Laboratory Testing for Alpha-1 Antitrypsin (A1AT) Deficiency
Defines Humana Medicare Advantage coverage and reimbursement criteria for serum A1AT quantification and A1AT phenotyping/proteotyping testing for members when clinical indications are present.
No material clinical or coverage changes in this revision.
Coverage Criteria
Covered Indications for CPT 82103 and 82104
Covered when ANY of the following clinical indications are present
From policy enumerated indications.
Reimbursement for serum alpha-1‑antitrypsin testing is limited to the clinical indications listed in this policy. Specifically, CPT 82103 (A1AT total) and CPT 82104 (A1AT phenotype/proteotyping) are reimbursable only when one or more of the following clinical indications are documented: emphysema, COPD, chronic bronchitis, bronchiectasis, or asthma; liver disease; necrotizing panniculitis; vasculitis; neonatal cholestasis; or a family history of alpha‑1 antitrypsin deficiency or related hereditary/metabolic/blood disorders. Testing performed outside of these enumerated indications is not described as reimbursable in this policy.
Specific Covered Indications
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