Will my Annual Physical labs be covered by insurance?
July 15, 2019 by Kerri Maxcy PA-C
We understand how difficult it can be to understand your insurance benefits and coverage. Here at Manhattan Primary Care, we hope to assist you in any way we can to understand what your out of pocket costs will be before they are incurred.
One common question we are asked to help patients answer, ‘Will my Annual Physical labs be covered by my insurance?’
Every insurance company and plan is different, so the answer will vary for each individual and may change from year to year.
You can check with your insurance carrier by asking: “Are the following lab tests covered at no out of pocket cost to me if billed with the corresponding ICD – 10 codes?”
| Lab Test | CPT Code | ICD – 10 Code |
| CBC | 85027 | Z00.00 |
| Complete Metabolic Panel (CMP) | 80053 | Z13.1, Z00.00 |
| Lipid Panel | 80061 | Z13.220, Z00.00 |
| Thyroid Stimulating Hormone (TSH) | 84443 | Z13.29, Z00.00 |
| RPR | 86592 | Z11.3, Z00.00, Z20.2 |
| HIV | 86730 | Z11.3, Z00.00, Z11.59 |
| Chlamydia/Gonorrhea | 87491 | Z11.3, Z00.00, Z11.8 |
| Hepatitis B | 87340 | Z11.3, Z00.00, Z11.59 |
| Hepatitis C | 86803 | Z11.59, Z00.00 |
| Microalbumin Creatinine Urinalysis | 82043 | R73.03, OR E11.9, OR E10.9 |
| A1C | 83036 | R73.03, OR E11.9, OR E10.9 |
| Urinalysis with Reflux to Culture | 81001 | Z13.1, Z00.00 |
| Prostate Specific Antigen (PSA) | 84153 | Z12.5, Z00.00 |
| Cologuard | 81528 | Z12.11, OR Z12.12 |
As always, we appreciate your trusting Manhattan Primary Care with your healthcare needs.
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