Testing of Homocysteine Metabolism-Related Conditions
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Defines Blue Cross Blue Shield of Oklahoma reimbursement criteria for laboratory testing related to homocysteine metabolism (including newborn screening and plasma testing) and applies to providers submitting claims under BCBSOK plans.
For the diagnosis of phenotype variants of classic homocystinuria due to CBS deficiency, the pyridoxine (B6) challenge test may be reimbursable.
Code 84207 was removed from the procedure/code list.
Document updated with literature review and references revised.
Reimbursement Criteria
Reimbursement criteria — homocysteine metabolism testing
Reimbursement criteria for testing related to homocysteine metabolism:
ALL of the following
ANY of the following
- Quantitative plasma amino acids analysis and/or plasma or urine total homocysteine analysis
- Screening from dried blood spots (newborn screening)
- Screening for hypermethioninemia in dried blood spots
ALL of the following
ANY of the following
- Repeat dried blood specimen submitted to the newborn screening program
- Quantitative plasma amino acids analysis
- Plasma total homocysteine analysis
Procedure Codes and Screening Follow-up
| 84207 | Removed from policy/code list |
Documentation and Claims Submission
Documentation, coding and claim review requirements
Providers are responsible for submission of accurate documentation of services performed and must submit claims using valid HIPAA‑approved code sets and appropriate industry coding guidelines. Claims are subject to code edit protocols and claim review and may require additional documentation upon request.
- Submit claims using valid code combinations from HIPAA‑approved code sets (eg, CPT, HCPCS, ICD‑10).
- Code claims according to industry standard coding guidelines (eg, UB, AMA CPT, CMS NCCI edits).
- Be prepared to provide additional documentation upon request for claim review.
Key Test Definitions
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