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Code edit notification

Notification Number: 3420

Effective date: 2/1/2018

Notification date: 11/3/2017

Category: CPT

Topic: Molecular diagnostic testing for vaginitis and sexually transmitted infections

Providers affected:

  • Inpatient/Outpatient Facilities
  • Physician/Health Care Providers
What is changing?

Charges for the following molecular diagnostic testing for vaginitis and sexually transmitted infections procedures will not be reimbursed:

  • CPT code 87481 – Infectious agent detection by nucleic acid (DNA or RNA); Candida species, amplified probe technique
  • CPT code 87482 – Infectious agent detection by nucleic acid (DNA or RNA); Candida species, quantification
  • CPT code 87511 – Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, amplified probe technique
  • CPT code 87512 – Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, quantification.
Why is Humana implementing this change?

Humana updated its medical coverage policy for molecular diagnostic testing for vaginitis and sexually transmitted infections to indicate that the procedures listed above are not covered. The reason is that they are considered to be experimental or investigational.

For more information, please review the molecular diagnostic testing for vaginitis and sexually transmitted infections medical coverage policy. To locate the policy, go to  Humana's Medical and Pharmacy Coverage Policies and search for “vaginitis.”

Impacted products

  • Select self-funded* products
  • Commercial fully insured products

Disclaimer

*All edits previously posted on Humana.com/providers for fully insured commercial Humana members may be applied to self-funded members, when requested by the self-funded group.