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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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