| Policy Name |
Policy ID Number |
Date Modified |
| Allergy and Sensitivity Tests of Uncertain Efficacy |
LAB01 |
09/01/2023 |
| Analysis of Proteomic and Metabolomic Patterns
for Cancer Detection, Risk, Prognosis, or Treatment Selection |
LAB41 |
02/01/2023 |
| Biochemical and Cellular Markers of Alzheimer's
Disease |
LAB22 |
09/01/2023 |
| Bone Turnover Markers for
Diagnosis and Management of Osteoporosis and Diseases Associated with High Bone Turnover |
LAB23 |
09/01/2023 |
Circulating
Tumor DNA and Circulating Tumor Cells for Management (Liquid Biopsy) of Solid Tumor Cancers |
LAB46 |
07/01/2023 |
| COVID-19 Testing |
LAB74 |
06/01/2023 |
Drug Testing for Substance Use and Pain Management |
LAB68 |
07/01/2023 |
| In Vitro Chemoresistance
and Chemosensitivity Assays |
LAB06 |
07/01/2023 |
Invetigational Gene Expression, Biomarker, and Multianalyte Testing |
LAB77 |
07/01/2023 |
| Laboratory and Genetic Testing for Use of Fluoropyrimidine Chemotherapy (5-FU and Capecitabine) in Patients with Cancer |
LAB64 |
03/01/2023 |
| Laboratory Tests for Organ Transplant Rejection |
LAB51 |
09/01/2023 |
| Maternal Serum Analysis for Risk of Adverse Obstetric Outcomes |
LAB75 |
07/01/2023 |
| Measurement of Lipoprotein-Associated Phospholipase A2 Lp-PLA2) in the Assessment of Cardiovascular Risk |
LAB63 |
07/01/2023 |
Measurement of Serum Antibodies to Selected Biologic Agents |
LAB65 |
07/01/2023 |
| Molecular Testing in the Management of Pulmonary Nodules |
LAB73 |
07/01/2023 |
| Multi-biomarker Disease Activity Blood Test for Rheumatoid Arthritis |
LAB67 |
09/01/2023 |
| Multianalyte and Gene Expression Assays for Predicting Recurrence in Colon Cancer |
LAB76 |
12/01/2022 |
| Multianalyte Assays with Algorithmic Analyses for the Evaluation and Monitoring of Patients with Chronic Liver Disease |
LAB47 |
08/01/2023 |
| Multimarker and Proteomics-based Serum Testing Related to Ovarian Cancer |
LAB60 |
04/01/2023 |
| Placental Rapid Immunoassay for Detection of Fetal Membrane Rupture |
LAB57 |
03/01/2023 |
| Protein Biomarkers and Multi-analyte Biomarker Tests for Screening, Detection, and/or Management of Prostate Cancer |
LAB69 |
04/01/2023 |
| Salivary Hormone Testing
for Aging and Menopause |
LAB36 |
05/01/2023 |
| Serum Holotranscobalamin
as a Marker of Vitamin B12 (i.e., Cobalamin)
Status |
LAB44 |
04/01/2023 |
| Urinary Biomarkers for Cancer Screening, Diagnosis, and Surveillance |
LAB72 |
04/01/2023 |
Vitamin D Testing |
LAB52 |
02/01/2023 |
