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CALR

Heather Posted Thu 28th of August, 2014 14:23:10 PM

What is the correct coding for CALR (Calreticulan) mutation analysis including PCR and classical sequencing, read by a pathologist?

SuperCoder Answered Fri 29th of August, 2014 06:31:16 AM

Researching

SuperCoder Answered Fri 29th of August, 2014 06:31:16 AM
Researching
SuperCoder Answered Sat 30th of August, 2014 16:13:43 PM

Thank you for your question.

The correct code for CALR Mutation Analysis is 81479. This is the unlisted code for Molecular Pathology. When billing you would want to include all documentation to support the code:
When reporting a procedure with an unlisted code, submit a cover letter explaining the reason for choosing the unlisted code instead of a defined, active code. Include one or more similar codes, and compare your service to those codes to justify the claim amount you are billing. Also include the relevant documentation to strengthen the claim and to avoid a possible denial. Your payers will consider claims with unlisted procedure codes on a case by case basis, and they will determine payment based on the documentation you provide.

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