High Sensitivity C-Reactive Protein

An article published in Medicare B Resource for June 2003 (page 21) announced that Medicare considered High sensitivity C-reactive protein to be used as a screening test only and therefore not reimbursable. This policy is being revised based on updated information. High sensitivity C-reactive protein (hsCRP) (CPT code 86141) has been found to be related to or somewhat predictive of atherogenic risk for cardiovascular disease or stroke. Recent literature supports this as the principal use of hsCRP. Effective immediately, NHIC-California will consider hsCRP (CPT 86141) for payment as part of the overall evaluation and treatment plan indicated for the signs or symptoms of disease. In the absence of signs or symptoms of disease, use of hsCRP as a screening test remains non covered by Medicare. In addition, where appropriate, the less costly standard CRP test (CPT 86140) should be considered.