Laboratory Management - Applicable Administrative Only Group Numbers
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Lists the administrative-only group numbers and their effective dates to which laboratory management clinical payment and coding policies apply; affects providers and administrative groups identified by the listed group numbers.
No material clinical or coverage changes in this revision.
Applicability by Group Number
Applicability by group number
Applicability criteria based on group number membership:
Applicability listing
This part of the document does not specify clinical coverage criteria; it enumerates groups for administrative applicability (majority effective 1/1/2026).
Group number applicability
This section provides the list of administrative-only group numbers and their effective dates. It does not state clinical coverage criteria.
Applicable Group Numbers
This section provides the specific group numbers that are designated administrative-only under the Laboratory Management policy and their effective dates.
Administrative group-number listings
Entries are group numbers with associated effective dates.
Applicability
Applicability by group number and effective date.
Applicability by group number
Applicability listing (group numbers and effective dates).
Administrative Group Number Examples (Coding Reference)
| 0M2250 | Example listed administrative group number |
| 0MC285 | Example listed administrative group number |
| 0M2788 | Example listed administrative group number |
| 0M6003 | Example listed administrative group number |
| No codes listed |
| No codes listed |
| No codes listed |
| 7BMC61 | Administrative-only group number listed with Effective Date = 1/1/2026 |
| 7BNP71 | Administrative-only group number listed with Effective Date = 1/1/2026 |
| 992640 | Administrative-only numeric group number listed with Effective Date = 1/1/2026 |
| 979568 | Administrative-only numeric group number listed with Effective Date = 1/1/2026 |
| P98366 | Example group number from list |
| P99735 | Example group number from list |
| No codes listed |
| PL5016 | Administrative-only group number for Laboratory Management (effective 1/1/2026) |
| PL5017 | Administrative-only group number for Laboratory Management (effective 1/1/2026) |
| PN0416 | PN series group number (effective 7/1/2026) |
| PN0846 | PN series group number (effective 7/1/2026) |
| PO0886 | PO series group number (effective 7/1/2026) |
| S18189 | S-prefixed identifier (effective 1/1/2026) |
Provider Guidance and Impact
Applicability statement
Laboratory management clinical payment and coding policies apply only to the administrative services only groups listed in this document.
Applicable group numbers — provider reference
Providers should reference the listed employer/group numbers to determine whether the administrative-only Laboratory Management policy applies to a member’s group.
Applicable Administrative Only Group Numbers list
This section lists administrative-only group numbers with their effective dates for Laboratory Management; the entries are administrative in scope and do not specify clinical coverage criteria.
Administrative-only group numbers list
The document provides a list of administrative-only group numbers and their effective dates (examples shown); review the enumerated group numbers to determine administrative applicability.
Group number applicability listing
Lists administrative-only group numbers and associated effective dates for Laboratory Management; use these entries to determine whether a group is subject to administrative-only application of the policy.
Applicable groups listing (partial segment)
Enumerates administrative-only group numbers and their effective dates for which Laboratory Management applies; most entries are effective 1/1/2026.
Applicable Group Numbers — administrative-only
This section enumerates administrative-only group numbers to which the Laboratory Management policy applies; no prior authorization, denial risk, documentation, billing rule, or step therapy actions are specified in this part.
Group number listing - excerpt start
Lists administrative-only group numbers and their effective dates (excerpt start), including PL-series examples such as PL5016 and PL5017, mostly effective 1/1/2026.
- Example entries: PL5016, Effective Date = 1/1/2026; PL5017, Effective Date = 1/1/2026
Group number listing - middle
Continues listing of PN and PM group numbers with effective dates; most are effective 1/1/2026, while some PN entries (e.g., PN0416, PN0846) have later effective dates (7/1/2026).
- Examples of later dates: PN0416, Effective Date = 7/1/2026; PN0846, Effective Date = 7/1/2026
Group number listing - end
Final portion of the group number list including PO-, S-, and T-prefixed identifiers; most entries effective 1/1/2026 with specific PO entries (e.g., PO0886, PO4608) effective 7/1/2026.
- Examples with later dates: PO0886, Effective Date = 7/1/2026; PO4608, Effective Date = 7/1/2026
Key Terms
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