Reimbursement
Reimbursement for the CELLSEARCH® Circulating Tumor Cell Test is available through various public and private payers
| Payer | States | Status/LCD ID* | Coding |
|---|---|---|---|
| Cigna Government Services Non-covered as of March 6, 2017 |
OH, KY | Positive coverage L 32301 |
86152; 86153 |
| First Coast Service Options | FL, USVI, PR | Positive coverage L 32096 L 32098 |
86152; 86153 |
| Cahaba Government Services | TN, AL, GA | Positive coverage L 32293 |
86152; 86153 |
| Wisconsin Physician Services | IA, IN, KS, MI, MO, NE | Positive coverage L 32218 |
86152; 86153 |
| Noridian | AK, AZ, ID, MT, ND, OR, SD, UT, WA, WY | Non Coverage L 32528 |
86152; 86153 |
| Noridian | CA, HI, NV | Non Coverage L 35217 |
86152; 86153 |
| Palmetto GBA | NC, SC, VA, WV | Non Coverage L 34631 |
86152; 86153 Z code: ZBD69 |
| Novitas | AR, CO, DE, DC, LA, MD, MS, NJ, OK, PA, TX | Retired Coverage Policy L 32930 L 33232 |
86152; 86153 |
| National Government Services | CT,IL,ME,MA,MN,NH,NY,RI,VT,WI | Non Coverage L 32965 |
86152; 86153 |
| United HealthCare | National Commercial | Positive Coverage | 86152; 86153 |
NOTE: Providers should check with their carriers and payers to determine appropriate coding and billing procedures which may be subject to change; check with your carrier/payer for any questions regarding coverage.
86152 Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood).
86153 Interpretation of results.
The information provided represents no statement, promise, or guarantee by Janssen Diagnostics concerning coverage, levels of reimbursement, payment or changes. Please consult your payer organization with regard to local or actual coverage and reimbursement policies and determination processes.
*Please note: All local coverage decision policies are available online at www.cms.gov/medicare-coverage-database.
