No 81171 One of the following ICD-10-CM diagnosis codes is required on the claim (except with valid TAR): AFF2 (AF4/FMR2 family, any member 2 [FMR2]) gene F70, F71, F80.0 F89, H93.25, R48.0, – provider, analysis evaluation to R62.0 R62.59, F82, F88, R48.2 – except with detect abnormal alleles valid TAR override No One of the following ICD-10-CM diagnosis codes is 81172 required on the claim (except with valid TAR): AFF2 (AF4/FMR2 family, any member 2 [FMR2]) gene F70, F71, F80.0 F89, H93.25, R48.0, – provider, analysis; characterization of R62.0 R62.59, F82, F88, R48.2 – except with alleles TAR override Yes 81173 A TAR for CPT code 81173 requires documentation of the following criteria: AR (androgen receptor) any gene analysis; full gene The patient has clinical or symptoms provider, sequence suspicious for bulbar muscular atrophy, and except with The patient requires the service as a confirmatory valid TAR test for spinal and bulbar muscular atrophy override Yes 81174 A TAR for CPT code 81174 requires documentation of the following criteria: AR (androgen receptor) any gene analysis; known The patient has clinical signs or symptoms provider, familial variant suspicious for bulbar muscular atrophy, and except with The patient requires the service as a confirmatory valid TAR test for spinal and bulbar muscular atrophy override No 81175 One of the following ICD-10-CM codes is required on the claim (except with valid TAR): ASXL gene analysis, full any gene sequence C93.10 C93.12, D46.0 D46.C, D47.1 – – provider, except with TAR override
81171 AFF2 (AF4/FMR2 family, member 2 [FMR2]) gene analysis evaluation to detect abnormal alleles No One of the following ICD-10-CM diagnosis codes is required on the claim (except with valid TAR): F70, F71, F80.0 – F89, H93.25, R48.0, R62.0 – R62.59, F82, F88, R48.2 any provider, except with valid TAR override 81172 AFF2 (AF4/FMR2 family, member 2 [FMR2]) gene analysis; characterization of alleles No One of the following ICD-10-CM diagnosis codes is required on the claim (except with valid TAR): F70, F71, F80.0 – F89, H93.25, R48.0, R62.0 – R62.59, F82, F88, R48.2 any provider, except with TAR override 81173 AR (androgen receptor) gene analysis; full gene sequence Yes A TAR for CPT code 81173 requires documentation of the following criteria: The patient has clinical or symptoms suspicious for bulbar muscular atrophy, and The patient requires the service as a confirmatory test for spinal and bulbar muscular atrophy any provider, except with valid TAR override 81174 AR (androgen receptor) gene analysis; known familial variant Yes A TAR for CPT code 81174 requires documentation of the following criteria: The patient has clinical signs or symptoms suspicious for bulbar muscular atrophy, and The patient requires the service as a confirmatory test for spinal and bulbar muscular atrophy any provider, except with valid TAR override 81175 ASXL gene analysis, full gene sequence 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 TAR override