tci Part B Insider - 2004 Issue 30

Physician Notes: Carrier Does Coverage Backflip, Will Reimburse 86141

Part B Carrier NHIC California reversed its previous decision and said it would cover high-sensitivity C-reactive protein (hsCRP) (86141) after all. In June 2003, NHIC said it considered hsCRP to be a screening test and therefore not reimbursable. The change came after new data showed hsCRP was related to, or somewhat predictive of, atherogenic risk for cardiovascular disease or stroke. But you have to document signs and symptoms of the disease being evaluated or diagnosed, or it will remain non-covered.The Centers for Medicare & Medicaid Services released quarterly changes to the 2003 physician fee schedule. Code G0336-26 (PET...

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