PLEASE NOTE: Presently the Intrinsic Hepcidin IDxTM Test does not have a CPT code and is not covered by insurance. Thus the cost of the Intrinsic Hepcidin IDxTM Test will be billed directly to the patient or institution. We are working to have the cost of the Intrinsic Hepcidin IDxTM Test covered by all major insurance providers. All other tests offered by IntrinsicDx are reimbursed by all major insurance providers.
- Electronically or manually complete the Laboratory Requisition Form.
- All fields on the form are required.
- Form must be signed by physician, and the patient/individual accepting financial responsibility for payment.
- Include the Laboratory Requisition Form with the sample when it is shipped to IntrinsicDx for hepcidin testing.
- . Prior to shipping samples, please fax or email the completed Laboratory Requisition Form, the Client Registration Form (for new clients) and the sample tracking number to 858-459-7777 or email@example.com.
To complete forms electronically, Adobe Reader is required. A free copy of Adobe Reader is available here.
For sample collection and preparation, please click here.