Beginning October 12, 2026, patients with Medicare Advantage coverage must have an appropriate medically necessary diagnosis associated with certain laboratory tests for the testing to be covered.
This change affects the following tests:
| Test | Lab Order Code(s) |
|---|---|
| Vitamin D | LAB1231384, LAB1231583 |
| Vitamin B12 | LAB67, LAB1231122 |
| Lipid Panel | LAB18, LAB2111122 |
| Hemoglobin A1c (Hgb A1c) | LAB90 |
| Thyroid Stimulating Hormone (TSH) | LAB129, LAB1231632, LAB1000, LAB3077 |
The following information was updated in the Lab Catalog.
All changes are for Corewell Health Laboratories in Southwest and West Michigan. For Laboratories in Southeast Michigan, please visit:corewellhealth.org/labcatalog and navigate to the Southeast Michigan site.
Effective October 7, 2026, the reflex-to-microscopy criteria for Urinalysis with Microscopy if Indicated (LAB1231026) will be updated. These changes are intended to reduce unnecessary microscopic examinations while ensuring clinically significant findings continue to receive appropriate follow-up testing.
Effective Date: Immediate
Key Update
The laboratory no longer accepts standing orders with a frequency ordered as “PRN,” “As Needed,” or “Indefinite.” Standing orders must include either:
These requirements provide clear guidance to support medical necessity, prevent misuse, and ensure compliance with federal regulations. This guidance aligns with requirements established by the Office of Inspector General (OIG). (Federal Register/Vol. 63, No. 163/Monday, August 24, 1998. 98-22559.pdf)