81407 Yes Coverage for CPT-4 code 81407 (molecular pathology procedure, Level 8) is limited to the any Molecular Pathology listed services. Reimbursement for code 81407 provider, Procedure, Level 8 requires an approved TAR and requires providers except with Continued to document one of the following on the TAR: valid TAR override (familial hyperinsulinism): The patient has persistent hyperinsulinemic hypoglycemia of infancy (PHHI) who failed medical therapy, and The patient is under evaluation for surgical intervention AGL (glycogen storage disease type III) The – patient has clinical features suspicious for, or requires the service as a confirmatory test for glycogen storage disease type III Continued
81407 Molecular Pathology Procedure, Level 8 Continued Yes Continued Coverage for CPT-4 code 81407 (molecular pathology procedure, Level 8) is limited to the listed services. Reimbursement for code 81407 requires an approved TAR and requires providers to document one of the following on the TAR: (familial hyperinsulinism): The patient has persistent hyperinsulinemic hypoglycemia of infancy (PHHI) who failed medical therapy, and The patient is under evaluation for surgical intervention AGL (glycogen storage disease type III) – The patient has clinical features suspicious for, or requires the service as a confirmatory test for glycogen storage disease type III any provider, except with valid TAR override