MEDICAL POLICY - Laboratory Testing Investigational Services
Defines Premera's policy that numerous laboratory genetic, molecular, proteomic, and other diagnostic/prognostic/risk assessment tests not covered by separate policies are considered investigational due to insufficient evidence of clinical utility. Lists many specific CPT/HCPCS (mostly PLA/Category III U-codes and unlisted) test codes considered investigational.
Policy statement unchanged during 01/01/26 Annual Review; literature review through September 06, 2025; references deleted.
Numerous CPT coding updates were made across multiple dates (codes added, removed, relocated to other policies).
Original policy created and approved 08/08/23; all tests listed considered investigational.
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