| Policy Number | Effective Date | End Date | |
|---|---|---|---|
| Biomarker Testing for Autoimmune Rheumatic Disease | CPCPLAB011 | 01/01/2025 | 05/14/2025 |
| Biomarker Testing for Autoimmune Rheumatic Disease | CPCPLAB011 | 01/01/2025 | 01/01/2025 |
| Policy Number | Effective Date | End Date | |
| β-Hemolytic Streptococcus Testing | CPCPLAB053 | 01/01/2025 | 05/14/2025 |
| β-Hemolytic Streptococcus Testing | CPCPLAB053 | 01/01/2025 | 01/01/2025 |
 Cardiovascular Disease Risk Assessment |
Policy Number | Effective Date | End Date |
| Cardiovascular Disease Risk Assessment | CPCPLAB020 | 01/01/2025 | 05/14/2025 |
| Cervical Cancer Screening |
Policy Number | Effective Date | End Date |
| Cervical Cancer Screening | CPCPLAB002 | 01/01/2025 | 05/14/2025 |
| Cervical Cancer Screening | CPCPLAB002 | 01/01/2025 | 01/01/2025 |
| Coronavirus Testing in the Outpatient Setting | Policy Number | Effective Date | End Date |
| Coronavirus Testing in the Outpatient Setting | CPCPLAB057 | 01/01/2025 | 05/14/2025 |
| Diabetes Mellitus Testing | Policy Number | Effective Date | End Date |
| Diabetes Mellitus Testing | CPCPLAB004 | 01/01/2025 | 05/14/2025 |
| Diagnostic Testing of Iron Homeostasis and Metabolism | Policy Number | Effective Date | End Date |
| Diagnostic Testing of Iron Homeostasis and Metabolism | CPCPLAB008 | 09/13/2024 | 05/14/2025 |
| Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant Testing | Policy Number | Effective Date | End Date |
| Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant Testing | CPCPLAB025 | 01/01/2025 | 05/14/2025 |
| Fecal Calprotectin Testing in Adults | Policy Number | Effective Date | End Date |
| Fecal Calprotectin Testing in Adults | CPCPLAB026 | 01/01/2025 | 02/04/2025 |
| Flow Cytometry | Policy Number | Effective Date | End Date |
| Flow Cytometry | CPCPLAB001 | 01/01/2025 | 05/14/2025 |
| Helicobacter Pylori Testing | Policy Number | Effective Date | End Date |
| Helicobacter Pylori Testing | CPCPLAB018 | 01/01/2025 | 05/14/2025 |
| Helicobacter Pylori Testing | CPCPLAB018 | 01/01/2025 | 01/01/2025 |
| Hepatitis Testing | Policy Number | Effective Date | End Date |
| Hepatitis Testing | CPCPLAB015 | 01/01/2025 | 05/14/2025 |
| Identification of Microorganisms Using Nucleic Acid Probes | Policy Number | Effective Date | End Date |
| Identification of Microorganisms Using Nucleic Acid Probes | CPCPLAB063 | 01/01/2025 | 05/14/2025 |
| In Vitro Chemoresistance and Chemosensitivities Assays | Policy Number | Effective Date | End Date |
| In Vitro Chemoresistance and Chemosensitivities Assays | CPCPLAB030 | 01/01/2025 | 05/14/2025 |
| In Vitro Chemoresistance and Chemosensitivities Assays | CPCPLAB030 | 01/01/2025 | 01/01/2025 |
| Gamma-glutamyl Transferase in Adults | Policy Number | Effective Date | End Date |
| Gamma-glutamyl Transferase in Adults | CPCPLAB056 | 01/01/2025 | 05/14/2025 |
| General Inflammation Testing | Policy Number | Effective Date | End Date |
| General Inflammation Testing | CPCPLAB049 | 01/01/2025 | 05/14/2025 |
| Laboratory Testing for the Diagnosis of Inflammatory Bowel Disease | Policy Number | Effective Date | End Date |
| Laboratory Testing for the Diagnosis of Inflammatory Bowel Disease | CPCPLAB035 | 01/01/2025 | 05/14/2025 |
| Oral Cancer Screening and Testing | Policy Number | Effective Date | End Date |
| Oral Cancer Screening and Testing | CPCPLAB032 | 01/01/2025 | 05/14/2025 |
| Pancreatic Enzyme Testing for Acute Pancreatitis | Policy Number | Effective Date | End Date |
| Pancreatic Enzyme Testing for Acute Pancreatitis | CPCPLAB047 | 01/01/2025 | 05/14/2025 |
| Pathogen Panel Testing | Policy Number | Effective Date | End Date |
| Pathogen Panel Testing | CPCPLAB045 | 01/01/2025 | 05/14/2025 |
| Pathogen Panel Testing | CPCPLAB045 | 01/01/2025 | 01/01/2025 |
| Prenatal Screening (Nongenetic) | Policy Number | Effective Date | End Date |
| Prenatal Screening (Nongenetic) | CPCPLAB014 | 1/01/2025 | 05/14/2025 |
| Serum Biomarker Testing for Multiple Sclerosis and Related Neurologic Diseases | Policy Number | Effective Date | End Date |
| Serum Biomarker Testing for Multiple Sclerosis and Related Neurologic Diseases | CPCPLAB036 | 01/01/2025 | 05/14/2025 |
| Serum Biomarker Testing for Multiple Sclerosis and Related Neurologic Diseases | CPCPLAB036 | 01/01/2025 | 01/01/2025 |
| Serum Tumor Markers for Malignancies | Policy Number | Effective Date | End Date |
| Serum Tumor Markers for Malignancies | CPCPLAB037 | 01/01/2025 | 05/14/2025 |
| Testing for Alpha-1 Antitrypsin Deficiency | Policy Number | Effective Date | End Date |
| Testing for Alpha-1 Antitrypsin Deficiency | CPCPLAB061 | 01/01/2025 | 05/14/2025 |
| Testing for Diagnosis of Active or Latent Tuberculosis | Policy Number | Effective Date | End Date |
| Testing for Diagnosis of Active or Latent Tuberculosis | CPCPLAB027 | 01/01/2025 | 05/14/2025 |
| Testing for Diagnosis of Active or Latent Tuberculosis | CPCPLAB027 | 01/01/2025 | 01/01/2025 |
| Testing for Vector-Borne Infections | Policy Number | Effective Date | End Date |
| Testing for Vector-Borne Infections | CPCPLAB052 | 01/01/2025 | 05/14/2025 |
| Thyroid Disease Testing | Policy Number | Effective Date | End Date |
| Thyroid Disease Testing | CPCPLAB019 | 01/01/2025 | 05/14/2025 |
| Urinary Tumor Markers for Bladder Cancer | Policy Number | Effective Date | End Date |
| Urinary Tumor Markers for Bladder Cancer | CPCPLAB038 | 01/01/2025 | 05/14/2025 |
| Venous and Arterial Thrombosis Risk Testing | Policy Number | Effective Date | End Date |
| Venous and Arterial Thrombosis Risk Testing | CPCPLAB058 | 01/01/2025 | 05/14/2025 |
| Vitamin B12 and Methylmalonic Acid Testing | Policy Number | Effective Date | End Date |
| Vitamin B12 and Methylmalonic Acid Testing | CPCPLAB010 | 1/01/2025 | 05/14/2025 |
| Vitamin D Testing | Policy Number | Effective Date | End Date |
| Vitamin D Testing | CPCPLAB003 | 01/01/2025 | 05/14/2025 |
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