BILLING NEWS

Initial Trofile Test Update

The Pathology: Microbiology section of the Part 2 provider manual was updated with new guidelines for providers billing an initial test with Trofile using CPT-4 code 87999 (unlisted microbiology procedure).

The new guidelines state that the indication for a Trofile test is based on Guidelines for the Use of Anti-retroviral Agents In HIV-1 Infected Adults and Adolescents developed by the U.S. Department of Health and Human Services (HHS) Panel on “Anti-retroviral Guidelines for Adults and Adolescents – A Working Group” of the Office of AIDS Research Advisory Council (OARAC).

The first Trofile test will be reimbursed when providers document the following items:

  • The use of a CCR5 inhibitor is being considered, or
  • The patient exhibits virologic failure on a CCR5 inhibitor.
Source: General Medicine | August 2010 | Bulletin 434

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INDUSTRY NEWS TAGS: California Medi-Cal


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