CurrentHumanaPolicy LAB2023054

Laboratory - Testing of Homocysteine Metabolism-Related Conditions

Payment policy governing reimbursement for total homocysteine testing (CPT 83090) for Humana Medicare Advantage products; describes when the test is reimbursable and references applicable Original Medicare LCDs.

Policy Summary

PayerHumana

PolicyLaboratory - Testing of Homocysteine Metabolism-Related Conditions

Policy CodePolicy LAB2023054

Change TypeNo material change

Effective Date07/2023

Next Review Date

Key ActionReimburse total homocysteine testing (CPT 83090) in plasma for patients with homocystinuria or vitamin B12 deficiency.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

83090CPT code for total homocysteine

Medicare AdvantageProduct type

REIMBURSABLECoverage status

Homocystinuria/B12 defIndications

Coverage Criteria for Total Homocysteine Testing

Total homocysteine testing coverage

Covered when ALL of the following are met:

Medicare Advantage member

Test ordered is total homocysteine (CPT code 83090)

ALL of the following

ONE of
- Homocystinuria
- Vitamin B12 deficiency

Policy Summary

PayerHumana

PolicyLaboratory - Testing of Homocysteine Metabolism-Related Conditions

Policy CodePolicy LAB2023054

Change TypeNo material change

Effective Date07/2023

Next Review Date

Key ActionReimburse total homocysteine testing (CPT 83090) in plasma for patients with homocystinuria or vitamin B12 deficiency.

SourceLink

On This Page

Provider Action / Reimbursement Statement

Billing Rule

Reimbursement statement for CPT 83090

Total homocysteine testing (CPT code 83090) in plasma is reimbursable when performed for patients with homocystinuria or vitamin B12 deficiency. Claims remain subject to medical necessity, plan requirements, and any applicable Original Medicare LCDs.

CPT code: 83090 — Homocysteine
Applicable to Medicare Advantage members; follow medical necessity and other plan requirements

Definitions

inv-04: Total homocysteine (CPT 83090) — definition and clinical context for the assay

Assay descriptionLaboratory assay measuring total homocysteine in plasma (CPT 83090).

Primary clinical usesEvaluation for homocystinuria and assessment of suspected vitamin B12 deficiency.

Applicable CPT code83090 — Homocysteine.

Policy scopeApplies to Humana Medicare Advantage members; claims are subject to medical necessity, plan requirements, and applicable Original Medicare LCDs.

Reimbursement stanceTotal homocysteine testing (CPT 83090) in plasma is reimbursable for patients with homocystinuria or vitamin B12 deficiency.

OpenPayer

Laboratory - Testing of Homocysteine Metabolism-Related Conditions

Coverage Criteria for Total Homocysteine Testing

Relevant Billing Codes

Provider Action / Reimbursement Statement

Definitions