Serum Folate and Red Blood Cell Folate Testing - (0567)

Cigna covers serum folate (CPT 82746) only for suspected folate deficiency in specified contexts (e.g., anemia with folate in the differential, neural tube defect/neurologic disorders, malabsorption, eating disorders, or to monitor therapy) and covers RBC folate (CPT 82747) only for the initial evaluation of cytopenia(s) when myelodysplasia is suspected; both tests are not covered for any other indications, including population screening or NTD risk assessment. Key requirements: claims must include one of the policy’s listed ICD‑10 codes and supporting clinical documentation (symptoms/diagnostic data such as CBC, peripheral smear, treatment rationale) demonstrating medical necessity or the claim will be denied.

"Serum folate testing (CPT® 82746) is considered medically necessary for EITHER of the following: Suspected diagnosis of folate deficiency associated with ANY of the following:"