Negotiated reimbursement rates for D0486 across 34 states, sourced from CMS Transparency in Coverage data. 282 rate records.
D0486 refers to the accession of a transepithelial cytologic sample, a procedure used to collect and analyze cells from the oral mucosa. This procedure is clinically indicated when there is a suspicion of oral lesions or conditions that may require further investigation, such as dysplasia or malignancy. Proper documentation is crucial, including the patient's clinical history, the reason for the sample collection, and the results of any preliminary examinations. Billing for this procedure may vary significantly among payors, with some covering the full amount while others may have specific limitations or require prior authorization. The average reimbursement for this code is around $101, but dental professionals should check with individual payors for specific coverage policies and state regulations that may affect reimbursement rates.
Reimbursement rates for D0486 vary significantly by state, payor, and provider network. The national average negotiated rate is $101. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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