Client and patient satisfaction is our first priority. We are pleased to provide this guide to assist in determining test coverage under Medicare Local and National Coverage Determination guidelines. Select generic drug name below to identify CPT and ICD-10 codes.
The information referenced in this guide is provided as an aid to physicians and office staff in determining when an ABN (Advance Beneficiary Notice) is necessary. It is the sole responsibility of the ordering physician to determine the appropriate diagnosis code(s) for the specific date of service based on the patient’s signs and symptoms. GeneIQ’s distribution of this information is provided as a customer service and does not suggest nor is it meant to suggest than any of these codes should or should not be used on any given occasion. The codes provided do not represent a complete list. Please refer to an ICD-10 manual for complete listing.
The ICD-10 codes referenced in this guide are listed as medically supportive under CMS Local Coverage Article A58801. Please refer to Local Coverage Determination (LCD) L39063 , Pharmacogenomics Testing for reasonable and necessary requirements.
Please refer to National Coverage Determination (NCD) for Pharmacogenomic Testing for Warfarin Response (90.1) for complete details regarding reasonable and necessary requirements for CYP2C9 and VKORC1. If you are ordering tests for diagnostic reasons that are not covered under Medicare policy, an Advance Beneficiary Notice form is required.