May 27, 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 new policy was implemented:
- CPCP044 Global OB Maternity Services Policy, effective Aug. 19, 2025
The following lab management policies were updated:
- CPCPLAB001 Flow Cytometry, effective Aug. 8, 2025
- CPCPLAB006 Prostate Specific Antigen Testing, effective Aug. 8, 2025
- CPCPLAB011 Biomarker Testing for Autoimmune Rheumatic Disease, effective Aug. 8, 2025
- CPCPLAB013 Allergen Testing, effective Aug. 8, 2025
- CPCPLAB014 Prenatal Screening (Nongenetic), effective Aug. 8, 2025
- CPCPLAB016 Pediatric Preventative Screening, effective Aug. 8, 2025
- CPCPLAB018 Helicobacter Pylori Testing, effective Aug. 8, 2025
- CPCPLAB019 Thyroid Disease Testing, effective Aug. 8, 2025
- CPCPLAB029 Intracellular Micronutrient Analysis, effective Aug. 8, 2025
- CPCPLAB034 Salivary Hormone Testing, effective Aug. 8, 2025
- CPCPLAB038 Urinary Tumor Markers for Bladder Cancer, effective Aug. 8, 2025
- CPCPLAB043 Evaluation of Dry Eyes, effective Aug. 8, 2025
- CPCPLAB44 Lyme Disease Testing, effective Aug. 8, 2025
- CPCPLAB055 Parathyroid Hormone, Phosphorous, Calcium and Magnesium Testing, effective Aug. 8, 2025
- CPCPLAB058 Venous and Arterial Thrombosis Risk Testing, effective Aug. 8, 2025
- CPCPLAB065 Human Immunodeficiency Virus, effective Aug. 8, 2025
- CPCPLAB068 Onychomycosis Testing, effective Aug. 8, 2025
- CPCPLAB070 Prescription Medication and Illicit Drug Testing, effective Aug. 8, 2025
- CPCPLAB071 Colorectal Cancer Screening, effective Aug. 8, 2025
CPT copyright 2024 American Medical Association. All rights reserved. CPT is a registered trademark of the AMA.
Clinical payment and coding policies are based on using healthcare professionals and industry standard guidelines. The clinical payment and coding guidelines are not intended to provide billing or coding advice but to serve as a reference for facilities and providers.