Respiratory Profile 2-IVD + SARS PCR deemed to lack medical necessity by Medicare

Please be aware that, as of April 1st, 2022, the profile #MRP2 Respiratory Profile 2-IVD + SARS PCR (CPT code #87633) was deemed to lack medical necessity by Medicare in regards to reimbursement. More information can be found on Medicare’s coverage database.

Due to such, all client facilities should be advised to submit an Advance Beneficiary Notice if ordering the test to ensure that the cost of the profile does not fall onto the facility as the party responsible for payment.

Please see below for the profile information:

CodeProfile NamePrice
#MRP2RESPIRATORY PROFILE 2-IVD + SARS PCR

  • M100 – ADENOVIRUS
  • M101 – CORONAVIRUS 229E
  • M102 – CORONAVIRUS HKU1
  • M103 – CORONAVIRUS NL63
  • M104 – CORONAVIRUS OC43
  • M105 – HUMAN METAPNEUMOVIRUS
  • M106 – HUMAN.RHINO/ENTEROVIRUS
  • M107 – INFLUENZA A H1-2009
  • M108 – INFLUENZA B
  • M109 – PARAINFLUENZA VIRUS 1
  • M110 – PARAINFLUENZA VIRUS 2
  • M111 – PARAINFLUENZA VIRUS 3
  • M112 – PARAINFLUENZA VIRUS 4
  • M113 – RESP. SYNCTIAL VIRUS
  • M114 – BORDATELLA PARAPERTUSSIS
  • M115 – BORDATELLA PERTUSSIS/ptxP
  • M116 – CHLAMYDIA PNEUMONIAE
  • M117 – MYCOPLASMA PNEUMONIAE
  • M118 – INFLUENZA A
  • M119 – INFLUENZA A H1
  • M120 – INFLUENZA A H3
  • M121 – INFLUENZA A (NO SUBTYPE)
  • MSC2 – SEVERE ACUTE RESP. SYNDROME CORONAVIRUS 2
$416.78

Due to the cost of the profile, Aculabs asks all facilities to share this notice with members of their nursing staff who use the online ordering system.

Client facilities are encouraged to routinely check the Billing Notices section to ensure they do not miss out on important updates. We thank you for your understanding and cooperation with such changes to the test(s) discussed above.

– Aculabs, Billing Department