Ambetter · PayerPolicy · AMBETTER-CONCERT-GENETIC-TESTING-ONCOLOGY-ALGORITHMIC-ASSAYS
Summary of the payer’s published policy. Not a coverage determination — confirm with Ambetter before submitting.
Free account. Policy pages stay open to everyone.
Each code’s status is what the policy records for it. This page does not show the policy’s criteria. Read them in the payer’s source.
| Code | Code system | Status in this policy |
|---|---|---|
| 0003U | CPT | Referenced |
| 0005U | CPT | Referenced |
| 0012M | CPT | Referenced |
| 0013M | CPT | Referenced |
| 0016M | CPT | Referenced |
| 0018U | CPT | Referenced |
| 0021U | CPT | Referenced |
| 0026U | CPT | Referenced |
| 0045U | CPT | Referenced |
| 0047U | CPT | Referenced |
| 0069U | CPT | Referenced |
| 0080U | CPT | Referenced |
| 0083U | CPT | Referenced |
| 0089U | CPT | Referenced |
| 0090U | CPT | Referenced |
| 0092U | CPT | Referenced |
| 0108U | CPT | Referenced |
|---|
| 0113U | CPT | Referenced |
|---|
| 0114U | CPT | Referenced |
|---|
| 0153U | CPT | Referenced |
|---|
| 0172U | CPT | Referenced |
|---|
| 0174U | CPT | Referenced |
|---|
| 0204U | CPT | Referenced |
|---|
| 0220U | CPT | Referenced |
|---|
| 0228U | CPT | Referenced |
|---|
| 0245U | CPT | Referenced |
|---|
| 0261U | CPT | Referenced |
|---|
| 0287U | CPT | Referenced |
|---|
| 0288U | CPT | Referenced |
|---|
| 0295U | CPT | Referenced |
|---|
| 0313U | CPT | Referenced |
|---|
| 0314U | CPT | Referenced |
|---|
| 0317U | CPT | Referenced |
|---|
| 0339U | CPT | Referenced |
|---|
| 0343U | CPT | Referenced |
|---|
| 0359U | CPT | Referenced |
|---|
| 0360U | CPT | Referenced |
|---|
| 0363U | CPT | Referenced |
|---|
| 0365U | CPT | Referenced |
|---|
| 0366U | CPT | Referenced |
|---|
| 0367U | CPT | Referenced |
|---|
| 0375U | CPT | Referenced |
|---|
| 0376U | CPT | Referenced |
|---|
| 0377U | CPT | Referenced |
|---|
| 0387U | CPT | Referenced |
|---|
| 0395U | CPT | Referenced |
|---|
| 0398U | CPT | Referenced |
|---|
| 0403U | CPT | Referenced |
|---|
| 0406U | CPT | Referenced |
|---|
| 0414U | CPT | Referenced |
|---|
| 0420U | CPT | Referenced |
|---|
| 0424U | CPT | Referenced |
|---|
| 0433U | CPT | Referenced |
|---|
| 0436U | CPT | Referenced |
|---|
| 0495U | CPT | Referenced |
|---|
| 0497U | CPT | Referenced |
|---|
| 0506U | CPT | Referenced |
|---|
| 0507U | CPT | Referenced |
|---|
| 0512U | CPT | Referenced |
|---|
| 0513U | CPT | Referenced |
|---|
| 81313 | CPT | Referenced |
|---|
| 81479 | CPT | Referenced |
|---|
| 81500 | CPT | Referenced |
|---|
| 81503 | CPT | Referenced |
|---|
| 81518 | CPT | Referenced |
|---|
| 81519 | CPT | Referenced |
|---|
| 81520 | CPT | Referenced |
|---|
| 81521 | CPT | Referenced |
|---|
| 81522 | CPT | Referenced |
|---|
| 81523 | CPT | Referenced |
|---|
| 81525 | CPT | Referenced |
|---|
| 81529 | CPT | Referenced |
|---|
| 81535 | CPT | Referenced |
|---|
| 81536 | CPT | Referenced |
|---|
| 81538 | CPT | Referenced |
|---|
| 81539 | CPT | Referenced |
|---|
| 81540 | CPT | Referenced |
|---|
| 81541 | CPT | Referenced |
|---|
| 81542 | CPT | Referenced |
|---|
| 81546 | CPT | Referenced |
|---|
| 81551 | CPT | Referenced |
|---|
| 81552 | CPT | Referenced |
|---|
| 81599 | CPT | Referenced |
|---|
| 84153 | CPT | Referenced |
|---|
| 84154 | CPT | Referenced |
|---|
| 86316 | CPT | Referenced |
|---|
| S3854 | HCPCS | Referenced |
|---|
| C18.0 | ICD10CM | Referenced |
|---|
| C18.9 | ICD10CM | Referenced |
|---|
| C50.011 | ICD10CM | Referenced |
|---|
| C50.92 | ICD10CM | Referenced |
|---|
| C50.929 | ICD10CM | Referenced |
|---|
| C57.0 | ICD10CM | Referenced |
|---|
| C79.9 | ICD10CM | Referenced |
|---|
| C80.0 | ICD10CM | Referenced |
|---|
| C80.1 | ICD10CM | Referenced |
|---|
| D03.0 | ICD10CM | Referenced |
|---|
| D03.9 | ICD10CM | Referenced |
|---|
| D05.1 | ICD10CM | Referenced |
|---|
| D22.0 | ICD10CM | Referenced |
|---|
| D22.9 | ICD10CM | Referenced |
|---|
| D27.0 | ICD10CM | Referenced |
|---|
| D27.1 | ICD10CM | Referenced |
|---|
| D27.9 | ICD10CM | Referenced |
|---|
| D38.1 | ICD10CM | Referenced |
|---|
| D38.6 | ICD10CM | Referenced |
|---|
| D39.10 | ICD10CM | Referenced |
|---|
| D39.12 | ICD10CM | Referenced |
|---|
| D39.9 | ICD10CM | Referenced |
|---|
| D44.0 | ICD10CM | Referenced |
|---|
| D48.5 | ICD10CM | Referenced |
|---|
| D49.2 | ICD10CM | Referenced |
|---|
| D49.59 | ICD10CM | Referenced |
|---|
| D49.9 | ICD10CM | Referenced |
|---|
| E04.1 | ICD10CM | Referenced |
|---|
| K86.2 | ICD10CM | Referenced |
|---|
| R31.9 | ICD10CM | Referenced |
|---|
| R91.1 | ICD10CM | Referenced |
|---|
| Z12.5 | ICD10CM | Referenced |
|---|
| Z12.83 | ICD10CM | Referenced |
|---|
| Z17.0 | ICD10CM | Referenced |
|---|
| Z17.1 | ICD10CM | Referenced |
|---|