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Sequenom Inc. Message Board

  • think_plan_act think_plan_act Oct 20, 2013 7:32 PM Flag

    UnitdHealthcare is approving MaterniT21™ PLUS, has medical billing codes too - SQMM should be atleast $15-$20

    DNA-based noninvasive prenatal tests of fetal aneuploidy (including, but not limited to,
    MaterniT21™ PLUS, verifi™ or Harmony Prenatal Test™) are "medically necessary" as
    screening tools for trisomy 21 (Down syndrome), trisomy 18 (Edwards syndrome) or trisomy 13
    (Patau syndrome) in ANY ONE of the following circumstances:

    • Maternal age of 35 years or older at delivery
    • Fetal ultrasound findings indicating an increased risk of aneuploidy
    • History of a prior pregnancy with a trisomy
    • Positive first- or second-trimester screening test results for aneuploidy
    • Parental balanced Robertsonian translocation with an increased risk of fetal trisomy 13 or
    trisomy 21.

    APPLICABLE CODES

    The codes listed in this policy are for reference purposes only. Listing of a service or device code
    in this policy does not imply that the service described by this code is a covered or non-covered
    health service. Coverage is determined by the Member’s plan of benefits or Certificate of
    Coverage. This list of codes may not be all inclusive.

    CPT®
    Code Description
    0005M

    Fetal aneuploidy (trisomy 21, 18, and 13) DNA sequence analysis of
    selected regions using maternal plasma, algorithm reported as a risk
    score for each trisomy
    81479 Unlisted molecular pathology procedure (effective 1/1/2013)
    81599 Unlisted multianalyte assay with algorithmic analysis (effective
    1/1/2013)

    Sentiment: Strong Buy

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SQNM
1.13-0.06(-5.04%)Jun 24 4:00 PMEDT