Billing and Coding: B-type Natriuretic Peptide (BNP) Testing (A57084) (2024)

A57084

CMS National Coverage Policy

Documentation supporting medical necessity must be legible, maintained in the patient's record, and made available to the A/B MAC upon request.

The patient's medical record must contain documentation that fully supports the medical necessity for services included within this LCD. (See "Indications and Limitations of Coverage.") This documentation includes, but is not limited to, relevant medical history, physical examination, and results of pertinent diagnostic tests or procedures.

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Bill Type Codes

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Revenue Codes

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CPT/HCPCS Codes

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CPT/HCPCS Modifiers

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ICD-10-CM Codes that Support Medical Necessity

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ICD-10-CM Codes that DO NOT Support Medical Necessity

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ICD-10-PCS Codes

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Additional ICD-10 Information

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Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typicallyused to report this service. Absence of a Bill Type does not guarantee that thearticle does not apply to that Bill Type. Complete absence of all Bill Types indicatesthat coverage is not influenced by Bill Type and the article should be assumed toapply equally to all claims.

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Revenue Codes

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service.In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under otherRevenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicatesthat coverage is not influenced by Revenue Code and the article should be assumed to apply equally to all Revenue Codes.

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Other Coding Information

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Excluded CPT/HCPCS Codes - Table Format

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Non-Excluded CPT/HCPCS Ended Codes - Table Format

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Medicare BPM Ch 15.50.2 SAD Determinations
Medicare BPM Ch 15.50.2

Related Local Coverage Documents
LCDs
L34038 - B-type Natriuretic Peptide (BNP) Testing

Statutory Requirements URLs

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Rules and Regulations URLs

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CMS Manual Explanations URLs

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Other URLs

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Public Versions

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