Parathyroid Hormone, Phosphorus, Calcium, and Magnesium Testing - Lab Benefit Program (LBM)
Defines coverage, limitations, clinical background, and testing guidance for PTH, phosphorus, calcium, and magnesium laboratory testing under EmblemHealth's Lab Benefit Program; applies to providers submitting claims to EmblemHealth products.
Coverage Criteria 1 updated to add the word 'hormone' to 'serum intact parathyroid hormone'.
Coverage Criteria 1.b. edited for clarity and consistency.
Coverage Criteria 1 subcriteria reordered to group testing frequencies together, causing renumbering of former subcriteria (e.g., former 1.e -> 1.g.).
Coverage Criteria 2 removed the word 'parathyroid' since PTH was already defined; language clarified that PTH testing is not allowed for conditions outside Coverage Criteria 1.
Coverage Criteria 3.e. removed as redundant after changes to Coverage Criteria 2.
Combined former Coverage Criteria 1 & 2 into a single criterion to describe all appropriate testing indications for PTH and added a new Note defining signs of hypoparathyroidism.
Policy content transferred to an individual company-branded template (no change to title or policy number).
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.