New Medical Policy: Folate Testing

New Medical Policy: Folate Testing


Folate, or vitamin B9, is a generic term for a water-soluble vitamin obtained from the diet that is involved in the transfer of methyl groups in multiple biochemical metabolic pathways. Folate metabolism is closely linked to vitamin B12. Folate deficiency can be implicated in many disease states and usually remedied with either a change in diet or a dietary supplement of the synthetic form, folic acid.

Effective Oct. 1, 2018, BlueCross® BlueShield® of South Carolina and BlueChoice HealthPlan will implement a new medical policy addressing folate testing. The policy, CAM 200 – Folate Testing, has been published on the Medical Policies pages of the BlueCross and BlueChoice® websites.

A portion of the policy reads:

1. Measurement of serum folate concentration is medically necessary for the evaluation of patients when all of the following criteria are met: 

  • Patient was diagnosed with megaloblastic, macrocytic anemia due to folate deficiency; and
  • Megaloblastic anemia and/or macrocytosis do not resolve after folic acid treatment. 

For complete information about CAM 200, visit our Medical Policies page. Please remember medical necessity is not a guarantee of payment. Payment is subject to the member’s plan coverage, to include prior authorization requirements and benefits, at the time the service is performed. You may contact Provider Education by using the Provider Education Contact Form or by calling 803-264-4730 with additional questions.

BlueCross BlueShield of South Carolina is an independent licensee of the Blue Cross Blue Shield Association.