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DESCRIPTIONGeneral health panel is set of laboratory tests consisting of a comprehensive metabolic panel, complete blood count (CBC), and thyroid stimulating hormone (TSH).
POLICYGeneral health panel is considered a not medically necessary procedure.
POLICY GUIDELINESThe coverage guidelines outlined in this Medical Policy should not be used in lieu of the Member's specific benefit plan language.
POLICY HISTORY7/16/2009: Approved by Medical Policy Advisory Committee (MPAC)
11/24/2009: Policy Statement Section revised, replaced non-covered verbiage with "not medically necessary"
12/28/2009: Policy Guidelines section was revised to remove definition of an investigative service.
SOURCESCenters for Medicare & Medicaid Services (CMS)
CODE REFERENCEThis may not be a comprehensive list of procedure codes applicable to this policy.
Not Medically Necessary Codes