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 - 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 - Irradiated Blood Products - 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
To review them: 1) Follow the link above 2) Click on "Accept"' after reading the attestation 3) Click on "Local Coverage Determinations" under Quick Links 4) Under Select a Specialty, select "Pathology/Laboratory" & under Status select "Active" 5) Click "Search"
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CMS
Medicare Coverage Database - Alpha Fetoprotein - HCG (Human Chorionic Gonadotropin) - Lipid Profile and Cholesterol Testing - Tumor Antigen by Immunoassay CA 15-3/CA27-29 To review them: 1) Follow the link above
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