BlueCross BlueShield of Vermont Prior Authorization Policies
BlueCross BlueShield of Vermont has partnered with Avalon Healthcare Solutions for Laboratory Benefits Management (LBM) a post-service pre-payment clinical claim editing program.
- F2019: Flow Cytometry
- G2002: Cervical Cancer Screening
- G2005: Vitamin D Testing
- G2006: Diabetes Mellitus Testing
- G2007: Prostate Biopsy Specimen Analysis
- G2008: Prostate Specific Antigen (PSA) Testing
- G2011: Diagnostic Testing of Iron Homeostasis & Metabolism
- G2013: Testosterone
- G2014: Vitamin B12 and Methylmalonic Acid Testing
- G2022: Biomarker Testing for Autoimmune Rheumatic Disease
- G2031: Allergen Testing
- G2035: Prenatal Screening (Nongenetic)
- G2036: Hepatitis Testing
- G2042: Pediatric Preventive Screening
- G2043: Celiac Disease Testing
- G2044: Helicobacter pylori Testing
- G2045: Thyroid Disease Testing
- G2048: Biochemical Markers of Alzheimer Disease and Dementia
- G2050: Cardiovascular Disease Risk Assessment
- G2051: Bone Turnover Markers Testing
- G2055: Prenatal Testing for Fetal Aneuploidy
- G2056: Diagnosis of Idiopathic Environmental Intolerance
- G2059: Epithelial Cell Cytology In Breast Cancer Risk Assessment
- G2060: Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant Testing
- G2061: Fecal Calprotectin Testing in Adults
- G2063: Testing for Diagnosis of Active or Latent Tuberculosis
- G2098: Immune Cell Function Assay
- G2099: Intracellular Micronutrient Analysis
- G2100: In Vitro Chemoresistance and Chemosensitivity Assays
- G2105: Immunopharmacologic Monitoring of Therapeutic Serum Antibodies
- G2107: Measurement of Thromboxane Metabolites for ASA Resistance
- G2110: Serum Testing for Hepatic Fibrosis in the Evaluation and Monitoring of Chronic Liver Disease
- G2113: Oral Cancer Screening and Testing
- G2115: Metabolite Markers of Thiopurines Testing
- G2119: Diagnostic Testing of Influenza
- G2120: Salivary Hormone Testing
- G2121: Laboratory Testing for the Diagnosis of Inflammatory Bowel Disease
- G2123: Serum Biomarker Testing for Multiple Sclerosis and Related Neurologic Diseases
- G2124: Serum Tumor Markers for Malignancies
- G2125: Urinary Tumor Markers for Bladder Cancer
- G2138: Evaluation of Dry Eyes
- G2143: Lyme Disease Testing
- G2149: Pathogen Panel Testing
- G2150: Biomarkers for Myocardial Infarction and Chronic Heart Failure
- G2151: Serum Testing for Evidence of Mild Traumatic Brain Injury
- G2153: Pancreatic Enzyme Testing for Acute Pancreatitis
- G2154: Folate Testing
- G2155: General Inflammation Testing
- G2156: Urine Culture Testing for Bacteria
- G2157: Diagnostic Testing of Common Sexually Transmitted Infections
- G2158: Testing for Vector-Borne Infections
- G2159: B-Hemolytic Streptococcus Testing
- G2164: Parathyroid Hormone, Phosphorus, Calcium, and Magnesium Testing
- G2173: Gamma-glutamyl Transferase Testing in Adults
- G2174: Coronavirus Testing in the Outpatient Setting
- G2181: Colorectal Cancer Screening
- M2041: RTM Venous and Arterial Thrombosis Risk Testing
- M2057: Diagnosis of Vaginitis
- M2068: RTM Testing for Alpha-1 Antitrypsin Deficiency
- M2097: Identification Of Microorganisms Using Nucleic Acid Probes
- M2112: Nerve Fiber Density Testing
- M2116: Human Immunodeficiency Virus (HIV)
- M2141: RTM Testing of Homocysteine Metabolism-Related Conditions
- M2172: Onychomycosis Testing
- M2176: Testing for Autism Spectrum Disorder and Developmental Delay
- P2018: Immunohistochemistry
- T2015: Prescription Medication and Illicit Drug Testing in the Outpatient Setting