Lyme Disease Testing
Reimbursement and coding criteria for laboratory testing for Lyme disease for Blue Cross Blue Shield of Oklahoma members; governs when serologic and PCR testing for Borrelia burgdorferi are reimbursable and when testing is not reimbursable.
Document updated with literature review; reimbursement information unchanged.
Reimbursement information revised for clarity in the 11/01/2023 update.
New policy established 11/01/2022.
Lyme Disease Testing Coverage Criteria
Lyme testing coverage criteria
Covered when ALL of the following criteria are met:
Reimbursable serology indications
- Individual has signs or symptoms of Lyme disease and history of travel to a Lyme-endemic region.
- Individual with history of travel to a Lyme-endemic region presenting with acute myocarditis or pericarditis of unknown cause.
- Individual with history of travel to a Lyme-endemic region presenting with meningitis, encephalitis, or myelitis.
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.