CurrentHumanaPolicy LAB2023027
Laboratory - Bone Turnover Markers Testing
Medicare Advantage payment policy describing Humana's claims payment position for laboratory bone turnover marker tests for individuals diagnosed with osteoporosis; applies to Humana Medicare Advantage products and providers who submit claims for these tests.
Policy Summary
PayerHumana
PolicyLaboratory - Bone Turnover Markers Testing
Policy CodePolicy LAB2023027
Change TypeNo material change
Effective Date06/2023
Next Review Date
Key ActionFor individuals diagnosed with osteoporosis, measurement of each listed bone turnover marker is reimbursable at a frequency of one test every three months.
SourceLink
POLICY UPDATE CHANGES
No material clinical or coverage changes in this revision.
1/3 monthsreimbursable frequency for each specified bone turnover marker
4 codesprocedure codes referenced
Medicare Advantageproduct applicability
Coverage Criteria
Reimbursable testing criteria
Coverage applies when the individual is diagnosed with osteoporosis.
Diagnosis of osteoporosis documented
ALL of the following
- Each of the following bone turnover markers is reimbursable:
Markers
- Serum bone-specific alkaline phosphatase (BALP) — CPT code 84080
- Serum osteocalcin (OC) — CPT code 83937
Policy Summary
PayerHumana
PolicyLaboratory - Bone Turnover Markers Testing
Policy CodePolicy LAB2023027
Change TypeNo material change
Effective Date06/2023
Next Review Date
Key ActionFor individuals diagnosed with osteoporosis, measurement of each listed bone turnover marker is reimbursable at a frequency of one test every three months.
SourceLink
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