I'm a provider
You will be redirected to myBlue. Would you like to continue?
Please wait while you are redirected.
Please enter a username and password.
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