Gamma-glutamyl Transferase (GGT) Testing in Adults
Defines reimbursement criteria for serum GGT testing for individuals aged 18 and older, including permitted clinical indications, frequency limits (no more than once every two weeks), and exclusions for asymptomatic wellness screening; applies to Blue KC lines of business and listed provider types.
No material clinical or coverage changes in this revision.
Coverage Criteria for Serum GGT Testing
Adult GGT reimbursement criteria
Covered when ALL of the following are met:
ALL of the following
- Patient is 18 years of age or older
- Testing frequency does not exceed once every two weeks
Maximum reimbursable frequency
AND at least ONE of the following clinical indications:
- Elevated alkaline phosphatase
- Chronic alcohol use
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