Cardiovascular Disease Risk Tests – Commercial and Individual Exchange Medical Policyopen_in_new

UnitedHealthcare (Commercial and Individual Exchange) considers arterial compliance/waveform analysis, carotid intima‑media thickness (CIMT), advanced lipoprotein analyses (including Lp(a), particle subfractions and methods such as NMR/VAP), Lp‑PLA2, endothelial function testing (PAT/FMD), and multi‑protein biomarker panels with algorithmic risk scores (specific CPT codes listed) unproven and not medically necessary. Advanced lipoprotein testing must comply with CLIA standards, coverage is determined by the member’s specific benefit plan and applicable federal/state mandates (check plan documents), and the policy specifies no additional mandatory documentation or prior‑authorization criteria beyond plan terms (FDA clearances noted for information only).

"Arterial compliance testing, using waveform analysis as a method to determine risk for cardiovascular disease — considered unproven and not medically necessary due to insufficient evidence of effic..."