Billing and Reimbursement Information
Fee for Performing the Brush Biopsy Procedure

OralCDx Laboratories’ Fee for Analysis of the Brush Biopsy Specimen

The fee for OralCDx Laboratories’ computer assisted analysis of the brush biopsy specimen appears on the Test Requisition Form.

With regard to the OralCDx Laboratory fee:

1) For non-Medicare patients, the patient’s check or credit card number may be submitted with the specimen. Alternatively, the patient’s medical or dental insurance information should be supplied on the Test Form or copies of the insurance card should be attached to the form.

2) For Medicare patients, OralCDx Laboratories must bill Medicare directly, and payment from patients can only be accepted for applicable deductibles and co-payments.


Dental Insurance
For all locations in the oral cavity, the ADA CDT code available for reporting this procedure is D7288.

Medical Insurance
A list of some possible CPT procedure codes that may be considered to report the biopsy procedure to the patient’s medical insurance is provided in the adjacent table. In addition to the procedure codes listed, a diagnosis code (ICD-9-CM) is also required when reporting the procedure to the patient’s medical insurance. The diagnosis code indicates the condition for which the biopsy was taken and must accurately reflect the patient’s actual condition. A list of some representative ICD-9-CM diagnosis codes that may be considered is provided in the adjacent table.

The choice of an appropriate procedure code and diagnosis code, however, is always the sole responsibility of the doctor considering the clinical circumstances of each case. As a result, the possible codes listed in the adjacent table should be used only when, in the judgment of the doctor, such codes are appropriate for the case at hand. OralCDx® Laboratories is providing information for educational purposes only and can make no recommendations as to what the correct code may be in a particular situation. Rather, OralCDx® Laboratories offers this information in good faith based upon publicly available information that may be relevant for a doctor’s consideration. OralCDx® Laboratories makes no promises that payers will pay any amount for services performed. You should always consult your local payer if you have any questions.