Medicare Coverage Policies
Currently Approved Medicare Part A
Medicare Coverage Policies
for Specific Clinical Laboratory Tests
DISCLAIMER
The policies listed below have been approved and published by either our local Medical Review Board for Local Medicare Coverage policies or by CMS as National Coverage policies regarding laboratory reimbursement. We are sharing these policies with you for your information. As an ordering provider you are required to provide the most appropriate code/text diagnosis for lab tests ordered, however you are not limited to these codes.
Local Coverage Policies are located at National Government Services' website. National Coverage Polices are located at CMS's website. You will need to exit the pop-up window to return to this page.
National Government Services Current lab policies include: - Acid Phosphatase - B-type Natriuretic Peptide (BNP) - Beta2-Microglobulin - Colorectal Cancer Screening - Erythrocyte Sedimentation Rate (ESR) - Flow Cytometry - Hepatic Function Panel - High-Sensitivity C-Reactive Protein (hsCRP) - Homocysteine Level, Serum - Human Papillomavirus (HPV) Testing - Immunohistochemistry - Ionized Calcium - Lipid Profile/Cholesterol Testing - Parathormone (Parathyroid Hormone, PTH, Immunoreactive PTH) - Prostate Specific Antigen - Qualitative Drug Screen - RAST Type Tests - Serum Magnesium Testing - Syphilis Tests - Viral Hepatitis Serology Tests - Vitamin D Assay Testing
To review them: 1) Follow the link above 2) Click on "Accept"' after reading the attestation 3) Click on "Medical Policy Center " under Quick Links 4) Click on "Active" under the Local Coverage Determinations header 5) Click on "Search" under the Medicare Coverage Database header on the left side of the page 6) Click on the "Advanced Search" link 7) Check "Local Coverage" and uncheck the "Articles" box under Step 1 8) Select "New York - Upstate" under Step 2 9) Check "CPT/HCPCS" under *Pick one or more and enter the range 80000-89999 10) Click "Search Now"
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CMS
Medicare Coverage Database - Alpha Fetoprotein (AFP) - Collagen Crosslinks, Any Method - Human Chorionic Gonadotropin (HCG) - Lipid Testing - Tumor Antigen by Immunoassay CA 15-3/CA27.29 To review them: 1) Follow the link above
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