Payer PolicyActive
LAB.00031 Advanced Lipoprotein Testing
ANTHEM-LAB.00031
Anthem
Effective: July 1, 2025
Updated: December 30, 2025
Policy Summary
This policy addresses advanced lipoprotein testing beyond a basic lipid panel, including tests such as apolipoprotein A‑I, apolipoprotein B, apolipoprotein E, intermediate-density lipoproteins, and other lipoprotein subfraction/particle analyses. Anthem considers these tests investigational and not medically necessary for all indications—including cardiovascular disease risk assessment and management—and therefore not covered. There are no covered indications under this policy; it does not apply to the standard basic lipid panel.
Coverage Criteria Preview
Key requirements from the full policy
"Advanced lipoprotein testing (testing beyond that of a basic lipid panel) is consideredinvestigational and not medically necessaryfor all indications, including for cardiovascular disease (CVD) ris..."
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