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    v1.0.28
    OpenPayerPolicy UpdatesLaboratory/PathologyConnectiCare Micronutrient Coverage Update | OpenP…
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    ModifiedConnectiCarePolicy AHS-G2099

    Micronutrient Testing - Lab Benefit Program (LBM)

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    This policy governs reimbursement for serum and intracellular micronutrient testing under ConnectiCare's Lab Benefit Program. The criteria do not apply to Exchange Plans for dates of service on or after January 1, 2026; coverage also depends on member benefit documents and applicable Medicare or Medicaid requirements.

    Policy Summary
    PayerConnectiCare
    PolicyMicronutrient Testing - Lab Benefit Program (LBM)
    Policy CodePolicy AHS-G2099
    Change TypeModified
    Effective DateSeptember 15, 2026
    Next Review DateN/A
    Key ActionDo not submit serum micronutrient testing used as a general screen for nutritional disorders because it does not meet coverage criteria.
    SourceLink
    POLICY UPDATE CHANGES

    A new coverage criterion states that serum micronutrient testing performed as a general screen for nutritional disorders does not meet coverage criteria.

    CPT codes 82607, 82652, 82725, 82746, and 88348 were removed from the applicable CPT/HCPCS procedure code section.

    The policy title changed from Intracellular Micronutrient Analysis to Micronutrient Testing.

    OpenPayer is powered by Trek Health's payer performance platform. Trek continuously ingests, validates, and normalizes Transparency in Coverage data alongside payer policies and other commercial payer data to create a structured payer intelligence foundation. OpenPayer uses this foundation to deliver personalized search results, dynamically generated policy pages, and tailored policy monitoring based on each user's payers, specialties, billing codes, and areas of interest. The same intelligence powers broader payer performance workflows, including reimbursement benchmarking, contract evaluation, payer negotiations, and financial decision-making.

    2
    Testing categories not meeting coverage criteria
    20Applicable CPT/HCPCS codes
    5CPT codes removed
    1New coverage criteria
    Exchange PlansCriteria-excluded plan type

    Coverage Criteria

    Serum Micronutrient Testing as General Screening

    The following does not meet coverage criteria due to a lack of available published scientific literature confirming that the test is required and beneficial for diagnosis and treatment of an individual's illness.

    Serum micronutrient testing as a general screen for nutritional disorders does not meet coverage criteria.

    Intracellular Micronutrient Panels

    The following does not meet coverage criteria due to a lack of available published scientific literature confirming that the test is required and beneficial for diagnosis and treatment of an individual's illness.

    Intracellular micronutrient panel testing does not meet coverage criteria, including panels such as SpectraCell, Cell Science Systems cell micronutrient assay, and ExaTest.

    General Screening

    General screening for nutritional disorders with serum micronutrient testing does not meet coverage criteria.

    Serum micronutrient testing as a general screen for nutritional disorders is excluded and does not meet coverage criteria.

    Intracellular micronutrient panel testing, including SpectraCell, Cell Science Systems cell micronutrient assay, and ExaTest, is excluded and does not meet coverage criteria.

    Policy criteria are not applicable to Exchange Plans for dates of service on or after January 1, 2026.

    Policy criteria are not applicable to Exchange Plans.

    Serum micronutrient testing as a general screen for nutritional disorders and intracellular micronutrient panel testing do not meet coverage criteria due to a lack of available published scientific literature confirming that these tests are required and beneficial for diagnosis and treatment of an individual's illness.

    Serum micronutrient testing as a general screen for nutritional disorders does not meet coverage criteria.

    Applicable Procedure Codes

    Applicable CPT/HCPCS Procedure CodesCPT/HCPCS
    82128Amino acids; multiple, qualitative, each specimen.
    82136Amino acids, 2 to 5 amino acids, quantitative, each specimen.
    82180Ascorbic acid (vitamin c), blood.
    82310Calcium; total.
    82379Carnitine (total and free), quantitative each specimen.
    82495Chromium.
    82525Copper.
    82978Glutathione.
    83735Magnesium.
    83785Manganese.
    1–10 of 20
    1/2
    Removed CPT/HCPCS Procedure CodesCPT
    82607Removed from applicable CPT/HCPCS procedure codes
    82652Removed from applicable CPT/HCPCS procedure codes
    82725Removed from applicable CPT/HCPCS procedure codes
    82746Removed from applicable CPT/HCPCS procedure codes
    88348Removed from applicable CPT/HCPCS procedure codes

    Provider and Billing Actions

    Denial Risk

    Coding and Billing Compliance Required

    Providers must follow applicable coding and billing guidelines, current reimbursement policies, and industry-standard claim-editing requirements. ConnectiCare may deny a claim or recoup payment when these requirements are not followed.

    • Coding edits may be based on AMA CPT® guidelines, specialty-organization guidance, and CMS requirements, including NCCI and MUE.
    • ConnectiCare uses industry-standard claims-editing software and may apply the edits it determines appropriate when authoritative sources conflict.
    • Upon request, ConnectiCare will provide an explanation of how it handles a specific coding issue.
    Denial Risk

    Excluded Micronutrient Testing

    The following testing does not meet coverage criteria because published scientific literature is not available to confirm that the testing is required and beneficial for diagnosing and treating an individual's illness.

    • Intracellular micronutrient panel testing does not meet coverage criteria, including examples such as SpectraCell, Cell Science Systems cell micronutrient assay, and ExaTest.

    Micronutrient Testing Background

    Micronutrients are vitamins and minerals required in small amounts for development, disease prevention, and well-being. Deficiency may result from malnutrition, illness, medications, or procedures and may be more likely in certain populations, including older adults and people who have undergone gastric bypass surgery. Serum nutrient concentrations can vary with body stores, recent intake, tissue, infection, stress, and other factors. The policy notes that general screening and testing intended to personalize supplementation are usually unwarranted.

    Definitions and Abbreviations

    Definitions
    ASEMAnalytical scanning electron microscopy
    Definitions
    CDCThe Centers for Disease Control
    Definitions
    CLIAClinical Laboratories Improvement Amendments
    Definitions
    CLIA '88Clinical Laboratory Improvement Amendments of 1988

    Services Not Covered

    The following services are not covered: serum micronutrient testing used as a general screen for nutritional disorders and intracellular micronutrient panel testing, including SpectraCell, the Cell Science Systems cellular micronutrient assay, and ExaTest.

    Policy Summary
    PayerConnectiCare
    PolicyMicronutrient Testing - Lab Benefit Program (LBM)
    Policy CodePolicy AHS-G2099
    Change TypeModified
    Effective DateSeptember 15, 2026
    Next Review DateN/A
    Key ActionDo not submit serum micronutrient testing used as a general screen for nutritional disorders because it does not meet coverage criteria.
    SourceLink
    On This Page
    Coverage CriteriaApplicable Procedure CodesProvider and Billing ActionsMicronutrient Testing BackgroundDefinitions and AbbreviationsServices Not Covered
  1. The policy criteria are not applicable to Exchange Plans for dates of service on or after January 1, 2026.
    2. Denial Risk

    General Nutritional Screening Not Covered

    Serum micronutrient testing performed as a general screen for nutritional disorders does not meet coverage criteria.

    • This general nutritional screening criterion was added with an effective date of September 15, 2026.
    Definitions
    CMACellular micronutrient assay
    Definitions
    CMSCenters for Medicare and Medicaid
    Definitions
    CSSCell Science Systems
    Definitions
    EXAEnergy dispersive x-ray analysis
    Definitions
    FDAFood and Drug Administration
    Definitions
    HPLCHigh-performance liquid chromatography
    Definitions
    LDTLaboratory-developed test
    Definitions
    SIStimulation index
    Definitions
    WHOWorld Health Organization
    Laboratory-developed test (LDT)
    DefinitionA test developed, validated, and performed in-house by a laboratory.
    Regulatory classificationRegulated by CMS as a high-complexity test under the Clinical Laboratory Improvement Amendments of 1988 (CLIA '88).
    FDA statusNot approved or cleared by the U.S. Food and Drug Administration; FDA clearance or approval is not currently required for clinical use.