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While Sequestration is in effect, all Medicare payments for services will be reduced by 2%.
The Medicare fees below do not reflect this reduction. Click here for more information.

1. Please select your state/locality before continuing:



Cardiovascular


Alere Cholestech LDX® System


Click here for information on coding and reimbursement for automated tests

Test Name
Order #
CPT® Code1
CPT® Code Description
Medicare Coverage2
National
Medicare
Reimbursement3
National
Medicaid
Reimbursement4
Lipid Profile•GLU
10-991
*
*Click here to login.
CCI   NCD Screening  
$ 20.21
N/A
*
*Click here to login.
CCI   NCD Screening  
Lipid Profile
10-989
*
*Click here to login.
CCI   NCD Screening  
$ 18.24
N/A
TC•HDL•GLU
10-990
*
*Click here to login.
CCI   NCD Screening  
$ 18.24
N/A
*
*Click here to login.
CCI   NCD Screening  
*
*Click here to login.
CCI   NCD Screening  
TC•HDL
10-987
*
*Click here to login.
CCI   NCD Screening  
$ 17.08
N/A
*
*Click here to login.
CCI   NCD Screening  
TC•GLU
10-988
*
*Click here to login.
CCI   NCD Screening  
$ 7.10
N/A
*
*Click here to login.
CCI   NCD Screening  
TC
10-986
*
*Click here to login.
CCI   NCD Screening  
$ 5.92
N/A
The national limit for any cassette or cassette combination including Lipid Profile was determined from the three constituent tests of the lipid panel; payers may pay the lesser of the fee schedule amount for an individual automated test panel test or the amount for 1-2 automated tests, so the lesser of the two amounts is shown.


Coding for individual tests
(using indicated Alere Cholestech LDX® test cassette to obtain result)
Test Name
Order #
CPT® Code1
CPT® Code Description
Medicare Coverage2
National
Medicare
Reimbursement3
National
Medicaid
Reimbursement4
Glucose alone
(Use TC•GLU)
10-988
*
*Click here to login.
CCI   NCD Screening  
$ 5.35
N/A
Glucose tolerance test (GTT; use TC•GLU)
10-988
*
*Click here to login.
CCI   Screening  
$ 17.53
N/A
GTT, additional samples (use TC•GLU)
10-988
*
*Click here to login.
CCI    
$ 5.34
N/A
HDL cholesterol alone (use TC•HDL)
10-987
*
*Click here to login.
CCI   NCD Screening  
$ 11.16
N/A
Triglycerides (TRG) alone
(use Lipid Profile)
10-989
*
*Click here to login.
CCI   NCD Screening  
$ 7.10
N/A



Alere Triage® System

Test Name
Order #
CPT® Code1
CPT® Code Description
Medicare Coverage2
National
Medicare
Reimbursement3
National
Medicaid
Reimbursement4
BNP
98000XR
*
*Click here to login.
 
$ 46.24
N/A
D-dimer
98100
*
*Click here to login.
CCI    
$ 13.87
N/A
Cardiac Panel (Troponin)
97021HS
*
*Click here to login.
 
$ 13.40
N/A
CK-MB (using Test Select)
97000HS 97022HS
*
*Click here to login.
CCI    
$ 15.73
N/A
Myoglobin (using Test Select)
97000HS
*
*Click here to login.
 
$ 17.59
N/A
Cardiac Panel (CK-MB and Troponin)
97022HS
*
*Click here to login.
 
$ 29.13
N/A
*
*Click here to login.
CCI    
Cardiac Panel
97000HS
*
*Click here to login.
CCI    
$ 46.72
*
*Click here to login.
 
*
*Click here to login.
 



Clearview® Simplify® D-dimer

Test Name
Order #
CPT® Code1
CPT® Code Description
Medicare Coverage2
National
Medicare
Reimbursement3
National
Medicaid
Reimbursement4
D-dimer
6100KCV
*
*Click here to login.
CCI    
$ 13.87
N/A



Alere Triage® BNP Test for the Beckman Coulter® Access Family of Immunoassay Systems

Test Name
Order #
CPT® Code1
CPT® Code Description
Medicare Coverage2
National
Medicare
Reimbursement3
National
Medicaid
Reimbursement4
BNP
98200
*
*Click here to login.
 
$ 46.24
N/A



Alere INRatio®2 PT/INR Professional Monitoring System


Click here for information on reimbursement for home PT/INR monitoring (patient self-testing)

Test Name
Order #
CPT® Code1
CPT® Code Description
Medicare Coverage2
National
Medicare
Reimbursement3
National
Medicaid
Reimbursement4
Alere INRatio® PT/INR Test Strips
0100139
*
*Click here to login.
CCI   NCD  
$ 5.36
N/A



Cardiovascular, Other

Test Name
Order #
CPT® Code1
CPT® Code Description
Medicare Coverage2
National
Medicare
Reimbursement3
National
Medicaid
Reimbursement4
MacraTM Lp(a)
339100
*
*Click here to login.
CCI    
$ 17.63
N/A





1Providers operating under a CLIA waiver should use the QW modifier when appropriate.

2CCI, Correct Coding Initiative edits; NCD, National Coverage Determination; LCD, Local Coverage Determination

3Centers for Medicare and Medicaid Clinical Diagnostic Laboratory Fee Schedule 2016, available at:
http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ClinicalLabFeeSched/clinlab.html



CPT copyright 2014 American Medical Association. All rights reserved.

The Medicare information provided on this website is current as of 06/28/2016, was obtained from publicly available sources, and is subject to change without notice. All content on this website is for informational purposes only, is general in nature, and does not cover all situations or all payers' rules and policies.

Alere cannot guarantee or promise coverage or payment for any particular item or service from any payer or health benefit plan. To be eligible for coverage, an item or service must be medically necessary for the individual patient, have been performed as reported, and appropriate documentation should be available in the patient's medical record.

It is the individual provider's responsibility to determine appropriate, medically necessary coding, charges and claims for a particular service. Providers are responsible for determining medical necessity for all Medicare and/or Medicaid recognized panel tests. To be eligible for coverage, each component test must be medically necessary for the individual patient. In addition, for tests grouped on single cassettes or cartridges, providers are responsible for determining the medical necessity of each test for each patient. Laws, regulations and payer policies regarding appropriate coding and payment levels can vary greatly from payer to payer and change over time. Alere recommends that providers contact their own regional payers to determine appropriate coding and charge or payment levels.

Alere specifically disclaims liability or responsibility for the results or consequences of any actions taken in reliance on information on this website.

This information is compiled and maintained by CodeMap® which remains solely responsible for its content.

All trademarks referenced are trademarks of their respective owners.



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