Diagnosis Code Added for Biochemical Assays

Effective for dates of service on or after March 1, 2014, CPT code 81508 (fetal congenital abnormalities, biochemical assays of two proteins [PAPP-A, hCG (any form)], utilizing maternal serum, algorithm reported as a risk score), and 81511 (fetal congenital abnormalities, biochemical assays of four analytes [AFP, uE3, hCG (any form), DIA] utilizing maternal serum, algorithm reported as a risk score [may include additional results from previous biochemical testing) are reimbursable with ICD-9-CM diagnosis code V28.89 (other specified antenatal screening). However, if the service dates of CPT codes 81508 and 81511 are within 70 days for the same recipient, the second claim will be denied.

Source: General Medicine | February 2014 | Bulletin 476