Lab Pricing updated for certain manually priced codes
May 28, 2014Effective July 1, 2014, the Indiana Health Coverage Programs (IHCP) is updating the pricing for the following CPT codes. The pricing for these procedure codes is changing from manual pricing to maximum fee pricing. The IHCP will adopt Medicare’s maximum fee rate for the listed codes for dates of service on or after July 1, 2014.
|
Proceure Code |
Description |
|
81211 |
BRCA1, BRCA2 (breast cancer 1 and 2) (eg, hereditary breast and ovarian cancer) gene analy-sis; full sequence analysis and common duplication/deletion variants in BRCA1 (ie, exon 13 del 3.835kb, exon 13 dup 6kb, exon 14-20 del 26kb, exon 22 del 510bp, exon 8-9 del 7.1kb) |
|
81212 |
BRCA1, BRCA2 (breast cancer 1 and 2) (eg, hereditary breast and ovarian cancer) gene analysis; 185delAG, 5385insC, 6174delT variants |
|
81213 |
BRCA1, BRCA2 (breast cancer 1 and 2) (eg, hereditary breast and ovarian cancer) gene analysis; uncommon duplication/deletion variants |
|
81214 |
BRCA1 (breast cancer 1) (eg, hereditary breast and ovarian cancer) gene analysis; full se-quence analysis and common duplication/deletion variants (ie, exon 13 del 3.835kb, exon 13 dup 6kb, exon 14-20 del 26kb, exon 22 del 510bp, exon 8-9 del 7.1kb) |
|
81215 |
BRCA1 (breast cancer 1) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant |
|
81217 |
BRCA2 (breast cancer 2) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant |
|
81235 |
EGFR (epidermal growth factor receptor) (eg, non-small cell lung cancer) gene analysis; common variants (eg, exon 19 LREA deletion, L858R, T790M, G719A, G719S, L861Q) |
|
81321 |
PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; full sequence analysis |
|
81322 |
PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; known familial variant |
|
81323 |
PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; duplication/deletion variant |