, Virginia and West Virginia. Medicare Part A and Part B MAC for Jurisdiction 1; comprised of California, Hawaii and Nevada. They are also the Ohio Part B Carrier.