Feb. 10, 2025
Clinical Payment and Coding Policies describe payment rules and methodologies for Current Procedural Terminology (CPT®) codes, Healthcare Common Procedure Coding System and ICD-10 coding for claims submitted as covered services. This information is a resource for our payment policies. It’s not intended to address all reimbursement-related issues. We regularly add and modify clinical payment and coding policy positions as part of our ongoing policy review process.
The following policies were updated:
- CPCP006: Preventive Services Policy – Effective 2/1/25
- CPCP025: Corrected Claim Submissions – Effective 1/22/25
- CPCPLAB003: Vitamin D Testing – Effective 4/15/25
- CPCPLAB004: Diabetes Mellitus Testing – Effective 4/15/25
- CPCPLAB008: Diagnostic Testing of Iron Homeostasis & Metabolism – Effective 4/15/25
- CPCPLAB009: Testosterone – Effective 4/15/25
- CPCPLAB010: Vitamin B12 and Methylmalonic Acid Testing – Effective 4/15/25
- CPCPLAB020: Cardiovascular Disease Risk Assessment – Effective 4/15/25
- CPCPLAB023: Diagnosis of Idiopathic Environmental Intolerance – Effective 4/15/25
- CPCPLAB028: Immune Cell Function Assay – Effective 4/15/25
- CPCPLAB032: Oral Cancer Screening and Testing – Effective 4/15/25
- CPCPLAB038: Urinary Tumor Markers for Bladder Cancer – Effective 4/15/25
- CPCPLAB045: Pathogen Panel Testing – Effective 4/15/25
- CPCPLAB051: Diagnostic Testing of Common Sexually Transmitted Infections – Effective 4/15/25
- CPCPLAB057: Coronavirus Testing in the Outpatient Setting – Effective 4/15/25
- CPCPLAB067: Testing of Homocysteine Metabolism-Related Conditions – Effective 4/15/25
- CPCPLAB069: Immunohistochemistry – Effective 4/15/25