Gastrointestinal Pathogen Nucleic Acid Detection Panel Testing
Defines coverage and reimbursement criteria for gastrointestinal pathogen multiplex nucleic acid (NAAT) panel testing for Fidelis Care Medicare products, including which CPT codes are covered and place-of-service restrictions.
Changed applicable products from 'ALL' to 'Medicare.'
Changed 'Last Review Date' in header to 'Date of Last Revision.'
Coverage Criteria
Coverage by CPT and place of service
Specifies which CPT codes are covered and any place-of-service limitations.
ALL of the following
- CPT 87505 — Infectious agent detection by nucleic acid; gastrointestinal pathogen, 3-5 targets; covered in any place of service.
- CPT 87506 — Infectious agent detection by nucleic acid; gastrointestinal pathogen, 6-11 targets; covered in any place of service.
ALL of the following
- Place of service code 21 — Inpatient Hospital.
- Place of service code 22 — Outpatient Hospital (Observation).
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