Pancreatic Enzyme Testing for Acute Pancreatitis
Defines reimbursement coverage for laboratory measurement of pancreatic enzymes and related biomarkers for diagnosis, assessment, prognosis, and severity determination of acute pancreatitis for Blue KC lines of business and affected provider settings.
No material clinical or coverage changes in this revision.
Coverage criteria and exclusions
Coverage criteria and exclusions
Covered or excluded as specified below.
Serum lipase - primary coverage
Also reimbursed in the following situations
- Individuals with an established diagnosis of acute or chronic pancreatitis.
- More than once per visit.
- For asymptomatic individuals during a general exam without abnormal findings.
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