No 81176 One of the following ICD-10-CM codes is required on the claim (except with valid TAR): ASXL gene analysis, any targeted sequence analysis C93.10 C93.12, D46.0 D46.C, D47.1 – – provider, except with valid TAR override Yes A TAR for CPT code requires documentation of 81177 the following criteria: ATN1 (atrophin 1) gene any analysis, evaluation to The patient has clinical or symptoms provider, detect abnormal alleles suspicious for dentatorubral pallidoluysian except with atrophy, and valid TAR The patient requires the service as a confirmatory override test for dentatorubral pallidoluysian atrophy Yes 81178 A TAR for CPT code 81178 requires documentation of the following criteria: ATXN1 (ataxin 1) gene any analysis, evaluation to The patient has clinical signs or symptoms provider, detect abnormal alleles suspicious for spinocerebellar ataxia type 1 except with (SCA1), and valid TAR The patient requires the service as a confirmatory override test for SCA1 Yes 81179 A TAR for CPT code 81179 requires documentation of the following criteria: ATXN2 (ataxin 2) gene any analysis, evaluation to The patient has clinical signs or symptoms provider, detect abnormal alleles suspicious for spinocerebellar ataxia type 2 except with (SCA2), and valid TAR The patient requires the service as a confirmatory override test for SCA2
81176 ASXL gene analysis, targeted sequence analysis No One of the following ICD-10-CM codes is required on the claim (except with valid TAR): C93.10 – C93.12, D46.0 – D46.C, D47.1 any provider, except with valid TAR override 81177 ATN1 (atrophin 1) gene analysis, evaluation to detect abnormal alleles Yes A TAR for CPT code requires documentation of the following criteria: The patient has clinical or symptoms suspicious for dentatorubral pallidoluysian atrophy, and The patient requires the service as a confirmatory test for dentatorubral pallidoluysian atrophy any provider, except with valid TAR override 81178 ATXN1 (ataxin 1) gene analysis, evaluation to detect abnormal alleles Yes A TAR for CPT code 81178 requires documentation of the following criteria: The patient has clinical signs or symptoms suspicious for spinocerebellar ataxia type 1 (SCA1), and The patient requires the service as a confirmatory test for SCA1 any provider, except with valid TAR override 81179 ATXN2 (ataxin 2) gene analysis, evaluation to detect abnormal alleles Yes A TAR for CPT code 81179 requires documentation of the following criteria: The patient has clinical signs or symptoms suspicious for spinocerebellar ataxia type 2 (SCA2), and The patient requires the service as a confirmatory test for SCA2 any provider, except with valid TAR override