CurrentBlue Cross Blue Shield - OklahomaPolicy CPCPLAB048

Folate Testing

Defines BCBSOK reimbursement stance and coding guidance for folate laboratory testing for covered members and instructs providers on coding and documentation expectations.

Policy Summary

PayerBlue Cross Blue Shield - Oklahoma

PolicyFolate Testing

Policy CodePolicy CPCPLAB048

Change TypeAdded and clarified reimbursement statements

Effective DateNov 1, 2023

Next Review Date

Key ActionProviders must submit accurate documentation and may be requested to provide additional documentation; claims are subject to code edit protocols and claim review per plan documents and provider contracts.

SourceLink

POLICY UPDATE CHANGES

For all situations, folate receptor autoantibody testing is not reimbursable.

Other reimbursement statements revised for clarity and references updated.

3reimbursement statements (including exclusions)

3procedure codes listed

2policy versions

Folate Testing Coverage Criteria

Folate testing coverage criteria

Reimbursement determinations for folate testing:

ALL of the following

ONE of
- Individual is diagnosed with megaloblastic anemia or macrocytic anemia.
- The megaloblastic anemia and/or macrocytosis does not resolve after folic acid treatment.
Measurement of serum folate concentration may be reimbursable when the above conditions are met.

Measurement of serum folate concentration is not reimbursable for indications other than megaloblastic or macrocytic anemia that fail to resolve after folic acid treatment.

Policy Summary

PayerBlue Cross Blue Shield - Oklahoma

PolicyFolate Testing

Policy CodePolicy CPCPLAB048

Change TypeAdded and clarified reimbursement statements

Effective DateNov 1, 2023

Next Review Date

SourceLink

On This Page

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 Codes and Reimbursement Notes

Listed procedure codesCPT

82746	Folate; serum
82747	Folate; other (e.g., RBC folate) — listed but RBC folate testing is not reimbursable
0399U	Folate receptor autoantibody (ancillary/research code) — listed but autoantibody testing is not reimbursable

Not reimbursable - RBC folateCPTNot Covered

82747

Folate; other (e.g., RBC folate) — not reimbursable for any indication

Not reimbursable - Folate receptor autoantibodyCPTNot Covered

0399U

Folate receptor autoantibody — not reimbursable for any situation

RBC folate reimbursement — policy statements

RBC folate reimbursementMeasurement of red blood cell (RBC) folate is not reimbursable for any indication.

Serum folate (contrast)Measurement of serum folate concentration may be reimbursable for individuals with megaloblastic or macrocytic anemia when the condition does not resolve after folic acid treatment.

Other serum folate indicationsMeasurement of serum folate concentration is not reimbursable for indications other than those described for post–folic acid treatment failure in megaloblastic or macrocytic anemia.

Documentation and Claim Review Requirements

Documentation Required

Documentation and claim review requirements

Providers must submit accurate documentation and may be asked to provide additional documentation to support billed services. Claims must be submitted using valid HIPAA-approved code combinations and coded according to industry-standard coding guidelines; they are subject to code edit protocols and claim review per plan documents and provider contracts.

Use valid code combinations from HIPAA-approved code sets (eg, CPT, HCPCS, ICD-10).
Code claims according to industry-standard guidelines (eg, UB Editor, AMA CPT, CMS NCCI/CCI edits).
Claims are subject to code edit protocols and medical policy and contract review.
Provide additional documentation upon BCBSOK request.

Covered Services and Plan Governance

Covered Services / plan governance

Plan document governsIf a conflict exists between this policy and any plan document, the plan document will govern.

Provider contract governsIf a conflict exists between this policy and any provider contract, the provider contract will govern.

Policy interpretation discretionBCBSOK may use reasonable discretion in interpreting and applying this policy and has full and final discretionary authority as provided under applicable plan documents.

Provider documentation and claim reviewProviders must submit accurate documentation; claims are subject to code edit protocols and claim review and providers may be asked to provide additional documentation.