SUPERSEDED LCD Reference Article Billing and Coding Article

Billing and Coding: Lab: Coenzyme Q10 (CoQ10)

A55709

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Draft Article
Draft Articles are works in progress and not necessarily a reflection of the current billing and coding practices. Revisions to codes are carefully and thoroughly reviewed and are not intended to change the original intent of the LCD.
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To see the currently-in-effect version of this document, go to the section.

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Contractor Information

Article Information

General Information

Source Article ID
N/A
Article ID
A55709
Original ICD-9 Article ID
Not Applicable
Article Title
Billing and Coding: Lab: Coenzyme Q10 (CoQ10)
Article Type
Billing and Coding
Original Effective Date
08/31/2017
Revision Effective Date
09/07/2023
Revision Ending Date
04/24/2024
Retirement Date
N/A
AMA CPT / ADA CDT / AHA NUBC Copyright Statement

CPT codes, descriptions and other data only are copyright 2023 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.

Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

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CMS National Coverage Policy

Title XVIII of the Social Security Act, §1833(e). Prohibits Medicare payment for any claim which lacks the necessary information to process the claim.

CMS Internet-Only Manual, Pub. 100-02, Medicare Benefit Policy Manual, Chapter 15, §§80.0 Requirements for Diagnostic X-ray, Diagnostic Laboratory, and Other Diagnostic Tests, 80.1.1 Certification Changes, 80.1.2 A/B MAC (B) Contacts with Independent Clinical Laboratories

CMS Internet-Only Manual, Pub. 100-04, Medicare Claims Processing Manual, Chapter 16, §50.5 Jurisdiction of Laboratory Claims, §60.1.1 Independent Laboratory Specimen Drawing, §60.2. Travel Allowance

CMS Internet-Only Manual, Pub. 100-04, Medicare Claims Processing Manual, Chapter 23, §10 Reporting ICD Diagnosis and Procedure Codes

Article Guidance

Article Text

The information in this article contains billing, coding or other guidelines that complement the Local Coverage Determination (LCD) for Lab: Coenzyme Q10 (CoQ10) L37022.

Coenzyme Q10 (CoQ10 or Q10) supplementation is purported to prolong life and prevent age-related functional declines; inhibit the development and/or progression of atherosclerosis; have value as an adjunct to conventional medical therapy in the treatment of congestive heart failure, conventional angina therapy, and cancer; provide protection against myocardial damage during ischemia-reperfusion during cardiac surgery; provide benefit in the treatment of hypertension, CV disease and diabetes; play a role in neurodegenerative diseases such as Parkinson’s disease, Huntington’s disease and Friedreich’s ataxia; enhance athletic performance and enhance fertility.  As such, serum or other body fluid testing for Q10 levels has been advocated.  However, the scientific evidence to support coverage for Q10 testing for any purpose is controversial and/or limited for all diseases.  Consequently, Q10 testing is not reasonable and necessary (LCD L37022), and claims for testing will be denied. 

To receive a Q10 service denial, please submit the following claim information:

  • CPT® code 82542
  • For a voluntary issued Advanced Beneficiary Notice (ABN), append with GX modifier

Response To Comments

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Coding Information

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CPT/HCPCS Codes

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82542 COLUMN CHROMATOGRAPHY, INCLUDES MASS SPECTROMETRY, IF PERFORMED (EG, HPLC, LC, LC/MS, LC/MS-MS, GC, GC/MS-MS, GC/MS, HPLC/MS), NON-DRUG ANALYTE(S) NOT ELSEWHERE SPECIFIED, QUALITATIVE OR QUANTITATIVE, EACH SPECIMEN
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CPT/HCPCS Modifiers

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GX NOTICE OF LIABILITY ISSUED, VOLUNTARY UNDER PAYER POLICY
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Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the article should be assumed to apply equally to all claims.

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Revenue Codes

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the article should be assumed to apply equally to all Revenue Codes.

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Coding Table Information

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Revision History Information

Revision History Date Revision History Number Revision History Explanation
09/07/2023 R4

Under CMS National Coverage Policy revised the following regulation: CMS Internet-Only Manual, Pub. 100-04, Medicare Claims Processing Manual, Chapter 16, §50.5 Jurisdiction of Laboratory Claims, §60.1.1 Independent Laboratory Specimen Drawing, §60.2 Travel Allowance and updated section headings.

11/07/2019 R3

This article is being revised in order to adhere to CMS requirements per chapter 13, section 13.5.1 of the Program Integrity Manual. Under Article Title changed the title from “Coenzyme Q10 (Q10) Coding and Billing Guideline” to “Billing and Coding: Lab: Coenzyme Q10 (CoQ10)”. Regulations regarding billing and coding were removed from the CMS National Coverage Policy section of the related Lab: Coenzyme Q10 (CoQ10) L37022 LCD and placed in this article. Under Article Text added the verbiage “The information in this article contains billing, coding or other guidelines that complement the Local Coverage Determination (LCD) for Lab: Coenzyme Q10 (CoQ10) L37022” and removed the bullet point “Select the appropriate diagnosis for the patient”. Under CPT/HCPCS Codes Group 1: Codes added 82542. Under CPT/HCPCS Modifiers Group 1: Codes added modifier GX. Under Bill Type Codes removed 028x. CPT® was inserted throughout the article where applicable.

02/26/2018 R2

Annual update on 8/17/18. No changes.

02/26/2018 R1 The Jurisdiction "J" Part A and Part B Contracts for Alabama (10111/10112), Georgia (10211/10212) and Tennessee (10311/10312) are now being serviced by Palmetto GBA. Effective 02/26/18, these 6 contract numbers are being added to this article. No coverage, coding or other substantive changes (beyond the addition of the 6 Part A and B contract numbers) have been completed in this revision.
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Associated Documents

Medicare BPM Ch 15.50.2 SAD Determinations
Medicare BPM Ch 15.50.2
Related Local Coverage Documents
LCDs
L37022 - Lab: Coenzyme Q10 (CoQ10)
Related National Coverage Documents
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SAD Process URL 1
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SAD Process URL 2
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Statutory Requirements URLs
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CMS Manual Explanations URLs
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Public Versions
Updated On Effective Dates Status
04/16/2024 04/25/2024 - N/A Currently in Effect View
08/31/2023 09/07/2023 - 04/24/2024 Superseded You are here
10/30/2019 11/07/2019 - 09/06/2023 Superseded View
Some older versions have been archived. Please visit the MCD Archive Site to retrieve them.

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