CG.CP.MP.01

Infectious Disease: Respiratory Lab Testing

This policy outlines criteria for Syndromic/Multiplex Respiratory Panels with 6 or More Targets, SARS-CoV-2, RSV, or Influenza A/B, OR Multiplex Respiratory Viral Panels with 5 or Fewer Targets, Bacterial Respiratory Infection/Pneumonia Panels, Influenza A and B Antibody Tests, Group A Streptococcus Pharyngitis Tests, Group A Streptococcus Pharyngitis Cultures, and Group A Streptococcus Antibody Tests.

CG.CP.MP.02

Infectious Disease: Multi-System Lab Testing

This policy outlines the appropriate use of tests for pathogens that can cause multisystem symptoms and/or infections. Tests for pathogens that infect multiple body systems can be targeted to detect a specific pathogen(s) or non-targeted to broadly detect nucleic acid from any potential pathogen.

CG.CP.MP.03

Infectious Disease: Dermatologic Testing

This policy outlines the appropriate use of Microscopy/Peroxidase Tests, Fungal Culture, and Culture-Independent Molecular Tests (NAAT/PCR) for Onychomycosis.

CG.CP.MP.04

Infectious Disease: Gastroenterologic Lab Testing

This policy outlines appropriate use of multi-pathogen panels, as well as diagnostic assays targeted at Helicobacter pylori (H. pylori).

CG.CP.MP.05

Infectious Disease Primary Care and Preventive Lab Screening

This policy outlines criteria for human papillomavirus (HPV), hepatitis C virus (HCV), and group B streptococcus (GBS).

CG.CP.MP.06

Infectious Disease: Vector-Borne and Tropical Diseases Lab Testing

This policy outlines criteria for Lyme disease and Zika virus testing via serologic and molecular methods.

CG.CP.MP.07

Infectious Disease: Genitourinary Lab Testing

This policy outlines criteria for Targeted Vaginitis/Vaginosis Pathogen Testing, Expanded Multiplex Vaginitis/Vaginosis Pathogen Panels, Urine Culture for Asymptomatic Bacteriuria, and Molecular/Multiplex UTI Panels.

CG.PP.551A

Genetic and Molecular Testing-Version A

This payment policy is supporting the entire Concert genetic testing QAI program. Concert outreaches to labs that have not already registered with them to inform them of the GTU and which codes are assigned to their tests as payable (never more than 5 per test), but registration is not required for them to have claims edited upon. This version (A) requires Concert’s unique genetic test identifier, the GTU, on every genetic testing claim.

CG.PP.551C

Genetic and Molecular Testing-Version C

This payment policy is supporting the entire Concert genetic testing QAI program. Concert outreaches to labs that have not already registered with them to inform them of the GTU and which codes are assigned to their tests as payable (never more than 5 per test), but registration is not required for them to have claims edited upon. This version (B) only requires a procedure code description (recommended to use the GTU but test name would also suffice) for the non-specific codes, 81479, 81599 and Tier 2 Codes.

CG.CC.PP.01

Concert Laboratory Payment Policy

This policy outlines correct coding requirements for lab testing, excluding and molecular testing.