BILLING NEWS

Hepatitis C Genotype Restriction Update

Effective for dates of service on or after December 1, 2008, CPT-4 code 87902 (infectious agent genotype analysis by nucleic acid [DNA or RNA]; hepatitis C virus) must be billed in conjunction with one of the following ICD-9-CM diagnosis codes:

ICD-9-CM Code Description
070.41 Acute hepatitis C with hepatic coma
070.44 Chronic hepatitis C with hepatic coma
070.51 Acute hepatitis C without mention of hepatic coma
070.54 Chronic hepatitis C without mention of hepatic coma
070.70 Unspecified viral hepatitis C without hepatic coma
070.71 Unspecified viral hepatitis C with hepatic coma
V02.62 Hepatitis C carrier

Diagnosis Restrictions Removed for Various HIV Tests

Effective for dates of services on or after December 1, 2008, any ICD-9-CM diagnosis code may be billed with the following CPT-4 codes:

86701 Antibody; HIV-1
86702 HIV-2
86703 HIV-1 and HIV-2, single assay

This change is pursuant to Assembly Bill 1894, which directs that HIV testing should be available regardless of whether the testing is related to a primary diagnosis.


Published by XIFIN
INDUSTRY NEWS TAGS: California Medi-Cal


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