CodeMap®  150 North Wacker Drive
Suite 1870
Chicago, IL 60606
847-381-5465 Phone
847-381-4606 Fax

2020 Printed Publications Early Bird Sale on Now through August 30, 2019!

User Information

Create New Account

Lost Password


Quick Links

PLA Codes

Laboratory Fee Schedule


Physician Fee Schedule


OPPS Fee Schedule


ASC Fee Schedule


APC Codes


DRG Codes


ASP Drug Pricing Files

April 2019
January 2019

CMS Transmittals

CodeMap® Securing Codes and Reimbursement for New Products

Securing Codes and Reimbursement for New Products

Let CodeMap assist in developing a strategy for achieving optimal coding and Medicare reimbursement for your new clinical laboratory and diagnostic products. Our approach to solving coding and reimbursement problems generally involves the following steps.

  • We analyze existing codes, reimbursement and coverage to determine if it is adequate to cover the anticipated costs associated with your new product. If a suitable combination of existing codes can be employed and billed according to Medicare rules, the engagement ends at this point.

  • If existing CPT® or HCPCS codes can not be used to accurately describe your product, or are inadequately reimbursed to make the product economically feasible, we will assist in obtaining a new code or modifying existing codes to accurately describe your new product. This process can take as long as 18 months, so be sure to plan ahead.

  • Once a new code is obtained, CodeMap will assist you developing a successful strategy for securing appropriate reimbursement for the code from the Centers for Medicare and Medicaid Services (CMS). 

  • After appropriate reimbursement is achieved, CodeMap can also assist in securing favorable Medicare coverage policies (either national or local) for the new product by working with Medicare contractors and CMS to inform and convince them of the clinical value of the test.

During the past ten years CodeMap has successfully assisted over 18 prominent diagnostic companies in obtaining new codes and reasonable reimbursement for numerous new clinical assays including hsCRP, urine electrophoresis, lactoferrin, lipoprotein-associated phospholipase, West Nile virus, methicillin resistant Staph. aureus, Aspergillus and Trichomonas vagnialis to name a few.

Please contact Dr. Charles Root at 847-381-5465 or to discuss your specific needs.




CodeMap® is a Registered Trademark of Wheaton Partners, LLC.