CG-LAB-19 Laboratory Evaluation of Vitamin B12

This policy addresses laboratory evaluation of vitamin B12 status (serum vitamin B12 testing) and related markers (methylmalonic acid [MMA] and holotranscobalamin). Serum vitamin B12 testing is medically necessary for any of the following: alcohol dependence; anemia; autoimmune conditions such as intrinsic factor deficiency, thyroid disease, or pernicious anemia; or blood dyscrasias (e.g., cytopenia, leukopenia, thrombocytopenia). Vitamin B12 and MMA testing are not covered when these criteria are not met or for any other indications, and holotranscobalamin testing is not covered for any indication.

"Vitamin B12 blood testing is consideredmedically necessaryforanyof the following indications:"

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