CurrentBlue Cross Blue Shield - New MexicoPolicy CPCPLABO29

Intracellular Micronutrient Analysis

This reimbursement policy governs whether intracellular micronutrient panel testing (e.g., SpectraCell, Cell Science Systems, ExaTest) is reimbursable for Blue Cross and Blue Shield of New Mexico members; it applies to providers submitting claims under BCBSNM plan documents.

Policy Summary

PayerBlue Cross Blue Shield - New Mexico

PolicyIntracellular Micronutrient Analysis

Policy CodePolicy CPCPLABO29

Change TypeNo material change

Effective DateAug 8, 2025

Next Review Date

Key ActionProviders must submit accurate documentation and use valid HIPAA-approved code combinations; claims may be subject to code edits and requests for additional documentation.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

1Specific service declared not reimbursable

15Procedure/code list entries shown

4Recent policy updates in history

1.0Policy version

Reimbursement Determination

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Procedure and Service Codes

Procedure/Service Codes ListedCPT

82128
82136
82180
82310
82379
82495
82525
82607
82652
82725

1–10 of 15

1/2

Inclusivity note — code list limitation

Scope of code listThe procedure code list provided is not all-encompassing; inclusion of a code does not guarantee it is a covered service or eligible for reimbursement.

Coverage implicationPresence of a code on the list does not establish coverage — providers must verify member plan documents and eligibility.

Action for providersConfirm coverage and reimbursement eligibility with the member's plan document or prior authorization processes before billing.

Coding sourceCodes shown are examples from HIPAA-approved code sets but do not imply automatic payment under BCBSNM policies.

Claims Submission and Governing Documents

Documentation Required

Claims Submission and Documentation — provider responsibilities

Providers are responsible for submission of accurate documentation of services performed. Providers must submit claims using valid code combinations from HIPAA‑approved code sets and code appropriately per industry standards and authoritative coding sources (for example: Uniform Billing Editor, American Medical Association Current Procedural Terminology including CPT Assistant, Healthcare Common Procedure Coding System, ICD‑10‑CM and PCS, National Drug Codes, Diagnosis Related Group guidelines, CMS National Correct Coding Initiative Policy Manual, CCI table edits, and other CMS guidance). Claims are subject to coding edits, claim review, and adjudication including but not limited to benefit terms, provider contract language, medical policies, clinical payment and coding policies, and coding software logic. Upon request, providers should supply additional documentation to support the claim.

Use HIPAA‑approved code sets and valid code combinations.
Code according to industry standards and authoritative coding manuals.
Claims are subject to code edit protocols, claim review, and adjudication.
Provide additional documentation upon request.

Note

Hierarchy of Governing Documents

When conflicts exist between this Clinical Payment and Coding Policy and any member plan document or provider contract, the governing document takes precedence. Specifically: the member's plan document (for example, Certificates of Health Care Benefits, benefit booklets, Summary Plan Descriptions, and other coverage documents) will govern over this policy; if a conflict exists between this policy and a provider contract under which a provider participates or provides Covered Services, the provider contract will govern. Blue Cross and Blue Shield of New Mexico may exercise reasonable discretion in interpreting and applying this policy to services being delivered in a particular case; BCBSNM retains discretionary authority for interpretation and application to the extent provided under applicable plan documents.

Plan documents include but are not limited to Certificates of Health Care Benefits, benefit booklets, and Summary Plan Descriptions.
Provider contracts governing terms of participation and reimbursement supersede this policy when in conflict.
BCBSNM may use reasonable discretion and retains interpretation authority as allowed by plan documents.

OpenPayer

Intracellular Micronutrient Analysis

Reimbursement Determination

Procedure and Service Codes

Claims Submission and Governing Documents

Key Definitions