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202212-156944

2023

Excellus

PPO

Genitourinary/ Kidney Disorder

Lab Work/ Blood Tests

Medical necessity

Upheld

Case Summary

Diagnosis: Gross Hematuria
Treatment: Lab Work/Blood Tests- Oncology Gene Expression Lab Work
The insurer denied Lab Work/Blood Tests- Oncology Gene Expression Lab Work.
The determination is upheld.

This patient has microscopic hematuria status/post (s/p) Cxbladder Detect test performed on 5/2/22. At issue is the medical necessity of the requested health service/treatment of Oncology Gene Expression Lab Work.

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