Coding for Flow Cytometry

Coding for diagnostic pathology/laboratory billing of flow cytometry

Flow cytometery of erythrocytes using anti-CD59 or of granulocytes using anti-CD55 or anti-CD59 provides the most accurate technique for the diagnosis of PNH. Flow cytometry is more sensitive, specific, and quantitative for PNH than other complement sensitivity measures, including the Ham, sucrose lysis, and complement lysis sensitivity tests.

Payors vary greatly on their specific medical policy for flow cytometry. It is important that laboratories clarify coding and billing requirements with the patient's respective health insurance plan. However, due to the rare nature of PNH, many payors may not have a formal PNH diagnostic code. Consequently, medical policies for flow cytometry should include one or more of the diagnosis codes listed in the table in order to reflect that a patient may be undergoing a diagnosis with flow cytometry for PNH clone determination.

• Obtain a printable copy of the ICD-9 codes for flow cytometry work-up
   
• Support your flow cytometry order with a Statement of Medical Necessity

Next: Ordering SOLIRIS

IMPORTANT SAFETY INFORMATION

The effect of withdrawal of anticoagulant therapy during SOLIRIS treatment has not been established. Therefore, treatment with SOLIRIS should not alter anticoagulant management.

SEE FULL PRESCRIBING INFORMATION FOR COMPLETE BOXED WARNING INCLUDING WARNINGS, PRECAUTIONS, AND ADVERSE REACTIONS.

The most frequent adverse events observed in clinical studies were headache, nasopharyngitis, back pain, nausea, fatigue, and cough.

Please see important safety information (including boxed warning) as well as the complete prescribing information.

• About PNH
  • Pathophysiology
  • The Role of Hemolysis
  • PNH Morbidity & Mortality
  • Presentation of PNH
  • Screening for PNH
  • Flow Cytometry in PNH Diagnosis
  • Therapeutic Options
  • PNH Registry
• About SOLIRIS®
  • Mechanism of Action
  • Efficacy
    • Impact on Hemolysis
    • Reduction in Anemia
    • Transfusion Reduction
    • SOLIRIS and Fatigue Reduction
    • SOLIRIS and Patient Quality of Life
    • Fewer Thrombotic Events
  • Safety
    • Vaccine Requirement
    • Long-Term Patient Safety
    • Discontinuation
  • Dosing and Administration
  • Side Effects
  • Adherence and Timely Dosing
• SOLIRIS OneSource™
  • Alexion Case Managers
  • Coverage Information
  • Reimbursement
  • Patient Assistance
  • Office Coding for SOLIRIS
  • Hospital Coding for SOLIRIS
  • Coding for Flow Cytometry
  • Ordering SOLIRIS
  • OneSource Materials
• SOLIRIS Resource
  Library
• Prescribing Information
• Safety Information