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商業報道和編碼指南

Commercial health plans publish limited coverage policies (LCPs) for certain laboratory tests. Tests subject to a commercial LCP must meet medical necessity criteria in order to be covered by the plan.

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When submitting lab orders for a test included in commercial payer policies, please ensure that all ICD-10 codes provided represent the signs, symptoms, or conditions that prompted the request. If the indications and limitations of the payer's policy are not met, your patient may be responsible for payment.

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商業健康計劃發布了有限的覆蓋政策(LCP),以進行某些實驗室測試。受到商業LCP的測試必須符合醫療必要性標準,才能涵蓋該計劃。

在提交商業付款人政策中包含的測試的實驗室訂單時,請確保所有提供的ICD-10代碼代表促使請求的標誌,症狀或條件。如果未滿足付款人政策的指示和局限性,則您的患者可能負責付款。

導航醫療保險政策的複雜性可能很複雜,但是Quest Diagnostics在這裏有所幫助。

了解覆蓋政策並有助於限製您的實踐中的幹擾

Quest’s Commercial Coverage and Coding Reference Guides can help you understand coverage limitations and which ICD-10 codes are most frequently ordered by physicians. Understanding these coverage limitations may help prevent administrative disruptions to your practice.

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To get started, choose a health plan below.

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Quest的商業覆蓋範圍和編碼參考指南可以幫助您了解覆蓋範圍的限製,以及哪些ICD-10代碼最常由醫生訂購。了解這些覆蓋範圍的限製可能有助於防止行政中斷。

首先,請在下麵選擇一個健康計劃。

Below, you’ll find a list of aetna’s limited coverage policies for certain tests or test groups. Click on the links to find the coverage limitations and indications within the policy for the test you want to order.

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下麵,您會找到Aetna的有限覆蓋範圍列表某些測試或測試組。單擊鏈接以找到您要訂購的測試的策略中的覆蓋範圍限製和指示。

Below, you’ll find a list of Cigna’s limited coverage policies for certain tests or test groups. Click on the links to find the coverage limitations and indications within the policy for the test you want to order.

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在下麵,您會找到Cigna的某些測試或測試組有限的覆蓋範圍策略列表。單擊鏈接以找到您要訂購的測試的策略中的覆蓋範圍限製和指示。

Below is a list of limited coverage policies for certain tests or test groups. Click on the link to find your patient's Blue Cross Blue Shield home plan coverage limitations and indications within the BCBS policy.

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Alabama

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Arkansas

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North Carolina

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South Carolina

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以下是某些測試或測試組有限的覆蓋範圍策略列表。單擊鏈接以發現患者的藍十字藍盾房屋計劃覆蓋範圍限製和BCBS政策中的指示。

阿拉巴馬州

阿肯色州

北卡羅來納

南卡羅來納

Below, you’ll find a list of EmblemHealth’s limited coverage policies for certain tests or test groups. Click on the links to find the coverage limitations and indications within the policy for the test you want to order.

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在下麵,您會發現EmblemHealth在某些測試或測試組中的覆蓋範圍有限策略列表。單擊鏈接以找到您要訂購的測試的策略中的覆蓋範圍限製和指示。

Healthfirst follows the Medicare Region JK NGS policies. Please click on the link for more information.

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Healthfirst遵循Medicare地區JK NGS政策。請單擊鏈接以獲取更多信息。

Below, you’ll find a list of UnitedHealthcare’s limited coverage policies for certain tests or test groups. Click on the links to find the coverage limitations and indications within the policy for the test you want to order.

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在下麵,您會找到聯合國健康公司針對某些測試或測試組的有限覆蓋範圍列表。單擊鏈接以找到您要訂購的測試的策略中的覆蓋範圍限製和指示。

Note: individual plans may vary. For the most up-to-date coverage policy for each patient, please contact the patient’s health plan.

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注意:個人計劃可能會有所不同。有關每個患者的最新覆蓋範圍政策,請聯係患者的健康計劃。

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有關Quest如何幫助您簡化練習的更多信息,請下載我們的商業有限覆蓋政策手冊。
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