Medicaid Coverage and Coding Guides
Medicaid has limited coverage policies (LCPs) for certain laboratory tests. Tests subject to an LCP must meet medical necessity criteria in order to be covered.
When submitting lab orders, you must provide ICD-10 codes that indicate the patient’s condition and/or the reasons for ordering the test. If those reasons are not considered medically necessary by Medicaid, coverage may be denied.
Help to ensure lab tests are performed without disruptions
Navigating the complexities of Medicaid can be challenging, but Quest Diagnostics is here to help. Our Medicaid coverage and coding reference guides can help you understand coverage limitation and find ICD-10 diagnosis codes that are most frequently ordered by physicians—preventing potential disruptions to your practice.
To get started, select a state or plan below.
Have questions? We can help.
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Individual plans may vary. For the most accurate coverage policy for each patient, please contact the patient’s health plan. To view a complete coverage policy, click on the state and download the policy on the following page.