Claims & Payment Policy - Pulmonary Function Testing

September 1, 2023

Thank you for your continued partnership in serving WellCare of Kentucky members.

We are updating the Pulmonary Function Testing policy (CP.MP.242) based on current, evidence-based industry standards to help ensure that our members get appropriate, member-centric care. This revision establishes an age threshold of three for pulmonary function testing, and also establishes that such testing must be for medically necessary indications.

We will implement this revised policy effective for dates of service beginning 10/15/23.

If you have any questions regarding this notice, please contact your Provider Relations Representative. Thank you again for your continued partnership in rendering quality healthcare to our members.

Sincerely,
WellCare Health Plans