CG-LAB-21 Serum Iron Testing

This policy addresses serum iron testing for evaluating iron status. It is medically necessary to evaluate suspected iron deficiency when there are supportive findings such as abnormal CBC indices (e.g., low MCV; low hemoglobin/hematocrit with low/normal MCV; elevated RDW with low/normal MCV), evidence of acute or chronic blood loss (GI bleeding, hematuria, menorrhagia), anemia related to malnutrition/malabsorption, iron deficiency associated with malignancy/chronic inflammation/infection, lack of response to iron therapy, or symptoms/clinical signs of iron deficiency. It is not medically necessary for routine screening without suggestive signs/symptoms/history, during acute inflammation or infection when results won’t change management, to monitor iron status after a normal ferritin in asymptomatic individuals, and concurrent ordering of transferrin and TIBC is not covered.

"Serum iron testing is consideredmedically necessaryfor any of the following indications:"