Prenatal Cystic Fibrosis Screening Update

Effective for dates of service on or after February 1, 2009, providers performing molecular diagnostic testing to screen for the presence of a mutant cystic fibrosis gene may bill for a quantity greater than 25 for the combination of required laboratory tests (CPT-4 codes 83890 - 83914).

In addition, the following conditions apply:

  • When codes 83890 - 83914 are used to bill for the purpose of cystic fibrosis screening tests, ICD-9-CM code V26.31 (testing of female of genetic disease carrier status) or code V26.34 (testing of male for genetic disease carrier status) is required.
  • Codes 83890 - 83914 must be billed with modifier 8A (genetic cystic fibrosis) when a potential carrier is tested for cystic fibrosis.
  • Screening for cystic fibrosis carrier status is limited to once in the recipient's lifetime.
  • The maximum reimbursement for any combination of the above codes remains $180.

Published by XIFIN
INDUSTRY NEWS TAGS: California Medi-Cal

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