Reminder: Multi-panel lab tests for viral infections aren't covered

The multi-panel lab tests listed below aren’t covered. They each include targets for identifying 21-22 specific viral infections, including COVID-19, which our teams have determined to be medically unnecessary in most cases.

What should you do?

This isn’t a change, but rather a reminder. If you receive a denial for one of the test codes below but feel it’s warranted, you can submit a medical appeal with documentation to support the medical need.

Which lab tests aren't covered?

• 0202U - Infectious disease (bacterial or viral respiratory tract infection), pathogen-specific nucleic acid (DNA or RNA), 22 targets including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), qualitative RT-PCR, nasopharyngeal swab, each pathogen reported as detected or not detected

• 0223U - Infectious disease (bacterial or viral respiratory tract infection), pathogen-specific nucleic acid (DNA or RNA), 22 targets including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), qualitative RT-PCR, nasopharyngeal swab, each pathogen reported as detected or not detected

• 0225U - Infectious disease (bacterial or viral respiratory tract infection) pathogen-specific DNA and RNA, 21 targets, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), amplified probe technique, including multiplex reverse transcription for RNA targets, each analyte reported as detected or not detected