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DiaSorin

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Fees Reflect 2020 CMS Medicare Fee Schedules


Section 3709 of the Coronavirus Aid, Relief, and Economic Security (CARES) Act temporarily suspends the 2% payment adjustment currently applied to all Medicare Fee-For-Service (FFS) claims due to sequestration. The suspension is effective for claims with dates of service from May 1 through December 31, 2020.
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Infectious Disease
Catalog #
Test Name
LOINC Code
Procedure Code
Medicare Coverage
NATIONAL LIMIT
Reimbursement Amount
311460 SARS-CoV-2 S1/S2 IgG
94563-4
86769
  MUE  
$42.13
318330 Lyme Total Antibody Plus
31738-8
86618
  CCI   MUE  
$17.03
318240 Murex HCV Ab
13955-0
86803
  CCI   MUE  
$14.27
318130 Anti-HBc
83100-8
86704
  CCI   MUE   NCD
$12.05
318220 Anti-HBs
5193-8
86706
  CCI   MUE   NCD
$10.74
318980 H. pylori IgG
17859-0
86677
  CCI   MUE  
$16.85
310480 Treponema (screening or confirmatory)
47236-5
86780
  CCI   MUE  
$13.24
310740 Cytomegalovirus IgG
13949-3
86644
  CCI   MUE  
$14.39
310750 Cytomegalovirus IgM
24119-0
86645
  CCI   MUE  
$16.85
310510 Epstein-Barr Virus VCA IgG
24114-1
86665
  CCI   MUE  
$18.14
310500 Epstein-Barr Virus VCA IgM
24115-8
86665
  CCI   MUE  
$18.14
310520 Epstein-Barr Virus EBNA IgG
5156-5
86664
  CCI   MUE  
$15.29
310540 Epstein-Barr Virus EA IgG
40752-8
86663
  CCI   MUE  
$13.12
318090 Procalcitonin (PCT)
75241-0
84145
  CCI   MUE  
$27.22
310700 Toxoplasma IgG
86738-2
86777
  CCI   MUE  
$14.39
310710 Toxoplasma IgM
12262-2
86778
  CCI   MUE  
$14.41
310490 Varicella-Zoster Virus IgG
15410-4
86787
  CCI   MUE  
$12.88
310460 Rubella IgG
25514-1
86762
  CCI   MUE  
$14.39
310730 Rubella IgM
24116-6
86762
  CCI   MUE  
$14.39
310830 HSV-1 Type Specific IgG
51916-5
86695
  CCI   MUE  
$13.19
310620 HSV-2 Type Specific IgG
43180-9
86696
  CCI   MUE  
$19.35
310200 HAV Total
13951-9
86708
  CCI   MUE  
$12.39
310210 HAV IgM
13950-1
86709
  CCI   MUE  
$11.26
310870 Borrelia burgdorferi
22131-7
86618
  CCI   MUE  
$17.03
318810 Measles IgG
35275-7
86765
  CCI   MUE  
$12.88
318840 Mumps IgG
6476-6
86735
  CCI   MUE  
$13.05
317130D Antibody, Zika virus, IgM
80824-6
86794
  CCI   MUE  
$16.85
311020 QuantiFERON®-TB Gold Plus
basic interferon gamma response
88518-6
86480
  CCI   MUE  
$61.98
311020 QuantiFERON®-TB Gold Plus
enumeration of gamma interferon-producing T-cells
88517-8
86481
  CCI   MUE  
$100.00


Bone & Mineral Metabolism
Catalog #
Test Name
LOINC Code
Procedure Code
Medicare Coverage
NATIONAL LIMIT
Reimbursement Amount
310600 25 OH Vitamin D
35365-6
82306
  CCI   MUE  
$29.60
310980 Vitamin D; 1, 25 dihydroxy
35365-1
82652
  CCI   MUE  
$38.50
317910
310630
Parathyroid Hormone (PTH)
90741-0
83970
  CCI   MUE  
$41.28


Endocrinology
Catalog #
Test Name
LOINC Code
Procedure Code
Medicare Coverage
NATIONAL LIMIT
Reimbursement Amount
310450 Aldosterone
1768-1
82088
  CCI   MUE  
$40.75
316171 C-Peptide
1986-9
84681
  CCI   MUE  
$20.81
320680 Estradiol
2243-4
82670
  CCI   MUE  
$27.94
312251 FSH
15067-2
83001
  CCI   MUE  
$18.58
311531 FT3
3051-0
84481
  CCI   MUE  
$16.94
311611 FT4
3024-7
84439
  CCI   MUE   NCD
$9.02
312321 hCG
53959-3
84702
  CCI   MUE   NCD
$15.05
310340 hGH
2963-7
83003
  CCI   MUE  
$16.67
313231 IGF-1
2484-4
84305
  CCI   MUE  
$21.26
310360 Insulin
20448-7
83525
  CCI   MUE  
$11.43
312201 LH
10501-5
83002
  CCI   MUE  
$18.52
310690 Progesterone
2839-9
84144
  CCI   MUE  
$20.86
312171 Prolactin
15081-3
84146
  CCI   MUE  
$19.38
310350 Renin
47883-4
84244
  CCI   MUE  
$21.99
310410 Testosterone
2986-8
84403
  CCI   MUE  
$25.81
311222 TSH
11580-8
84443
  CCI   MUE   NCD
$16.80


Stool Diagnostics
Catalog #
Test Name
LOINC Code
Procedure Code
Medicare Coverage
NATIONAL LIMIT
Reimbursement Amount
318200 H. pylori SA
17780-8
87338
  CCI   MUE  
$14.38
318960 Calprotectin
82874-9
83993
  CCI   MUE  
$19.63
319140 Elastase-1
25907-7
82656
  CCI   MUE  
$11.53


Molecular
Catalog #
Test Name
LOINC Code
Procedure Code
Medicare Coverage
NATIONAL LIMIT
Reimbursement Amount
MOL2150 Simplexa HSV 1 & 2 Direct
16130-7
16131-5
87529 X 2
  CCI   MUE  
$70.18
MOL2655 Simplexa Flu A/B & RSV Direct Gen ll
76078-5
76080-1
76089-2
87631
  CCI   MUE  
$142.63
MOL2600 Simplexa Flu A/B & RSV
76078-5
76080-1
76089-2
87631
  CCI   MUE  
$142.63
MOL2500 Simplexa Influenza A H1N1
92809-3
87502
  CCI   MUE  
$95.80
MOL2750 Simplexa Bordetella Direct (Pertussis/Parapertussis)
43913-3
42588-4
87798 X 2
  CCI   MUE  
$70.18
MOL2850 Simplexa Group A Strep
60489-2
87651
  CCI   MUE  
$35.09
MOL2950 Simplexa C difficile Direct
34713-8
87493
  CCI   MUE  
$37.27
MOL2975 Simplexa C difficile Universal Direct
61367-9
87493
  CCI   MUE  
$37.27
MOL4150 Simplexa COVID-19 Direct
(Emergency Use Authorization)
94500-6
87635
  MUE  
$51.31
MOL3550 Simplexa GBS Direct
91875-5
87653
  CCI   MUE  
$35.09
91875-5
87077
  CCI   MUE  
$8.08
Total for 87653 and 87077:
$43.17
MOL3650 Simplexa VZV Direct (for CSF)
21598-8
87798
  CCI   MUE  
$35.09
MOL3655 Simplexa VZV Swab Direct
11483-5
87798
  CCI   MUE  
$35.09


DiaSorin is not responsible for any actions taken by website users in billing Medicare for DiaSorin 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 Medicare contractors to verify coverage, coding and payment.

The information contained in this website has been compiled by CodeMap, L.L.C. to assist DiaSorin 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 at (847) 381-5465.

CodeMap® has made every reasonable effort to ensure the accuracy of the information contained on this website. However, the ultimate responsibility for correct coding and claims submission lies with the provider of services. CodeMap® makes no representation, warranty, or guarantee that this compilation of Medicare information is error-free or that the use of this information will result in Medicare coverage and subsequent payment of claims. Final coverage and payment of claims are subject to many factors exclusively controlled by CMS and its contractors.

No part of this web page or data displayed may be redistributed or used without the express written consent of CodeMap®.
09/22/2020 06:34:12 3.235.137.159