Article Detail - JE Part B

This Billing and Coding Article has been revised and published for notice under contract numbers: 01112 (NCA), 01182 (SCA), 01212 (AS, GU, HI, NMI), and 01312 (NV).

Effective Date: September 21, 2023

Summary of Article Changes: Under Article Text subheading Billing Instructions revised 1st bullet to read "Select the appropriate CPT® or PLA code". Revised 3rd and 6th bullets to remove "DEX Z-Code™" and replaced with "DEX Z-Code®". Under subheading Gene/CPT coding/Drug Information revised the first sentence to add "related to metabolizing enzymes". Revised Table 1 to read, "This table represents metabolism gene/drug associations from CPIC and FDA sources" and deleted rows 3-4, 43-51, and 59. Added new Table 2 to clarify gene use. Under subheading Covered multigene panels with intended uses renamed "Table 2" to "Table 3". Formatting was corrected throughout the article. This revision is due to updated published guidelines and recommendations and is effective on September 21, 2023.

Revised Table 1 to add new row for CYP2B6 for sertraline. Revised Table 2 to add new rows for G6PD for pegloticase, dapsone, primaquine, and tafenoquine. This revision is due to updated published guidelines and recommendations and is effective for 4/10/2023.

Revised Table 3 to add new row for PGXPSYCH. This revision is due to new covered multigene panel with specified uses that has successfully completed a TA and is effective for 4/17/2023.

Revised Table 2 to add new row for APOE for lecanemab. Under CPT/HCPCS Group 1: Codes added 81401 for APOE. This revision is due to FDA guidelines and is effective for July 6, 2023.

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