Sedimentation Rate, Erythrocyte

ESR is covered when used to aid diagnosis or monitor disease activity for conditions such as temporal arteritis/polymyalgia rheumatica, treated Hodgkin’s disease, autoimmune or connective tissue inflammatory disorders, or as a rapid screen for elevated serum protein/globulin. Testing should be used selectively—supported by documentation of a history and physical exam showing unexplained symptoms—and is not medically necessary for general screening; contractors may further limit coverage via Local Coverage Determinations per CMS guidance.

"ESR is covered to aid in the diagnosis of temporal arteritis (giant cell arteritis) and polymyalgia rheumatica."

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