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CellSearch: Coding and Claim Submission Guidelines

CellSearch™ is an FDA-approved in vitro diagnostic device for serial monitoring of metastatic disease, marketed by Veridex.

Claims for CellSearch must include:

  • CPT code 86152 – Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood)
  • In the rare instances in which a physician performs a formal interpretation and report, and not the laboratory technologist/laboratory scientist, submit CPT code 86153– physician interpretation and report.
  • Enter '1' in the Days/Unit field
  • The appropriate ICD-9-CM code appropriate for the diagnosed metastatic disease
  • Enter 'CellSearch' in the comment/narrative field:
    • Electronic claims: Loop 2400, NTE02, or SV101-7 field (note: if the claim includes both CPT codes 86152 and 86153, submit this information for both claim detail lines)
    • Paper claims: submit 'CellSearch' in Block 19

Note: CGS will consider all other cell enumeration technologies investigational and noncovered by Medicare.

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