New Laboratory Codes for Celiac Disease Diagnosis and Management

Effective Date: April 1, 2025.

This bulletin applies to NC Medicaid Direct and NC Medicaid Managed Care.

NC Medicaid will expand laboratory coverage to include the codes for celiac disease coverage below. For information regarding the collecting and transportation of laboratory specimens, please refer to clinical coverage policy 1S-3: Laboratory Services. Providers can access this policy at the following link: Clinical Coverage Policies.

Newly Covered Procedure Codes

  • 86364 Tissue transglutaminase, each immunoglobulin (Ig) class
  • 86258 Gliadin (deamidated) (DGP) antibody, each immunoglobulin (Ig) class

For beneficiaries enrolled in a managed care plan, providers should contact the appropriate health plan for additional guidance on claims submission and coverage.

Contact

NCTracks Call Center: 800-688-6696
NC Medicaid Managed Care Health Plans

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