SUPERSEDED LCD Reference Article Billing and Coding Article

Billing and Coding: Coenzyme Q10 (CoQ10)

A55715

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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.
Superseded
To see the currently-in-effect version of this document, go to the section.

Document Note

Note History

Contractor Information

Article Information

General Information

Source Article ID
N/A
Article ID
A55715
Original ICD-9 Article ID
Not Applicable
Article Title
Billing and Coding: Coenzyme Q10 (CoQ10)
Article Type
Billing and Coding
Original Effective Date
08/31/2017
Revision Effective Date
11/16/2023
Revision Ending Date
01/31/2024
Retirement Date
N/A

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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, 80.1.1, 80.2. Clinical Laboratory services.

CMS Internet-Only Manual, Pub. 100-04, Medicare Claims Processing Manual, Chapter 16, §50.5 Jurisdiction of Laboratory Claims, §60.1.2 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

 

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
  • Select the appropriate diagnosis for the patient

 

 

 

Response To Comments

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Coding Information

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CPT/HCPCS Codes

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Group 1 Codes
Code Description
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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ICD-10-CM Codes that Support Medical Necessity

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Additional ICD-10 Information

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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.

Code Description
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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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Other Coding Information

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Coding Table Information

Excluded CPT/HCPCS Codes - Table Format
Code Descriptor Generic Name Descriptor Brand Name Exclusion Effective Date Exclusion End Date Reason for Exclusion
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Non-Excluded CPT/HCPCS Ended Codes - Table Format
Code Descriptor Generic Name Descriptor Brand Name Exclusion Effective Date Exclusion End Date Reason for Exclusion
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Revision History Information

Revision History Date Revision History Number Revision History Explanation
11/16/2023 R7

Revision Effective: 11/16/2023

Revision Explanation: Updated LCD Reference Article section.

 

01/26/2023 R6

R6

Revision Effective: 01/26/2023

Revision Explanation: Annual review, no changes were made.

02/03/2022 R5

R5

Revision Effective: 02/03/2022

Revision Explanation: Annual review, no changes were made.

05/27/2021 R4

R4

Revision Effective: 5/27/2021

Revision Explanation: Annual review, no changes were made.

11/07/2019 R3

R3

Revision Effective: n/a

Revision Explanation: Annual review, no changes made.

11/07/2019 R2

R2

Revision Effective: 11/07/2019

Revision Explanation: Added regulations to CMS National Policy Section for billing and coding no other changes made.

09/12/2019 R1

 

R1

Revision Effective: 09/19/2019

Revision Explanation: Converted article into new Billing and Coding template no other changes made.

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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
L37126 - 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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Rules and Regulations URLs
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CMS Manual Explanations URLs
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Other URLs
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Public Versions
Updated On Effective Dates Status
01/25/2024 02/01/2024 - N/A Currently in Effect View
11/08/2023 11/16/2023 - 01/31/2024 Superseded You are here
01/20/2023 01/26/2023 - 11/15/2023 Superseded View
Some older versions have been archived. Please visit the MCD Archive Site to retrieve them.

Keywords

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