LCDActive
Lab: Cystatin C Measurement
L37616
Effective: September 11, 2025
Updated: December 31, 2025
Policy Summary
Cystatin C measurement is covered when all of these are met: an adult with creatinine-based eGFR 45–59 ml/min/1.73 m2 (CKD stage 3A) without markers of kidney damage, creatinine-based eGFR is suspected to be inaccurate, and the confirmation will affect key clinical decisions (confirming CKD, evaluating kidney donation eligibility, or adjusting dosing of renally excreted toxic drugs). Testing to assess cardiovascular risk is investigational and not covered, and cystatin C testing is not considered reasonable and necessary for CKD stages 1, 2, 3B, 4, or 5.
Coverage Criteria Preview
Key requirements from the full policy
"Cystatin C testing is medically reasonable and necessary when all of the following are met: adult with serum creatinine–based eGFR 45–59 ml/min/1."
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