JM Palmetto | Quest Diagnostics

Alabama, Georgia, North Carolina, South Carolina, Tennessee, Virginia, and West Virginia are included under this policy. Jurisdiction is determined by the state in which your performing Quest lab is located.

Below, you’ll find a list of Medicare Coverage Policies for tests or test groups applicable to your state. Diagnosis codes are required for all Medicare orders to document medical necessity.

Click on the links below to find the associated diagnosis codes and frequency information within the policy for the test you want to order. Some links will provide a concise Medicare Coverage and Coding Guide for the coverage policy, while others will direct you to the CMS website policy page.

National Coverage Guides
Non-Covered ICD-10 Codes
Local Reference Guides
Local CMS Policies

Find links to PDF Reference Guides for Medicare National Coverage Determination Lists below.

Alpha-fetoprotein

Blood Counts

Blood Glucose Testing

Carcinoembryonic Antigen

Collagen Crosslinks, Any Method

Cytogenetic Studies

Digoxin Therapeutic Drug Assay

Fecal Occult Blood Test

Gamma Glutamyl Transferase

Glycated Hemoglobin/Glycated Protein

Hepatitis Panel/Acute Hepatitis Panel

Histocompatibility Testing

Human Chorionic Gonadotropin

Human Immunodeficiency Virus (HIV) Testing (Prognosis Including Monitoring)

Human Immunodeficiency Virus (HIV) Testing (Diagnosis)

Lipid Testing

Lymphocyte Mitogen Response Assays

Next Generation Sequencing (NGS)

Partial Thromboplastin Time (PTT)

Prostate-Specific Antigen

Prothrombin Time (PT)

Serum Iron Studies

Sweat Test

Thyroid Testing

Tumor Antigen by Immunoassay CA 15-3/CA 27.29

Tumor Antigen by Immunoassay CA 19-9

Tumor Antigen by Immunoassay CA 125

Urine Culture, Bacterial

Non-covered ICD-10 codes apply to all lab National Coverage Determinations. See the PDF Reference Guide here.

Access PDF reference guides for Medicare region JM Palmetto local coverage determination lists below.

Assays for Vitamins and Metabolic Function (Ascorbic Acid, B2, B1, E, A, NOE, K)

Assays for Vitamins and Metabolic Function (Carnitine)

Assays for Vitamins and Metabolic Function (Cell Function and Lymphocyte Transformation)

Assays for Vitamins and Metabolic Function (C-Reactive Protein HS)

Assays for Vitamins and Metabolic Function (Fibrinogen Antigen)

Assays for Vitamins and Metabolic Function (Vitamin B6)

Assays for Vitamins and Metabolic Function (Vitamin B12, Folic Acid, Homocysteine)

Assays for Vitamins and Metabolic Function (Vitamin D)

Brain Natriuretic Peptide (BNP) Level

Brain Natriuretic Peptide (BNP) Testing

Bladder Urothelial Tumor Markers

Controlled Substance Monitoring and Drugs of Abuse Testing

Flow Cytometry

Foodborne Gastrointestinal Panels

GlycoMark Testing for Glycemic Control

HbA1c

Homocysteine Level, Serum

MolDX: APC and MUTYH Gene Testing

MolDX: BDX-XL2

MolDX: Biomarkers in CA Risk Assessment

MolDX: BRCA1 and BRCA2 Genetic Testing

MolDX: Circulating Tumor Cell Marker

MolDX: Cystatin C Measurement

MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease

MolDX: Genetic Testing for Lynch Syndrome

MolDX: Genetic Testing for Hypercoagulability Thrombophilia

MolDX: Prometheus IBD sgi

Special Histochemical Stains and Immunohistochemical Stains

4Kscore Assay

Access links to CMS Site Policies for Medicare region JM Palmetto below.

Breast Cancer Assay: Prosigna

MolDX: 9p21 Genotype Test

MolDX: ApoE Genotype

NRAS Genetic Testing

For more information about how Quest can help you streamline your practice, download our Medicare coverage brochure.

Download

Have a billing question? Contact customer service

Medicare coverage & coding guides

Looking for patient billing?

If you are a patient, visit Patient billing

Have questions? We’re available.

Contact a Quest representative at 1.866.MYQUEST (1.866.697.8378).

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