Coding and Reimbursement Information
As a service to our valued customers, the following reimbursement and coding information is provided as a resource to help assist healthcare providers with preparing and submitting claims for the VerifyNow® Tests.
Billing Codes for The VerifyNow Tests*
Common Coding Tips
Following are a few helpful tips for healthcare providers based on some commonly asked questions about claims submissions for the VerifyNow Tests:
• If performing ONLY the VerifyNow Aspirin Test, bill 85576 with a -QW modifier and a unit of 1.
• If running the VerifyNow Aspirin Test and another VerifyNow Test, do not use a -QW modifier, and use the total units for all tests. Example: One VerifyNow Aspirin and one VerifyNow P2Y12 Test should be billed as 85576, units = 3.
• If performing the VerifyNow P2Y12 or IIb/IIIa Tests, do not use a -QW modifier and use the total units.
• If billing for more than one test, bill on a single line and use the total units for all tests combined.
Download the latest VerifyNow Reimbursement Materials
Click Here
2012 VerifyNow CPT® Code Sheet
CPT Code Sheet topics include the following:
• Billing Codes
• Modifier Code Descriptions
• ICD-9 Codes
• VerifyNow Coding Tips
Click Here 2012 VerifyNow Reimbursement Guide
Reimbursement guide topics include the following:
• Medicare Billing Rules
• CPT Coding For VerifyNow Tests
• Procedure Code Modifiers
• Diagnosis (ICD-9) Codes
• Reimbursement for Lab Testing by Site of Service, National and Local Coverage Policy
• Use of Advance Beneficiary Notices
• Evaluation & Management (E&M) Coding
• CLIA Certification Requirements
CPT® is a registered trademark of the American Medical Association. The VerifyNow logo is a registered trademark of Accumetrics Inc.
*These codes are provided for informational purposes only. 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. Accumetrics recommends that providers contact their contracted payers to determine appropriate coding and charge or payment levels prior to submitting claims. The use of these codes does not guarantee payment.