2024 Coding Reference

For questions, please email reimbursementsupport@quidelortho.com

Rapid & Molecular Reimbursement Summary

Fee schedules do not reflect 2% Payment Adjustment (Sequestration).
Click here for more information.


Rapid Diagnostics

Molecular Diagnostics

Cell Culture & Fluorescent Tests

ELISA

VITROS ECi/ECiQ

VITROS 350/XT 3400

VITROS 3600

VITROS 4600


VITROS 5600

VITROS 7600



VITROS® ECi/ECiQ Immunodiagnostic Systems Download this page as PDF
Test Name CPT® Code(s) LOINC® Code     CPT® Description
Please Select a State
Medicare
Coverage
Medicare
Reimbursement
AFP
82105
53962-7
More
Alpha-fetoprotein (AFP); serum
  CCI   MUE   NCD
$ 16.77
Anti-HAV IgM
86709
13950-1 Hepatitis A antibody (HAAb), IgM antibody
  CCI   MUE  
$ 11.26
Anti-HAV Total
86708
13951-9 Hepatitis A antibody (HAAb)
  CCI   MUE  
$ 12.39
Anti-HBc
86704
22316-4 Hepatitis B core antibody (HBcAb); total
  CCI   MUE   NCD
$ 12.05
Anti-HBc IgM
86705
24113-3 Hepatitis B core antibody (HBcAb); IgM antibody
  CCI   MUE  
$ 11.77
Anti-HBe
86707
22321-4 Hepatitis Be antibody (HBeAb)
  CCI   MUE  
$ 11.57
Anti-HBs
86706
5193-8 Hepatitis B surface antibody (HBsAb)
  CCI   MUE   NCD
$ 10.74
Anti-HCV
86803
13955-0 Hepatitis C antibody;
  CCI   MUE  
$ 14.27
Anti-HIV 1+2
87389
31201-7 Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], fluorescence immunoassay [FIA], immunochemiluminometric assay [IMCA]), qualitative or semiquantitative; HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies, single result
  CCI   MUE  
$ 24.08
G0433
31201-7 Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening
  CCI   MUE   NCD
$ 18.29
Anti-SARS-CoV-2 IgG
86769
94505-5 Antibody; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19])
  CCI   MUE  
$ 42.13
Anti-SARS-CoV-2 IgG Quantitative
86769
94505-5 Antibody; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19])
  CCI   MUE  
$ 42.13
Anti-SARS-CoV-2 Total
86769
94505-5 Antibody; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19])
  CCI   MUE  
$ 42.13
Anti-SARS-CoV-2 Total Nucleocapsid
86769
94505-5 Antibody; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19])
  CCI   MUE  
$ 42.13
C-Peptide
84681
1986-9
More
C-peptide
  CCI   MUE  
$ 20.81
CA 125 II
86304
10334-1 Immunoassay for tumor antigen, quantitative; CA 125
  CCI   MUE   NCD
$ 20.81
CA 15-3
86300
6875-9 Immunoassay for tumor antigen, quantitative; CA 15-3 (27.29)
  CCI   MUE   NCD
$ 20.81
CA 19-9
86301
24108-3 Immunoassay for tumor antigen, quantitative; CA 19-9
  CCI   MUE   NCD
$ 20.81
CEA
82378
2039-6
More
Carcinoembryonic antigen (CEA)
  CCI   MUE   NCD
$ 18.96
CKMB Mass
82553
50757-4
More
Creatine kinase (CK), (CPK); MB fraction only
  CCI   MUE  
$ 11.55
Cortisol
82533
2143-6
More
Cortisol; total
  CCI   MUE  
$ 16.30
Estradiol
82670
2243-4
More
Estradiol; total
  CCI   MUE  
$ 27.94
Ferritin
82728
2276-4
More
Ferritin
  CCI   MUE   NCD
$ 13.63
Folate
82746
2284-8
More
Folic acid; serum
  CCI   MUE  
$ 14.70
82747
2284-8
More
Folic acid; RBC
  CCI   MUE  
$ 17.65
Free T3
84481
3051-0
More
Triiodothyronine T3; free
  CCI   MUE  
$ 16.94
Free T4
84439
3024-7
More
Thyroxine; free
  CCI   MUE   NCD
$ 9.02
FSH
83001
15067-2 Gonadotropin; follicle stimulating hormone (FSH)
  CCI   MUE  
$ 18.58
HBeAg
87350
13953-5 Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], fluorescence immunoassay [FIA], immunochemiluminometric assay [IMCA]), qualitative or semiquantitative; hepatitis Be antigen (HBeAg)
  CCI   MUE  
$ 11.53
HBsAg
87340
5196-1 Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], fluorescence immunoassay [FIA], immunochemiluminometric assay [IMCA]), qualitative or semiquantitative; hepatitis B surface antigen (HBsAg)
  CCI   MUE   NCD
$ 10.33
Hepatitis Acute Panel
80074
24363-4 Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsAg) (87340) Hepatitis C antibody (86803)
  CCI   MUE   NCD
$ 47.63
HIV Combo
86703
95524-5 Antibody; HIV-1 and HIV-2, single result
  CCI   MUE   NCD
$ 13.71
Insulin
83525
20448-7
More
Insulin; total
  CCI   MUE  
$ 11.43
Intact PTH
83970
2731-8
More
Parathormone (parathyroid hormone)
  CCI   MUE  
$ 41.28
LH
83002
10501-5 Gonadotropin; luteinizing hormone (LH)
  CCI   MUE  
$ 18.52
Myoglobin
83874
2639-3 Myoglobin
  CCI   MUE  
$ 12.92
NT-proBNP
83880
33763-4 Natriuretic peptide
  CCI   MUE  
$ 39.26
NTx
82523
14115-0 Collagen cross links, any method
  CCI   MUE   NCD
$ 18.68
Procalcitonin
84145
33959-8
More
Procalcitonin (PCT)
  CCI   MUE  
$ 27.22
Progesterone
84144
2839-9
More
Progesterone
  CCI   MUE  
$ 20.86
Prolactin
84146
2842-3
More
Prolactin
  CCI   MUE  
$ 19.38
PSA
84153
2857-1 Prostate specific antigen (PSA); total
  CCI   MUE   NCD
$ 18.39
G0103
2857-1 Prostate cancer screening; prostate specific antigen test (psa)
  CCI   MUE   NCD
$ 19.31
Rubella IgG
86762
40667-8 Antibody; rubella
  CCI   MUE  
$ 14.39
T3 Uptake
84479
3050-2 Thyroid hormone (T3 or T4) uptake or thyroid hormone binding ratio (THBR)
  CCI   MUE   NCD
$ 6.47
Testosterone
84403
2986-8
More
Testosterone; total
  CCI   MUE  
$ 25.81
Total ß-hCG Generation II
84702
2116-2
More
Gonadotropin, chorionic (hCG); quantitative
  CCI   MUE   NCD
$ 15.05
Total T3
84480
3053-6
More
Triiodothyronine T3; total (TT-3)
  CCI   MUE  
$ 14.18
Total T4
84436
3026-2
More
Thyroxine; total
  CCI   MUE   NCD
$ 6.87
Troponin I ES
84484
10839-9 Troponin, quantitative
  CCI   MUE  
$ 12.47
TSH
84443
11579-0 Thyroid stimulating hormone (TSH)
  CCI   MUE   NCD
$ 16.80
Vitamin B12
82607
2132-9 Cyanocobalamin (Vitamin B-12);
  CCI   MUE  
$ 15.08
Vitamin D
82306
1989-3
More
Vitamin D; 25 hydroxy, includes fraction(s), if performed
  CCI   MUE  
$ 29.60

  For Medicare Clinical Laboratory Fee Schedule, go to www.cms.hhs.gov.

*QW modifier is added to report use of CLIA-waived test system(s) for Medicare/Medicaid claims.

CMS has set the effective date for the addition of the QW modifier with 87420 and 87430 as October 6, 2020 and an implementation date of July 6, 2021. That means Medicare/Medicaid have until July 6, 2021 to update their systems to accept the QW modifier with these codes. We recommend customers check with their payers prior to submitting claims to verify if their system has been updated.

Effective January 1, 2010, CPT 81025 DOES NOT require a QW modifier to be recognized as a waived test. Source: CMS Job Aid 6685.

This information is being provided as a reference, for informational purposes only, with no expressed or implied warranty and does not purport to provide legal or certified coding advice. Under Federal and State law, it is the individual provider's responsibility to determine appropriate coding, charges and claims for a particular service. Policies regarding appropriate coding and payment levels can vary greatly from payer to payer and change over time. Quidel Corporation strongly recommends that providers contact their contracted payers to determine appropriate coding and charge or payment levels prior to submitting claims.

The information contained in this website has been compiled by CodeMap, L.L.C. who remains solely responsible for its content. The information provided is for general educational purposes only and may not be conclusive or exhaustive. Reimbursement information does not indicate overage for these services. While every effort is made to ensure that all payment amounts and regulatory information is current and complete, it is the responsibility of each user to verify specific coverage and payment information with their Medicare contractors. Actual reimbursement for healthcare facilities will vary depending on local carrier coverage and payment policies. Recent changes in applicable law, regulations and interpretations may not be reflected in the information contained herein.

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.

CPT copyright 2023 American Medical Association. All rights reserved.

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

04/17/2024 09:09:21 3.227.240.72