Medical Policy
Effective Date:04/07/2010 Title:Hair Analysis
Revision Date: Document:BI266:00
CPT Code(s):P2031
Public Statement

Effective Date:

a)    This policy will apply to all services performed on or after the above revision date which will become the new effective date.

b)    For all services referred to in this policy that were performed before the revision date, contact customer service for the rules that would apply.

1)    Hair analysis has been proposed to test for a variety of conditions and deficiencies.

2)    Hair analysis is not covered except for testing possible arsenic poisoning.
Medical Statement

1)    Microscopic examination of hair samples is a covered service for diagnosis for potential arsenic poisoning.

2)    Hair or follicle analysis for protein, vitamin or other metabolic deficiencies is considered experimental/investigative and is not covered.

 

Codes Used In This BI:

P2031           HAIR ANALYSIS
Limits
Intentially left empty
Reference
  1. U.S. Department of Health and Human Services, Health Care Financing Administration (HCFA). Hair analysis -- not covered. Medicare Coverage Issues Manual §50-24. Baltimore, MD: HCFA; 2000.
  2. Lazar P. Hair analysis: What does it tell us? JAMA. 1974;229:1908-1909.
  3. Hambidge KM. Hair analyses: Worthless for vitamins, limited for minerals. Am J Clin Nutr. 1983;36:943-949.
  4. Klevay LM, Bistrian BR, Fleming CR, Neumann CG. Hair analysis in clinical and experimental medicine. Am J Clin Nutr. 1987;46(2):233-236.
  5. Barrett S. Commercial hair analysis: Science or scam? JAMA. 1985;254:1041-1045.
  6. Filipek PA, Accardo PJ, Ashwal S, et al. Practice parameter: Screening and diagnosis of autism. Report of the Quality Standards Subcommittee of the American Academy of Neurology and the Child Neurology Society. Neurology. 2000;55(4):468-479.
  7. Kruse-Jarres JD. Limited usefulness of essential trace element analyses in hair. Am Clin Lab. 2000;19(5):8-10.
  8. Hu H. Exposure to metals. Prim Care. 2000;27(4):983-996.
Application to Products
This policy applies to all health plans administered by QualChoice, both those insured by QualChoice and those that are self-funded by the sponsoring employer, unless there is indication in this policy otherwise or a stated exclusion in your medical plan booklet. Consult the individual plan sponsor Summary Plan Description (SPD) for self-insured plans or the specific Evidence of Coverage (EOC) for those plans insured by QualChoice. In the event of a discrepancy between this policy and a self-insured customer’s SPD or the specific QualChoice EOC, the SPD or EOC, as applicable, will prevail. State and federal mandates will be followed as they apply.
Changes: QualChoice reserves the right to alter, amend, change or supplement benefit interpretations as needed.