Medical Necessity Guide

Name: Absolute Leukocyte Count
PHL Test Code: ABS
CPT Coding: 85048
Medical Necessity Documentation:

Name: Acetyl Salicylic Acid, IgE Allergen
PHL Test Code: MSOT
CPT Coding: 86003
Medical Necessity Documentation:

Name: Acid Phosphatase, Total
PHL Test Code: MSOT
CPT Coding: 84060
Medical Necessity Documentation:

Name: Activated Partial Thromboplastin Time
PHL Test Code: PTT
CPT Coding: 85730
Medical Necessity Documentation:

Name: Allergy Panel 1
PHL Test Code: FWP11
CPT Coding: 86003 x 11
Medical Necessity Documentation:

Name: Allergy Panel 2
PHL Test Code: FWP22
CPT Coding: 86003 x 12
Medical Necessity Documentation:

Name: Allergy Panel 3
PHL Test Code: FWP33
CPT Coding: 86003 x 9
Medical Necessity Documentation:

Name: Almond IgE, Allergen
PHL Test Code: AG46G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Alpha Lactalbumin IgE, Allergen
PHL Test Code: AG6G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Alpha-Fetoprotein Tumor Marker
PHL Test Code: AFPTM
CPT Coding: 82105
Medical Necessity Documentation:

Name: Alternaria alternata/tenuis IgE, Allergen
PHL Test Code: AG19G
CPT Coding: 86003
Medical Necessity Documentation:

Name: American Beech IgE, Allergen
PHL Test Code: AG91G
CPT Coding: 86003
Medical Necessity Documentation:

Name: AMI Activate Panel
PHL Test Code: AMI
CPT Coding: 83735, 84484, 85027, 85610, 85730 (Reflexes 85008)
Medical Necessity Documentation:

Name: Amoxicillin/Amoxicilloyl IgE, Allergen
PHL Test Code: AG145
CPT Coding: 86003
Medical Necessity Documentation:

Name: Ampicillin/Ampicilloyl IgE, Allergen
PHL Test Code: AG146
CPT Coding: 86003
Medical Necessity Documentation:

Name: Animal Allergen Panel
PHL Test Code: ANIM1
CPT Coding: 86003 x 4
Medical Necessity Documentation:

Name: Apple IgE, Allergen
PHL Test Code: AG47G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Apricot IgE, Allergen
PHL Test Code: AG187
CPT Coding: 86003
Medical Necessity Documentation:

Name: Arthritis Profile Comprehensive
PHL Test Code: ARTPC
CPT Coding: 82310, 84075, 84100, 84520, 84550, 85652, 86083, 86063, 86140, 86320, 86430
Medical Necessity Documentation:

Name: Aspergillus fumigatus IgE, Allergen
PHL Test Code: AG20G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Aspergillus IgE Panel
PHL Test Code: ASGE
CPT Coding: 86003 (x7)
Medical Necessity Documentation:

Name: Aspergillus niger IgE, Allergen
PHL Test Code: A150G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Aubergine Eggplant, IgE Allergen
PHL Test Code: AG196
CPT Coding: 86003
Medical Necessity Documentation:

Name: Aureobasidium Pullulans IgE, Allergen
PHL Test Code: AG27G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Avocado IgE, Allergen
PHL Test Code: AG201
CPT Coding: 86003
Medical Necessity Documentation:

Name: Bahia Grass IgE, Allergen
PHL Test Code: AG11G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Banana IgE, Allergen
PHL Test Code: AG48G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Barley IgE, Allergen
PHL Test Code: AG49G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Basil IgE, Allergen
PHL Test Code: AG119
CPT Coding: 86003
Medical Necessity Documentation:

Name: BCR-ABL1 Gene Rearrangement, Quantitative, PCR
PHL Test Code: BCRP
CPT Coding: 81206, 81207
Medical Necessity Documentation:

Name: Beef IgE, Allergen
PHL Test Code: AG50G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Bermuda Grass IgE, Allergen
PHL Test Code: AG12G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Beta-2 Microglobulin
PHL Test Code: BE2MC
CPT Coding: 82232
Medical Necessity Documentation:

Name: Beta-2 Microglobulin, Urine
PHL Test Code: B2MCU
CPT Coding: 82232
Medical Necessity Documentation:

Name: Beta-lactoglobulin, IgE
PHL Test Code: MSOT
CPT Coding: 86003
Medical Necessity Documentation:

Name: Black Pepper IgE, Allergen
PHL Test Code: AG144
CPT Coding: 86003
Medical Necessity Documentation:

Name: Blackberry IgE, Allergen
PHL Test Code: AG194
CPT Coding: 86003
Medical Necessity Documentation:

Name: Blue Mussel IgE, Allergen
PHL Test Code: A151G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Blueberry IgE, Allergen
PHL Test Code: AG156
CPT Coding: 86003
Medical Necessity Documentation:

Name: Bordetella pertussis IgM Antibody
PHL Test Code: BTPM
CPT Coding: 86615 (86615)
Medical Necessity Documentation:
Because this test is for Research Use Only it will not be billed to Medicaid, Medicare or Medicare Advantage Plans.  The Patient will be responsible for  payment.

Name: Box Elder IgE, Allergen
PHL Test Code: AG94G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Brazil Nut IgE, Allergen
PHL Test Code: A130G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Broccoli IgE, Allergen
PHL Test Code: AG166
CPT Coding: 86003
Medical Necessity Documentation:

Name: Bumble Bee Venom IgE, Allergen
PHL Test Code: AG10G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Cabbage IgE, Allergen
PHL Test Code: AG206
CPT Coding: 86003
Medical Necessity Documentation:

Name: Cacao (Chocolate) IgE, Allergen
PHL Test Code: AG57G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Calcium, Ionized
PHL Test Code: CAION
CPT Coding: 82330
Medical Necessity Documentation:


Name: Calcium, Ionized - Post Filter
PHL Test Code: CAIPO
CPT Coding: 82330
Medical Necessity Documentation:

Name: Calcium, Ionized - Pre Filter
PHL Test Code: CAIPR
CPT Coding: 82330
Medical Necessity Documentation:

Name: Cancer Antigen 125
PHL Test Code: C1251
CPT Coding: 86304
Medical Necessity Documentation:



Name: Cancer Antigen 19-9
PHL Test Code: CA199
CPT Coding: 86301
Medical Necessity Documentation:

Name: Cancer Antigen 27-29
PHL Test Code: C2729
CPT Coding: 86300
Medical Necessity Documentation:

Name: Candida albicans IgE, Allergen
PHL Test Code: AG21G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Carcinoembryonic Antigen
PHL Test Code: CEA
CPT Coding: 82378
Medical Necessity Documentation:

Name: Carcinoembryonic Antigen, Fluid
PHL Test Code: FCEA
CPT Coding: 82378
Medical Necessity Documentation:

Name: Carmine
PHL Test Code: AG215
CPT Coding: 86003
Medical Necessity Documentation:  

Name: Carrot IgE, Allergen
PHL Test Code: AG51
CPT Coding: 86003
Medical Necessity Documentation:

Name: Casein IgE, Allergen
PHL Test Code: AG52
CPT Coding: 86003
Medical Necessity Documentation:

Name: Cashew Nut IgE, Allergen
PHL Test Code: AG53G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Cat Epithelium/Dander IgE, Allergen
PHL Test Code: AG1G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Cauliflower IgE, Allergen
PHL Test Code: AG184
CPT Coding: 86003
Medical Necessity Documentation:

Name: Cedar IgE, Allergen
PHL Test Code: A198G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Celery IgE, Allergen
PHL Test Code: AG54
CPT Coding: 86003
Medical Necessity Documentation:

Name: Cheese Mold Type IgE, Allergen
PHL Test Code: AG167
CPT Coding: 86003
Medical Necessity Documentation:

Name: Cheese, Cheddar Type IgE, Allergen
PHL Test Code: AG55
CPT Coding: 86003
Medical Necessity Documentation:

Name: Chicken Feathers IgE, Allergen
PHL Test Code: AG2G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Chicken Meat IgE, Allergen
PHL Test Code: AG56
CPT Coding: 86003
Medical Necessity Documentation:

Name: Childhood Allergy Panel
PHL Test Code: CHAP2
CPT Coding: 86003 x 15, 82785
Medical Necessity Documentation:

Name: Cholesterol
PHL Test Code: CHOL
CPT Coding: 82465
Medical Necessity Documentation:

Name: Cholesterol, Fluid
PHL Test Code: FCHOL
CPT Coding: 82465
Medical Necessity Documentation:

Name: Cinnamon IgE, Allergen
PHL Test Code: AG169
CPT Coding: 86003
Medical Necessity Documentation:

Name: Cladosporium herbarum IgE, Allergen
PHL Test Code: AG22G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Clam IgE, Allergen
PHL Test Code: AG58G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Coag Profile
PHL Test Code: COAG
CPT Coding: 85049, 85610, 85730, 85384
Medical Necessity Documentation:

Name: Cocklebur IgE, Allergen
PHL Test Code: AG32G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Cocksfoot (Orchard Grass) IgE, Allergen
PHL Test Code: AG16G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Coconut IgE, Allergen
PHL Test Code: AG161
CPT Coding: 86003
Medical Necessity Documentation:

Name: Codfish IgE, Allergen
PHL Test Code: AG59G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Coffee IgE, Allergen
PHL Test Code: AG171
CPT Coding: 86003
Medical Necessity Documentation:

Name: Collagen Cross-Linked, 24-Hour Urine
PHL Test Code: NTX24
CPT Coding: 82523, 82570
Medical Necessity Documentation:

Name: Collagen Profile
PHL Test Code: COLL
CPT Coding: 85025, 85652, 86038, 86140, 86430 (Reflexes 85007, 85008, 86039, 86431)
Medical Necessity Documentation:

Name: Common Ragweed, IgE Allergen
PHL Test Code: A108G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Common Silver Birch IgE, Allergen
PHL Test Code: AG92G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Complete Blood Count
PHL Test Code: CBCND
CPT Coding: 85027
Medical Necessity Documentation:

Name: Complete Blood Count with Differential
PHL Test Code: CBCWD
CPT Coding: 85025 (Reflex 85007, 85008)
Medical Necessity Documentation:

Name: Corn (Pollen) IgE, Allergen
PHL Test Code: MSOT
CPT Coding: 86003
Medical Necessity Documentation:

Name: Corn IgE, Allergen
PHL Test Code: AG60G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Cotton Seed IgE, Allergen
PHL Test Code: AG178
CPT Coding: 86003
Medical Necessity Documentation:

Name: Cottonwood IgE, Allergen
PHL Test Code: AG95G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Cow Dander IgE, Allergen
PHL Test Code: A162G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Cow Milk IgE, Allergen
PHL Test Code: AG69G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Crab IgE, Allergen
PHL Test Code: AG61G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Cranberry IgE, Allergen
PHL Test Code: AG170
CPT Coding: 86003
Medical Necessity Documentation:

Name: C-Reactive Protein, Ultrasensitive
PHL Test Code: CRPS1
CPT Coding: 86141
Medical Necessity Documentation:

Name: CTx Collagen Type I-C
PHL Test Code: CCTX
CPT Coding: 82523
Medical Necessity Documentation:

Name: Cucumber IgE, Allergen
PHL Test Code: AG168
CPT Coding: 86003
Medical Necessity Documentation:

Name: Curry IgE, Allergen
PHL Test Code: AG126
CPT Coding: 86003
Medical Necessity Documentation:

Name: Dermatophagoides farinae IgE, Allergen
PHL Test Code: AG29G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Dermatophagoides pteronyssinus IgE, Allergen
PHL Test Code: AG30G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Digoxin
PHL Test Code: DIG
CPT Coding: 80162
Medical Necessity Documentation:

Name: Dill IgE, Allergen
PHL Test Code: AG121
CPT Coding: 86003
Medical Necessity Documentation:

Name: Disseminated Intravascular Coagulation Panel
PHL Test Code: DIC2
CPT Coding: 85049, 85379, 85384, 85610, 85730
Medical Necessity Documentation:

Name: Dog Dander IgE, Allergen
PHL Test Code: A105G
CPT Coding: 86003
Medical Necessity Documentation:

Name: DPD N-Telopeptide
PHL Test Code: DPDTP
CPT Coding: 82523, 82570
Medical Necessity Documentation:

Name: Drug Screen 10, Urine
PHL Test Code: DRU10
CPT Coding: 80301 (G0431 for Medicare)
Medical Necessity Documentation:

Name: Drug Screen, Clinical
PHL Test Code: UDS
CPT Coding: 80301 (Medicare - G0431)
Medical Necessity Documentation:

Name: Duck Feathers IgE, Allergen
PHL Test Code: AG3G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Dust Allergen Panel
PHL Test Code: DSPN1
CPT Coding: 86003 x 5
Medical Necessity Documentation:

Name: Eastern Midwest Panel
PHL Test Code: EMWP1
CPT Coding: 86003 x 25
Medical Necessity Documentation:

Name: Egg Component Panel
PHL Test Code: EGGP
CPT Coding: 86003 x 2
Medical Necessity Documentation:

Name: Egg White IgE, Allergen
PHL Test Code: A106G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Egg Whole IgE, Allergen
PHL Test Code: A107G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Egg Yolk IgE, Allergen
PHL Test Code: AG62
CPT Coding: 86003
Medical Necessity Documentation:

Name: EHS Panel
PHL Test Code: EHSP
CPT Coding: 80051, 82040, 82247, 82248, 82565, 82947, 84075, 84155, 84450, 84460, 84520, 85025 (Reflex 85007, 85008)
Medical Necessity Documentation:

Name: Electron Microscopy, Renal Biopsy
PHL Test Code: PS
CPT Coding: 88348, 88305, 88346
Medical Necessity Documentation:

Name: Electron Microscopy, Tissue
PHL Test Code: PS
CPT Coding: 88348, (Based on tissue type - 88302, 88304, 88305, 88307, 88309)
Medical Necessity Documentation:

Name: Elm IgE, Allergen
PHL Test Code: AG96G
CPT Coding: 86003
Medical Necessity Documentation:

Name: False Ragweed IgE, Allergen
PHL Test Code: AG39G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Ferritin
PHL Test Code: FER
CPT Coding: 82728
Medical Necessity Documentation:

Name: Fibro Panel
PHL Test Code: FIBRO
CPT Coding: Refer to Individual Tests
Medical Necessity Documentation:  

Name: Fibro Panel no Urine
PHL Test Code: FIBNU
CPT Coding: Refer to Individual Tests
Medical Necessity Documentation:  

Name: Fire Ant IgE, Allergen
PHL Test Code: AG9G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Firebush, Kochia IgE, Allergen
PHL Test Code: AG35G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Flounder IgE, Allergen
PHL Test Code: AG116
CPT Coding: 86003
Medical Necessity Documentation:

Name: Food Allergy Panel
PHL Test Code: FP10
CPT Coding: 86003 x 10
Medical Necessity Documentation:  

Name: Food Panel 2
PHL Test Code: FDP4
CPT Coding: 86003 x 12, 82785
Medical Necessity Documentation:

Name: Fructosamine
PHL Test Code: FRUC
CPT Coding: 82985
Medical Necessity Documentation:

Name: Gamma-Glutamyl Transferase
PHL Test Code: GGT
CPT Coding: 82977
Medical Necessity Documentation:

Name: Garlic IgE, Allergen
PHL Test Code: AG63
CPT Coding: 86003
Medical Necessity Documentation:

Name: General Health Panel
PHL Test Code: GHP1
CPT Coding: 80053, 84443, 85025 (Reflex 85007, 85008)
Medical Necessity Documentation:  

Name: German Cockroach IgE, Allergen
PHL Test Code: AG8G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Giant Ragweed IgE, Allgergen
PHL Test Code: AG40G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Ginger IgE, Allergen
PHL Test Code: AG124
CPT Coding: 86003
Medical Necessity Documentation:

Name: Glucose
PHL Test Code: GLU
CPT Coding: 82947
Medical Necessity Documentation:

Name: Glucose Diabetes Screening
PHL Test Code: GTTDM
CPT Coding: 82947, 82950
Medical Necessity Documentation:

Name: Glucose Post Prandial
PHL Test Code: GLPP
CPT Coding: 82947
Medical Necessity Documentation:

Name: Glucose, 4 PM
PHL Test Code: GLU4P
CPT Coding: 82947
Medical Necessity Documentation:

Name: Gluten IgE, Allergen
PHL Test Code: AG64
CPT Coding: 86003
Medical Necessity Documentation:

Name: Glycohemoglobin
PHL Test Code: GLYC1
CPT Coding: 83036
Medical Necessity Documentation:

Duplicate testing on this test is not acceptable per Medicare:  Testing to only be done every 90 days


Name: Goldenrod IgE, Allergen
PHL Test Code: AG34G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Goose Feathers IgE, Allergen
PHL Test Code: AG4G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Goosefoot, Lambs Quarters IgE, Allergen
PHL Test Code: AG36G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Grape IgE, Allergen
PHL Test Code: AG181
CPT Coding: 86003
Medical Necessity Documentation:

Name: Grapefruit IgE, Allergen
PHL Test Code: AG207
CPT Coding: 86003
Medical Necessity Documentation:

Name: Great Lakes Panel
PHL Test Code: GLWG1
CPT Coding: 86003 x 10
Medical Necessity Documentation:

Name: Green Bean IgE, Allergen
PHL Test Code: AG200
CPT Coding: 86003
Medical Necessity Documentation:

Name: Green Pepper IgE, Allergen
PHL Test Code: AG183
CPT Coding: 86003
Medical Necessity Documentation:

Name: Guinea Pig Epithelium IgE, Allergen
PHL Test Code: AG155
CPT Coding: 86003
Medical Necessity Documentation:

Name: Halibut IgE, Allergen
PHL Test Code: AG114
CPT Coding: 86003
Medical Necessity Documentation:

Name: Hazel IgE, Allergen
PHL Test Code: AG177
CPT Coding: 86003
Medical Necessity Documentation:

Name: Hazel Nut IgE, Allergen
PHL Test Code: AG65G
CPT Coding: 86003
Medical Necessity Documentation:

Name: hCG Tumor Marker
PHL Test Code: HCGTM
CPT Coding: 84702
Medical Necessity Documentation:

Name: Helminthosporium Halodes IgE, Allergen
PHL Test Code: A133G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Helminthosporium sativum/drecshlera IgE, Allergen
PHL Test Code: MSOT
CPT Coding: 86003
Medical Necessity Documentation:

Name: Hematocrit
PHL Test Code: HCT
CPT Coding: 85014
Medical Necessity Documentation:

Name: Hematocrit, Fluid
PHL Test Code: FHCT
CPT Coding: 85013
Medical Necessity Documentation:

Name: Hematocrit, Micro
PHL Test Code: MHCT
CPT Coding: 85013
Medical Necessity Documentation:

Name: Hemoglobin
PHL Test Code: HGB
CPT Coding: 85018
Medical Necessity Documentation:

Name: Hemoglobin and Hematocrit
PHL Test Code: HH
CPT Coding: 85014, 85018
Medical Necessity Documentation:

Name: Hemoglobin Electrophoresis Cascade
PHL Test Code: MSOT
CPT Coding: 83020, 83021
Medical Necessity Documentation:

Name: Hepatitis A Antibody, Total with reflex IgM
PHL Test Code: HEPTM
CPT Coding: 86708 (Reflex 86709)
Medical Necessity Documentation:

Name: Hepatitis A IgM Antibody
PHL Test Code: HAV
CPT Coding: 86709
Medical Necessity Documentation:
Duplicate testing on this test is not acceptable per Medicare:  Testing to only be done every 3 days

Name: Hepatitis B Core Antibody IgM
PHL Test Code: HBCAB
CPT Coding: 86705
Medical Necessity Documentation:
Duplicate testing on this test is not acceptable per Medicare:  Testing to only be done every 3 days

Name: Hepatitis B Core Total Antibody
PHL Test Code: HBCOR
CPT Coding: 86704
Medical Necessity Documentation:

Name: Hepatitis B Surface Antibody
PHL Test Code: HBSAB
CPT Coding: 86706
Medical Necessity Documentation:
Duplicate testing on this test is not acceptable per Medicare:  Testing to only be done every 365 days

Name: Hepatitis B Surface Antigen
PHL Test Code: HBSAG
CPT Coding: 87340 (Reflexes 87341)
Medical Necessity Documentation:
Duplicate testing on this test is not acceptable per Medicare:  Testing to only be done every 365 days

Name: Hepatitis Be Antibody
PHL Test Code: HBEAB
CPT Coding: 86707
Medical Necessity Documentation:

Name: Hepatitis Be Antigen
PHL Test Code: HBEAG
CPT Coding: 87350
Medical Necessity Documentation:

Name: Hepatitis C Antibody
PHL Test Code: HEPC3
CPT Coding: 86803
Medical Necessity Documentation:
Duplicate testing on this test is not acceptable per Medicare:  Testing to only be done every 365 days

Name: Hepatitis C Virus (HCV) FibroSure®
PHL Test Code: ACTI
CPT Coding: 82172, 82247, 82977, 83010, 83883, 84460
Medical Necessity Documentation:

Name: Hepatitis Immunity Panel
PHL Test Code: HEPIM
CPT Coding: 86704, 86706
Medical Necessity Documentation:

Name: Hepatitis Panel
PHL Test Code: HEP3
CPT Coding: 80074
Medical Necessity Documentation:
Duplicate testing on this test is not acceptable per Medicare:  Testing to only be done every 365 days

Name: High Density Lipoprotein
PHL Test Code: HDL
CPT Coding: 83718
Medical Necessity Documentation:

Name: HIV 1 & 2 Antibody
PHL Test Code: HIV1
CPT Coding: 86703 (Reactive 86701,86702)
Medical Necessity Documentation:
Duplicate testing on this test is not acceptable per Medicare:  Testing to only be done every 365 days

Name: HIV Rapid
PHL Test Code: HIVR
CPT Coding: 86703
Medical Necessity Documentation:

Name: HIV-1 RNA, Quantitative
PHL Test Code: RTPCR
CPT Coding: 87536
Medical Necessity Documentation:

Name: HIV-1 RNA, Quantitative RNA PCR, with Reflex to HIV-1 Genotype
PHL Test Code: MSOT
CPT Coding: 87536 (Reflex 87901, 87900)
Medical Necessity Documentation:

Name: HIV-1/2 Antibody Differentiation
PHL Test Code: HVAB
CPT Coding: 86701 (Reflexes 87535), 86702
Medical Necessity Documentation:

Name: Homocysteine
PHL Test Code: HCYS1
CPT Coding: 83090
Medical Necessity Documentation:

Name: Honey, IgE Allergen
PHL Test Code: AG197
CPT Coding: 86003
Medical Necessity Documentation:

Name: Honeybee Venom IgE, Allergen
PHL Test Code: AG110
CPT Coding: 86003
Medical Necessity Documentation:

Name: Horse Dander IgE, Allergen
PHL Test Code: AG5G
CPT Coding: 86003
Medical Necessity Documentation:

Name: House Dust - Hollister Stier IgE, Allergen
PHL Test Code: A160G
CPT Coding: 86003
Medical Necessity Documentation:

Name: House Dust-Greer IgE, Allergen
PHL Test Code: AG31G
CPT Coding: 86003
Medical Necessity Documentation:

Name: HTLV I/II Antibody, w/Reflex to Confirmatory Assay
PHL Test Code: HTLVP
CPT Coding: 86790 (reflexes 86689)
Medical Necessity Documentation:

Name: Human Chorionic Gonadotropin, Qualitative Reflex HCG Quantitative
PHL Test Code: PRSR
CPT Coding: 84703, reflex 84702
Medical Necessity Documentation:

Name: Human Chorionic Gonadotropin, Quantitative
PHL Test Code: HCG1
CPT Coding: 84702
Medical Necessity Documentation:

Name: Hyper Alimentation Panel
PHL Test Code: HYPAL
CPT Coding: 80051, 82310, 83735, 84100
Medical Necessity Documentation:

Name: Immunoperoxidase Stains
PHL Test Code: PS
CPT Coding: 88342 per stain
Medical Necessity Documentation:

Name: Inflammatory Group 1 with Westergren Sed Rate
PHL Test Code: INFLP
CPT Coding: 86038, 86140, 86430, 86060, 84550, 85652 (Reflex 86039)
Medical Necessity Documentation:

Name: Inhalant Panel
PHL Test Code: ENTP1
CPT Coding: 86003 x 16, 82785
Medical Necessity Documentation:

Name: Iron
PHL Test Code: IRON
CPT Coding: 83540
Medical Necessity Documentation:

Name: Iron Deficiency Panel
PHL Test Code: IDP
CPT Coding: 82728, 83540, 83550
Medical Necessity Documentation:

Name: Iron Profile
PHL Test Code: IRONP
CPT Coding: 83540, 83550
Medical Necessity Documentation:

Name: Isocyanate HDI IgE, Allergen
PHL Test Code: AG142
CPT Coding: 86003
Medical Necessity Documentation:

Name: Isocyanate MDI IgE, Allergen
PHL Test Code: AG141
CPT Coding: 86003
Medical Necessity Documentation:

Name: Isocyanate TDI IgE, Allergen
PHL Test Code: AG140
CPT Coding: 86003
Medical Necessity Documentation:

Name: JAK2 V617F, Qualitative, Leumeta® with Reflex to Exons 12,13 and Reflex to MPL W515, S505
PHL Test Code: JAK2R
CPT Coding: 81270
Medical Necessity Documentation:

Name: Johnson Grass IgE, Allergen
PHL Test Code: AG13G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Kiwi IgE, Allergen
PHL Test Code: AG163
CPT Coding: 86003
Medical Necessity Documentation:

Name: Latex IgE
PHL Test Code: LATEX
CPT Coding: 86003
Medical Necessity Documentation:

Name: LDL, Direct Measure
PHL Test Code: LDL
CPT Coding: 83721
Medical Necessity Documentation:

Name: Lemon IgE, Allergen
PHL Test Code: AG204
CPT Coding: 86003
Medical Necessity Documentation:

Name: Lettuce IgE, Allergen
PHL Test Code: AG67
CPT Coding: 86003
Medical Necessity Documentation:

Name: Lima Bean IgE, Allergen
PHL Test Code: AG175
CPT Coding: 86003
Medical Necessity Documentation:

Name: Lipid Profile
PHL Test Code: LIPID
CPT Coding: 80061 (Reflex 83721)
Medical Necessity Documentation:

Name: Lipoprotein Electrophoresis
PHL Test Code: LIPE
CPT Coding: 82465, 83700, 84478
Medical Necessity Documentation:

Name: Liver Profile
PHL Test Code: LIVER
CPT Coding: 80076
Medical Necessity Documentation:

Name: Lobster IgE, Allergen
PHL Test Code: AG68
CPT Coding: 86003
Medical Necessity Documentation:

Name: Lupus Anticoagulant Evaluation with Reflex
PHL Test Code: LUPA
CPT Coding: 85613, 85730
Medical Necessity Documentation:  

Name: Macadamia Nut IgE, Allergen
PHL Test Code: AG185
CPT Coding: 86003
Medical Necessity Documentation:

Name: Mackerel IgE, Allergen
PHL Test Code: AG115
CPT Coding: 86003
Medical Necessity Documentation:

Name: Magnesium
PHL Test Code: MG
CPT Coding: 83735
Medical Necessity Documentation:

Name: Magnesium, 24-hour Urine
PHL Test Code: UMG24
CPT Coding: 83735
Medical Necessity Documentation:

Name: Magnesium, RBC
PHL Test Code: MAGBR
CPT Coding: 83735
Medical Necessity Documentation:  

Name: Magnesium, Urine
PHL Test Code: UMGR
CPT Coding: 83735
Medical Necessity Documentation:

Name: Malt IgE, Allergen
PHL Test Code: AG180
CPT Coding: 86003
Medical Necessity Documentation:

Name: Mannose-binding Lectin
PHL Test Code: MBL
CPT Coding: 83520
Medical Necessity Documentation:

Name: Maple Leaf Sycamore IgE, Allergen
PHL Test Code: A102G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Meadow Fescue IgE, Allergen
PHL Test Code: AG15G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Meadow Grass, Kentucky Blue IgE, Allergen
PHL Test Code: AG14G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Milk Component Panel
PHL Test Code: MILKP
CPT Coding: 86003 x3
Medical Necessity Documentation:

Name: Mitochondrial Depletion and Multiple Depletion Panel
PHL Test Code: MSOT
CPT Coding: 81406, 81479
Medical Necessity Documentation:

Name: Mold Allergen Panel
PHL Test Code: MLDP1
CPT Coding: 86003 x 4
Medical Necessity Documentation:

Name: Mountain Juniper IgE, Allergen
PHL Test Code: A199G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Mucor racemosus IgE, Allergen
PHL Test Code: AG25G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Mugwort IgE, Allergen
PHL Test Code: AG38G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Mulberry IgE, Allergen
PHL Test Code: A154G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Mushroom (Champignon) IgE, Allergen
PHL Test Code: AG165
CPT Coding: 86003
Medical Necessity Documentation:

Name: Mustard Seed IgE, Allegren
PHL Test Code: AG148
CPT Coding: 86003
Medical Necessity Documentation:

Name: Mutton IgE, Allergen
PHL Test Code: AG179
CPT Coding: 86003
Medical Necessity Documentation:

Name: Nettle IgE, Allergen
PHL Test Code: A153G
CPT Coding: 86003
Medical Necessity Documentation:

Name: NT-pro BNP
PHL Test Code: BNP1
CPT Coding: 83880
Medical Necessity Documentation:

Name: Nutmeg IgE, Allergen
PHL Test Code: AG128
CPT Coding: 86003
Medical Necessity Documentation:

Name: Oak IgE, Allergen
PHL Test Code: AG98G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Oat IgE, Allergen
PHL Test Code: AG70G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Occult Blood 1, Fecal, Diagnostic
PHL Test Code: OCBL1
CPT Coding: 82272
Medical Necessity Documentation:

Name: Occult Blood 1, Fecal, Screening
PHL Test Code: OCBS1
CPT Coding: 82270 (G0107 for Medicare)
Medical Necessity Documentation:

Name: Occult Blood 2, Fecal, Diagnostic
PHL Test Code: OCBL2
CPT Coding: 82272
Medical Necessity Documentation:

Name: Occult Blood 2, Fecal, Screening
PHL Test Code: OCBS2
CPT Coding: 82270 (G0107 for Medicare)
Medical Necessity Documentation:

Name: Occult Blood 3, Fecal, Diagnostic
PHL Test Code: OCBL3
CPT Coding: 82272
Medical Necessity Documentation:

Name: Occult Blood 3, Fecal, Screening
PHL Test Code: OCBS3
CPT Coding: 82270 (G0107 for Medicare)
Medical Necessity Documentation:

Name: Onion IgE, Allergen
PHL Test Code: AG71
CPT Coding: 86003
Medical Necessity Documentation:

Name: Orange IgE, Allergen
PHL Test Code: AG72
CPT Coding: 86003
Medical Necessity Documentation:

Name: Oregano IgE, Allergen
PHL Test Code: AG127
CPT Coding: 86003
Medical Necessity Documentation:

Name: Ovalbumin, IgE
PHL Test Code: MSOT
CPT Coding: 86003
Medical Necessity Documentation:

Name: Ovomucoid IgE
PHL Test Code: MSOT
CPT Coding: 86003
Medical Necessity Documentation:

Name: Oyster IgE, Allergen
PHL Test Code: AG117
CPT Coding: 86003
Medical Necessity Documentation:

Name: Pain Management Profile 5 with Confirmation, with D/L Isomers, Urine
PHL Test Code: PAINI
CPT Coding: 80301 (HCPCS: G0431), 84311, 82570, 83986
Medical Necessity Documentation:

Name: Paper Wasp Venom IgE, Allergen
PHL Test Code: AG109
CPT Coding: 86003
Medical Necessity Documentation:

Name: Paprika Sweet Pepper IgE, Allergen
PHL Test Code: AG202
CPT Coding: 86003
Medical Necessity Documentation:

Name: Parathyroid Hormones Intact
PHL Test Code: PTHIN
CPT Coding: 83970
Medical Necessity Documentation:

Name: Parsley IgE, Allergen
PHL Test Code: AG129
CPT Coding: 86003
Medical Necessity Documentation:

Name: Pea IgE, Allergen
PHL Test Code: AG73
CPT Coding: 86003
Medical Necessity Documentation:

Name: Peach IgE, Allergen
PHL Test Code: AG74
CPT Coding: 86003
Medical Necessity Documentation:

Name: Peanut Component Panel
PHL Test Code: PEANP
CPT Coding: 86003 (x5)
Medical Necessity Documentation:

Name: Peanut IgE, Allergen
PHL Test Code: AG75G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Pecan (Hickory) IgE, Allergen
PHL Test Code: AG97G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Pecan Nut IgE, Allergen
PHL Test Code: AG76G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Pediatric Allergen Panel
PHL Test Code: PEDP
CPT Coding: 82785, 86003 x 5
Medical Necessity Documentation:

Name: Penicillium notatum IgE, Allergen
PHL Test Code: AG26G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Penicilloyl G IgE, Allergen
PHL Test Code: AG134
CPT Coding: 86003
Medical Necessity Documentation:

Name: Penicilloyl V IgE, Allergen
PHL Test Code: AG135
CPT Coding: 86003
Medical Necessity Documentation:

Name: Penta Screen
PHL Test Code: PENT
CPT Coding: 82105, 82397, 82677, 84702, 86336 or 81512*
Medical Necessity Documentation:

Name: Phthalic Anhydride IgE, Allergen
PHL Test Code: MSOT
CPT Coding: 86003
Medical Necessity Documentation:

Name: Pigweed IgE, Allergen
PHL Test Code: AG42G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Pine Nut, Pignoles IgE, Allergen
PHL Test Code: A131G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Pineapple IgE, Allergen
PHL Test Code: AG193
CPT Coding: 86003
Medical Necessity Documentation:

Name: Pinto Bean IgE, Allergen
PHL Test Code: MSOT
CPT Coding: 86003
Medical Necessity Documentation:

Name: Pistachio IgE, Allergen
PHL Test Code: A132G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Plantain (English), Ribwort IgE, Allergen
PHL Test Code: AG33G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Platelet Count
PHL Test Code: PLT
CPT Coding: 85049
Medical Necessity Documentation:

Name: Plum IgE, Allergen
PHL Test Code: AG182
CPT Coding: 86003
Medical Necessity Documentation:

Name: Pork IgE, Allergen
PHL Test Code: AG77G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Potato IgE, Allergen
PHL Test Code: AG78G
CPT Coding: 86003
Medical Necessity Documentation:

Name: PPG Pregnancy Induced Hypertension
PHL Test Code: NEPIH
CPT Coding: 82575, 84450, 85027, 80076 (Reflex 85008), 84156
Medical Necessity Documentation:

Name: PPG Prenatal 1
PHL Test Code: PN11
CPT Coding: 85025, 86592, 86762, 86850, 86900, 86901, 87340, (Reflexes 85007, 85008, 86593, 86870, 87341)
Medical Necessity Documentation:

Name: PPG Prenatal I
PHL Test Code: PNNE5
CPT Coding: 82947, 85025, 86592, 86703, 86762, 86850, 86900, 86901, 87340 (Reflexes 85007, 85008, 86593, 86689, 86870)
Medical Necessity Documentation:

Name: PPG Prenatal I without Glucose
PHL Test Code: PNNE6
CPT Coding: 85025, 86592, 86703, 86762, 86850, 86900, 86901, 87340 (Reflexes 85007, 85008, 86593, 86689, 86870)
Medical Necessity Documentation:

Name: PPG Prenatal Profile I without Glucose and HIV
PHL Test Code: PNNE3
CPT Coding: 85025, 86592, 86762, 86900, 86901, 87340 (Reflex 87077, 87106, 87107, 87186)
Medical Necessity Documentation:

Name: PPG Prenatal Profile III
PHL Test Code: PNNE2
CPT Coding: 82950, 85025, 86592, 86850, 87340 (Reflexes 85007, 85008, 86593, 86870)
Medical Necessity Documentation:

Name: PPG Thyroid Panel
PHL Test Code: NEOB5
CPT Coding: 84481, 84442, 8443 (reflex 84439)
Medical Necessity Documentation:  

Name: Prenatal 1 with Glucose and HBsAg
PHL Test Code: PNGG
CPT Coding: 82947, 85025, 86592, 86762, 86850, 86900, 86901, 87340 (Reflexes 85007, 85008, 86593, 86870, 87341)
Medical Necessity Documentation:

Name: Prenatal 1 with Glucose, HBsAg, & Urinalysis (C&S if indicated)
PHL Test Code: PNUX1
CPT Coding: 81003, 82947, 85025, 86592, 86762, 86850, 86900, 86901, 87340 (Reflexes 85007, 85008, 86593, 86870, 87341, 87086, 87077, 87088, 87186)
Medical Necessity Documentation:

Name: Prenatal 1 with Glucose, HBsAg, HIV, & Urinalysis (C&S if indicated)
PHL Test Code: PNUX2
CPT Coding: 81003, 82947, 85025, 86592, 86703, 6762, 86850, 86900, 86901, 87340 (Reflexes 85007, 85008, 86593, 86689, 86870, 87341, 87086, 87077, 87088, 87186)
Medical Necessity Documentation:

Name: Prenatal 1 with HBsAg & FTA
PHL Test Code: PNHX1
CPT Coding: 85025, 86592, 86703, 86762, 86850, 86900, 86901, 87340 (Reflexes 85007, 85008, 87341, 86593, 86689, 86780, 86870)
Medical Necessity Documentation:

Name: Prenatal 1 with Urinalysis
PHL Test Code: PN1U2
CPT Coding: 81003, 84443, 85025, 86592, 86762, 86850, 86900, 86901 (Reflexes 85007, 85008, 86593, 86870)
Medical Necessity Documentation:  

Name: Prenatal 3 (Rh-Negative)
PHL Test Code: PN3P1
CPT Coding: 82950, 85014, 85018, 86592, 86850 (Reflexes 86593, 86870)
Medical Necessity Documentation:

Name: Prenatal Profile
PHL Test Code: PNN
CPT Coding: Panel Code 80055
Medical Necessity Documentation:

Name: Prenatal w/ HIV and Glucose
PHL Test Code: PNGL
CPT Coding: 81003, 85025, 82947, 84443, 86592, 86703, 86762, 86850, 86900, 86901, 87340, (Reflexes 84439, 85007, 85008, 86689, 86593, 86780, 86870, 87341, 87086, 87077, 87088, 87186)
Medical Necessity Documentation:  

Name: Prostate Specific Antigen with Free PSA Reflex
PHL Test Code: PSAR
CPT Coding: 84153 (Reflexes 84154)
Medical Necessity Documentation:

Name: Prostate Specific Antigen, Diagnostic
PHL Test Code: PSA
CPT Coding: 84153
Medical Necessity Documentation:

Name: Prostate Specific Antigen, Free and Total
PHL Test Code: PSAFR
CPT Coding: 84153, 84154
Medical Necessity Documentation:

Name: Prostate Specific Antigen, Screening
PHL Test Code: PSAS
CPT Coding: 84153, G0103
Medical Necessity Documentation:
Duplicate testing on this test is not acceptable per Medicare:  Testing to only be done every 365 days

Name: Prothrombin Time
PHL Test Code: PT
CPT Coding: 85610
Medical Necessity Documentation:

Name: PSA, Post-Prostatectomy
PHL Test Code: MSOT
CPT Coding: 84153
Medical Necessity Documentation:

Name: Quad Screen
PHL Test Code: QUADS
CPT Coding: 82105, 82677, 84702, 86336
Medical Necessity Documentation:

Name: Raspberry IgE, Allergen
PHL Test Code: AG159
CPT Coding: 86003
Medical Necessity Documentation:

Name: Red Kidney Bean IgE, Allergen
PHL Test Code: AG172
CPT Coding: 86003
Medical Necessity Documentation:

Name: Red Maple Tree IgE, Allergen
PHL Test Code: AG99
CPT Coding: 86003
Medical Necessity Documentation:

Name: Redtop Bentgrass IgE, Allergen
PHL Test Code: A149G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Region 5 Allergy Panel
PHL Test Code: REGV1
CPT Coding: 82785, 86003 x 17
Medical Necessity Documentation:

Name: Respiratory Region V Standard Panel
PHL Test Code: RESP3
CPT Coding: 82785, 86003 x 26
Medical Necessity Documentation:

Name: Rhizopus nigricans IgE, Allergen
PHL Test Code: AG28G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Rice IgE, Allergen
PHL Test Code: AG79
CPT Coding: 86003
Medical Necessity Documentation:

Name: Rough Marshelder IgE, Allergen
PHL Test Code: AG37G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Rye Grass IgE, Allergen
PHL Test Code: AG17G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Rye IgE, Allergen
PHL Test Code: AG80G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Sage IgE, Allergen
PHL Test Code: AG122
CPT Coding: 86003
Medical Necessity Documentation:

Name: Salmon IgE, Allergen
PHL Test Code: AG81G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Saltwort, Russian Thistle IgE, Allergen
PHL Test Code: AG43G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Scallops IgE, Allergen
PHL Test Code: A118G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Sedimentation Rate
PHL Test Code: ESR
CPT Coding: 85652
Medical Necessity Documentation:

Name: Sepsis Panel
PHL Test Code: SEPSI
CPT Coding: 80053, 82150, 82330, 82805 x 5, 83605, 83690; 85025, 85610, 85730, 87040 (Reflex 85007, 85008, 87186, 87077)
Medical Necessity Documentation:

Name: Sesame Seed IgE, Allergen
PHL Test Code: A147G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Sheep Epithelium IgE, Allergen
PHL Test Code: AG6G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Sheep Sorrel IgE, Allergen
PHL Test Code: AG44G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Shrimp IgE, Allergen
PHL Test Code: AG82G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Sole IgE, Allergen
PHL Test Code: AG164
CPT Coding: 86003
Medical Necessity Documentation:

Name: Soybean IgE, Allergen
PHL Test Code: AG83G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Stinging Insect Allergen
PHL Test Code: HRNW1
CPT Coding: 82785, 86003 x 3
Medical Necessity Documentation:

Name: Strawberry IgE, Allergen
PHL Test Code: AG84
CPT Coding: 86003
Medical Necessity Documentation:

Name: Stroke Panel
PHL Test Code: STRP2
CPT Coding: 80048, 82247, 82550, 83735, 84075, 84450, 84484, 85025, 85610, 85652, 85730 (Reflex 85007, 85008)
Medical Necessity Documentation:

Name: Sugar Beet IgE, Allergen
PHL Test Code: AG205
CPT Coding: 86003
Medical Necessity Documentation:

Name: Sugar Maple Tree IgE, Allergen
PHL Test Code: AG216
CPT Coding: 86003
Medical Necessity Documentation:

Name: Summer Squash IgE, Allergen
PHL Test Code: MSOT
CPT Coding: 86003
Medical Necessity Documentation:

Name: Sweet Potato IgE, Allergen
PHL Test Code: AG195
CPT Coding: 86003
Medical Necessity Documentation:

Name: T3 Uptake
PHL Test Code: T3UPC
CPT Coding: 84479
Medical Necessity Documentation:

Name: Tartrazine
PHL Test Code: MSOT
CPT Coding: 86003
Medical Necessity Documentation:

Name: Tetracycline IgE, Allergen
PHL Test Code: MSOT
CPT Coding: 86003
Medical Necessity Documentation:

Name: Thyme IgE, Allergen
PHL Test Code: AG123
CPT Coding: 86003
Medical Necessity Documentation:

Name: Thyroid Stimulating Hormone with Thyroxine Reflex
PHL Test Code: TSHR
CPT Coding: 84443 (Reflexes 84439)
Medical Necessity Documentation:  

Name: Thyroxine, Free
PHL Test Code: T4FRE
CPT Coding: 84439
Medical Necessity Documentation:

Name: Thyroxine, Free Direct Dialysis
PHL Test Code: T4FR
CPT Coding: 84439
Medical Necessity Documentation:

Name: Thyroxine, Total
PHL Test Code: T4
CPT Coding: 84436
Medical Necessity Documentation:

Name: Timothy Grass IgE, Allergen
PHL Test Code: AG18G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Tomato IgE, Allergen
PHL Test Code: AG85
CPT Coding: 86003
Medical Necessity Documentation:

Name: Transferrin
PHL Test Code: TRSF
CPT Coding: 84466
Medical Necessity Documentation:

Name: Trauma Panel
PHL Test Code: TRAM2
CPT Coding: 80048, 82150, 85025, 85610, 85730,(Reflex 85007, 85008)
Medical Necessity Documentation:

Name: Tree Allergen Panel
PHL Test Code: TREP1
CPT Coding: 86003 x 5
Medical Necessity Documentation:

Name: Treponema pallidum Antibody, IgG
PHL Test Code: MSOT
CPT Coding: 86780
Medical Necessity Documentation:

Name: Triglycerides
PHL Test Code: TRIG
CPT Coding: 84478
Medical Necessity Documentation:

Name: Triglycerides, Fluid
PHL Test Code: FTRIG
CPT Coding: 84478
Medical Necessity Documentation:  

Name: Tuna IgE, Allergen
PHL Test Code: AG86G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Turkey Meat IgE, Allergen
PHL Test Code: AG87
CPT Coding: 86003
Medical Necessity Documentation:

Name: Urinalysis with Microscopic and Culture and Sensitivity if Indicated
PHL Test Code: UAMC2
CPT Coding: 81001 (Reflex 87086)
Medical Necessity Documentation:

Name: Urine Culture
PHL Test Code: CXURN
CPT Coding: 87086 (Reflexes 87077, 87088, 87186)
Medical Necessity Documentation:

Name: VDRL, CSF
PHL Test Code: VDRLF
CPT Coding: 86592
Medical Necessity Documentation:

Name: Virginia Live Oak IgE, Allergen
PHL Test Code: AG24G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Vitamin D, 25 Hydroxy
PHL Test Code: VD251
CPT Coding: 82306
Medical Necessity Documentation:


Name: Walnut IgE, Allergen
PHL Test Code: AG88G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Walnut Tree Pollen IgE, Allergen
PHL Test Code: AG93G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Watermelon IgE, Allergen
PHL Test Code: AG158
CPT Coding: Watermelon IgE
Medical Necessity Documentation:

Name: Weed Allergen Panel 5
PHL Test Code: WEDPP
CPT Coding: 86003 x 6
Medical Necessity Documentation:

Name: Western Ragweed IgE, Allergen
PHL Test Code: AG41G
CPT Coding: 86003
Medical Necessity Documentation:

Name: WHA Prenatal 28 Week Rh-Positive
PHL Test Code: PNFO2
CPT Coding: 82950, 85014, 85018, 86592, 86781 (Reflexes 86593, 86780)
Medical Necessity Documentation:

Name: Wheat IgE, Allergen
PHL Test Code: AG89G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Whey IgE, Allergen
PHL Test Code: AG157
CPT Coding: 86003
Medical Necessity Documentation:

Name: White Ash IgE, Allergen
PHL Test Code: A103G
CPT Coding: 86003
Medical Necessity Documentation:

Name: White Bean IgE, Allergen
PHL Test Code: AG173
CPT Coding: 86003
Medical Necessity Documentation:

Name: White Blood Cell Count
PHL Test Code: WBC
CPT Coding: 85048
Medical Necessity Documentation:

Name: White Pine IgE, Allergen
PHL Test Code: A101G
CPT Coding: 86003
Medical Necessity Documentation:

Name: White-Faced Hornet Venom IgE, Allergen
PHL Test Code: A111G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Willow IgE, Allergen
PHL Test Code: A104G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Wormwood IgE, Allergen
PHL Test Code: AG45G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Yeast (Bakers/Brewers) IgE, Allergen
PHL Test Code: AG90G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Yellow Hornet Venom IgE, Allergen
PHL Test Code: A112G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Yellow Jacket Venom IgE, Allergen
PHL Test Code: A113G
CPT Coding: 86003
Medical Necessity Documentation:

Name: Yellow Wax Bean IgE, Allergen
PHL Test Code: AG176
CPT Coding: 86003
Medical Necessity Documentation: