Prior Auth Required

0042U - Lyme ImmunoBlot IgM and IgG by IGeneX Inc. , All

This procedure appears on the selected insurer prior authorization source.

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Procedure / ServiceLyme ImmunoBlot IgM and IgG by IGeneX Inc. , All
Procedure / Service Description

Service Category Benefit/Description Codes Requiring Authorization Member Program* - Sensivea Droplet 25OH vitamin D2/D3 Microvolume LC/MS Assay by InSource Diagnostics 0038U All Anti-dsDNA, high salt/avidity 0039U All Lyme ImmunoBlot IgM and IgG by IGeneX Inc. 0041U, 0042U All Tick-borne Relapsing Fever (TBRF) Borrelia ImmunoBlots IgM & IgG Test 0043U, 0044U All PolypDx 0002U All

Likely documents
  • Confirm benefit details
  • Submit clinical notes if requested by the plan
Next actions
  • Confirm the current plan policy before submission.
  • Use the insurer authorization workflow for this listed code.