| Allergen Testing | Policy Number | Effective Date | End Date |
|---|
| Allergen Testing | CPCPLAB013 | 01/01/2026 | 09/03/2026 |
| Biomarker Testing for Autoimmune Rheumatic Disease | Policy Number | Effective Date | End Date |
|---|
| Biomarker Testing for Autoimmune Rheumatic Disease | CPCPLAB011 | 01/01/2026 | 09/03/2026 |
| Cardiovascular Disease Risk Assessment | Policy Number | Effective Date | End Date |
|---|
| Cardiovascular Disease Risk Assessment | CPCPLAB020 | 01/01/2026 | 09/03/2026 |
| Colorectal Cancer Screening | Policy Number | Effective Date | End Date |
|---|
| Colorectal Cancer Screening | CPCPLAB071 | 01/01/2026 | 09/03/2026 |
| Diagnosis of Idiopathic Environmental Intolerance | Policy Number | Effective Date | End Date |
|---|
| Diagnosis of Idiopathic Environmental Intolerance | CPCPLAB023 | 01/01/2026 | 04/30/2026 |
| Diagnostic Testing of Iron Homeostasis and Metabolism | Policy Number | Effective Date | End Date |
|---|
| Diagnostic Testing of Iron Homeostasis and Metabolism | CPCPLAB008 | 01/01/2026 | 04/30/2026 |
| Epithelial Cell Cytology in Breast Cancer Risk Assessment | Policy Number | Effective Date | End Date |
|---|
| Epithelial Cell Cytology in Breast Cancer Risk Assessment | CPCPLAB024 | 01/01/2026 | 09/03/2026 |
| Evaluation of Dry Eyes | Policy Number | Effective Date | End Date |
|---|
| Evaluation of Dry Eyes | CPCPLAB043 | 01/01/2026 | 09/03/2026 |
| Flow Cytometry | Policy Number | Effective Date | End Date |
|---|
| Flow Cytometry | CPCPLAB001 | 01/01/2026 | 09/03/2026 |
| Folate Testing | Policy Number | Effective Date | End Date |
|---|
| Folate Testing | CPCPLAB048 | 01/01/2026 | 09/03/2026 |
| Helicobacter pylori Testing | Policy Number | Effective Date | End Date |
| Helicobacter pylori Testing | CPCPLAB018 | 01/01/2026 | 09/03/2026 |
| Hepatitis Testing | Policy Number | Effective Date | End Date |
| Hepatitis Testing | CPCPLAB015 | 01/01/2026 | 09/03/2026 |
| Human Immunodeficiency Virus (HIV) | Policy Number | Effective Date | End Date |
| Human Immunodeficiency Virus (HIV) | CPCPLAB065 | 01/01/2026 | 09/03/2026 |
| Immune Cell Function Assay | Policy Number | Effective Date | End Date |
|---|
| Immune Cell Function Assay | CPCPLAB028 | 01/01/2026 | 04/30/2026 |
| Immunohistochemistry | Policy Number | Effective Date | End Date |
|---|
| Immunohistochemistry | CPCPLAB069 | 01/01/2026 | 04/30/2026 |
| Lyme Disease Testing | Policy Number | Effective Date | End Date |
|---|
| Lyme Disease Testing | CPCPLAB044 | 04/01/2026 | 09/03/2026 |
| Lyme Disease Testing | CPCPLAB044 | 01/01/2026 | 03/31/2026 |
| Intracellular Micronutrient Analysis | Policy Number | Effective Date | End Date |
| Intracellular Micronutrient Analysis | CPCPLAB029 | 01/01/2026 | 09/03/2026 |
| Nerve Fiber Density Testing | Policy Number | Effective Date | End Date |
|---|
| Nerve Fiber Density Testing | CPCPLAB064 | 01/01/2026 | 04/30/2026 |
| Onychomycosis Testing | Policy Number | Effective Date | End Date |
| Onychomycosis Testing | CPCPLAB068 | 01/01/2026 | 09/03/2026 |
| Pancreatic Enzyme Testing for Acute Pancreatitis | Policy Number | Effective Date | End Date |
| Pancreatic Enzyme Testing for Acute Pancreatitis | CPCPLAB047 | 01/01/2026 | 09/03/2026 |
| Parathyroid Hormone, Phosphorous, Calcium and Magnesium Testing | Policy Number | Effective Date | End Date |
| Parathyroid Hormone, Phosphorous, Calcium and Magnesium Testing | CPCPLAB055 | 01/01/2026 | 09/03/2026 |
| Pathogen Panel Testing | Policy Number | Effective Date | End Date |
|---|
| Pathogen Panel Testing | CPCPLAB045 | 01/01/2026 | 04/23/2026 |
| Pediatric Preventive Screening | Policy Number | Effective Date | End Date |
| Pediatric Preventive Screening | CPCPLAB016 | 01/01/2026 | 09/03/2026 |
| Prescription Medication and Illicit Drug Testing | Policy Number | Effective Date | End Date |
|---|
| Prescription Medication and Illicit Drug Testing | CPCPLAB070 | 04/24/2026 | 09/03/2026 |
| Prescription Medication and Illicit Drug Testing | CPCPLAB070 | 01/01/2026 | 04/23/2026 |
| Prostate Specific Antigen (PSA) Testing | Policy Number | Effective Date | End Date |
| Prostate Specific Antigen (PSA) Testing | CPCPLAB006 | 01/01/2026 | 09/03/2026 |
| Salivary Hormone Testing | Policy Number | Effective Date | End Date |
| Salivary Hormone Testing | CPCPLAB034 | 01/01/2026 | 09/03/2026 |
| Serum Tumor Markers for Malignancies | Policy Number | Effective Date | End Date |
| Serum Tumor Markers for Malignancies | CPCPLAB037 | 01/01/2026 | 09/03/2026 |
| Testing for Diagnosis of Active or Latent Tuberculosis | Policy Number | Effective Date | End Date |
|---|
| Testing for Diagnosis of Active or Latent Tuberculosis | CPCPLAB027 | 01/01/2026 | 04/23/2026 |
| Testing of Homocysteine Metabolism-Related Conditions | Policy Number | Effective Date | End Date |
|---|
| Testing of Homocysteine Metabolism-Related Conditions | CPCPLAB067 | 01/01/2026 | 04/30/2026 |
| Testosterone | Policy Number | Effective Date | End Date |
|---|
| Testosterone | CPCPLAB009 | 01/01/2026 | 04/30/2026 |
| Thyroid Disease Testing | Policy Number | Effective Date | End Date |
|---|
| Thyroid Disease Testing | CPCPLAB019 | 01/01/2026 | 09/03/2026 |
| Urinary Tumor Markers for Bladder Cancer | Policy Number | Effective Date | End Date |
|---|
| Urinary Tumor Markers for Bladder Cancer | CPCPLAB038 | 05/01/2026 | 09/03/2026 |
| Urinary Tumor Markers for Bladder Cancer | CPCPLAB038 | 01/01/2026 | 04/30/2026 |
| Venous and Arterial Thrombosis Risk Testing | Policy Number | Effective Date | End Date |
| Venous and Arterial Thrombosis Risk Testing | CPCPLAB058 | 01/01/2026 | 09/03/2026 |
| Vitamin B12 and Methylmalonic Acid Testing | Policy Number | Effective Date | End Date |
|---|
| Vitamin B12 and Methylmalonic Acid Testing | CPCPLAB010 | 01/01/2026 | 04/30/2026 |
| Vitamin D Testing | Policy Number | Effective Date | End Date |
|---|
| Vitamin D Testing | CPCPLAB003 | 01/01/2026 | 04/30/2026 |
