New lab testing and clinical guidelines for Anthem

Anthem is adopting new CMS national coverage determinations (NCD) for the lab testing listed below.

The guidelines state that only clinically appropriate lab testing will be covered. Effective September 1, 2024, coverage for these lab tests will be denied unless supported by the appropriate diagnosis code(s) found in the NCD.

CMS NCD number and title:

• 190.22: Thyroid Testing
• 190.18: Serum Iron Testing
• 190.12: Outpatient Urine Culture Testing
• 190.21: Outpatient Glycated Hemoglobin and Protein Testing
• 190.25: Outpatient Alpha-Fetoprotein Testing
• 190.27: Human Chorionic Gonadotropin Testing
• 190.32: Gamma Glutamyl Transferase Testing
• 190.20: Blood Glucose Testing

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