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Reminder — experimental and investigational labs

 

We consider certain laboratory tests to be experimental and investigational. These noncovered laboratory tests are not covered by most of our plans. This means your patient may be responsible for the full cost of these laboratory tests.

 

There are several tests that Aetna® may not cover, but the most common are:

 

  • Lyme Disease (CPB #0215)
  • Vitamin D Assay (CPB #0945)
  • Lipoprotein Cholesterol Test (CPB #0381)
  • Homocysteine Test (CPB #0381)

 

Information you should share with patients

 

It is important that your patients understand that they are financially responsible for these tests, as they are noncovered services. Please remind them at the time you order the test that they are responsible for the full cost of the laboratory tests.

 

You can verify if we cover a lab test

 

We provide an online reference tool listing laboratory tests that are considered experimental and investigational or that may be conditionally covered. Access this tool on our provider website. You can also view our corresponding Clinical Policy Bulletins (CPBs), which we post alongside the CPT® code descriptions.