Medicare Coverage Policies
Currently Approved Medicare Part A
Medicare Coverage Policies or Specific Clinical Laboratory Tests
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.
Current lab policies include:
- Acid Phosphatase
- B-type Natriuretic Peptide (BNP)
- Human Papillomavirus (HPV) Testing
- Lipid Profile/Cholesterol Testing
- Qualitative Drug Screen
- RAST Type Tests
- Vitamin D Assay Testing
To review Local Coverage Determinations:
1)Follow the link at the top of this list.
2)In right column, click bullet for Local Coverage Documents.
3)Under *Select Geographic Area/Region: choose New York – Upstate from the drop down menu.
4)Under *Select One or Both: type in the test name.
- Alpha Fetoprotein (AFP)
- Collagen Crosslinks, Any Method
- Human Chorionic Gonadotropin (HCG)
- Lipid Testing
- Tumor Antigen by Immunoassay CA 15-3/CA27.29
To review National Coverage Determinations:
1) Follow the link at the top of this list.
2)In right column, click bullet for National Coverage Documents.
3)Under *Select One or Both: type in the test name
There are currently no drafts open for comment. When applicable, to comment on a policy, click on the “Add Comments” phrase under each policy below and complete the response page: