Molecular Diagnostics at Abbott


The information contained in this website has been compiled by CodeMap, L.L.C. to assist Abbott customers. CodeMap, L.L.C. remains solely responsible for its content. The information provided is for general educational purposes only and may not be conclusive or exhaustive. Recent changes in applicable law, regulations and interpretations may not be reflected in the information contained herein. For technical questions, please contact Dr. Charles Root.

For other questions, please contact the Abbott Reimbursement Helpline at (800) 553-7042, option 6.


Fees reflect revised 2021 Physician Fee Schedule Updated 1/5/2021. Source

The Coronavirus Aid, Relief, and Economic Security (CARES) Act suspended the payment adjustment percentage of 2% applied to all Medicare Fee-For-Service (FFS) claims from May 1 through December 31. The Consolidated Appropriations Act, 2021, signed into law on December 27, extends the suspension period to March 31, 2021. An Act to Prevent Across-the-Board Direct Spending Cuts, and for Other Purposes, signed into law on April 14, 2021, extends the suspension period to December 31, 2021.
Click here for more information.



      FISH
            AneuVysion®
      RealTime PCR
            RealTime CT/NG
            RealTime CMV
            RealTime HBV
            RealTime HCV
            RealTime HCV Genotype II
            RealTime HIV-1
            RealTime SARS-CoV-2

      Sequencing
            ViroSeq HIV-1 Genotyping System

      Alinity m
            Alinity m HBV Assay
            Alinity m HCV Assay
            Alinity m HIV Assay
            Alinity m Resp-4-Plex
            Alinity m SARS-CoV2 Assay

      FISH
            PathVysion® HER-2 DNA Probe Kit
            UroVysion®
            Vysis ALK Break Apart FISH Probes Kit
            Vysis CLL FISH Probe Kit
            Vysis EGR1 FISH Probes Kit

      RealTime PCR
            RealTime IDH1®
            RealTime IDH2®
Alinity m SARS-CoV2 Assay

U.S. Medicare Part B Reimbursement for
Fees Reflect 2021 CMS Medicare Fee Schedules

Alinity m SARS-CoV2 Assay



Procedure Code: U0003*   CCI   MUE  

Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r

Medicare Fee Schedule Amount: $ 75.00

*U0003 has been issued by CMS and the effective date is for dates of service on/after April 14,2020; there will not be any retroactivity.

*SOURCE: Centers for Medicare and Medicaid Services Ruling No. CMS-2020-01-R effective April 14, 2020 available at: https://www.cms.gov/files/document/cms-2020-01-r.pdf



Procedure Code: U0005*   MUE  

Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2

Medicare Fee Schedule Amount: $ 25.00

*U0005 has been issued by CMS and the effective date is for dates of service on/after January 1, 2021; there will not be any retroactivity.

*SOURCE: Centers for Medicare and Medicaid Services Ruling No. CMS-2020-01-R2 available at: https://www.cms.gov/files/document/cms-ruling-2020-1-r2.pdf



Procedure Code: 87635*   CCI   MUE  

Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique
Medicare Laboratory Fee Schedule Amount: $51.31*
*Reimbursement information source: Centers for Medicare and Medicaid Services Medicare Administrative Contractor (MAC) COVID-19 Test Pricing, May 19, 2020, available at: https://www.cms.gov/files/document/mac-covid-19-test-pricing.pdf

LOINC Codes-Updated 3/29/2018

Under the MolDx program, certain molecular tests require a Z-Code(TM) identifier in addition to the appropriate CPT code. Services within the scope of this program require the Z-Code(TM) to be submitted as additional information at the time of claim submission in order to be fully adjudicated Laboratories performing these molecular tests may be required to register with the MolDx program for each molecular pathology test they furnish. For more information on the MolDx program, registration and covered procedures, please click here: https://www.palmettogba.com/palmetto/MolDX.nsf

The information contained in this website has been compiled by CodeMap, L.L.C. to assist Abbott customers in preparing and submitting claims to Federal health care programs and CodeMap, L.L.C. remains solely responsible for its content. The information provided is for general educational purposes only and may not be conclusive or exhaustive. Recent changes in applicable law, regulations and interpretations may not be reflected in the information contained herein.

Abbott assumes no responsibility for omissions or errors contained in this website. Abbott does not guarantee that the use of any information provided herein will result in coverage or payment by Federal health care programs at any particular level. Many factors affect Federal health care program reimbursement, not all of which may be described in the information provided. Website users are encouraged to seek individual legal and/or coding guidance. IN PROVIDING THIS WEBSITE, ABBOTT MAKES NO WARRANTIES, EXPRESS, IMPLIED OR STATUTORY, INCLUDING, BUT NOT LIMITED TO, WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE AND/OR NON-INFRINGEMENT.

Abbott is not responsible for any actions taken by website users in billing Medicare or Medicaid for Abbott products, equipment or devices, including but not limited to, any billing and/or coding errors. Website users rely on the information contained in this website at their own risk and should check with the individual Federal health care program contractors to verify coverage, coding and payment. As a courtesy to its customers, Abbott provides the most accurate and up-to-date information available, but it is subject to change and interpretation. The customer is ultimately responsible for determining the appropriate codes, coverage, and payment policies for individual patients. Abbott does not guarantee third party coverage or payment for our products or reimburse customers for claims that are denied by third party payors.

This website is a private website and is not associated, endorsed or authorized by the Department of Health and Human Services, the Center for Medicare and Medicaid Services or any other public or government organization or agency. © 2019 Abbott. All rights reserved. All trademarks referenced are trademarks of either the Abbott group of companies or their respective owners.

CPT copyright 2020 American Medical Association. All rights reserved.

09/17/2021 11:00:49