BlueCross BlueShield of Tennessee Medical Policy Manual

Intracellular Micronutrient Analysis


“Micronutrients” is a collective term used to describe essential vitamins and minerals. Clinical deficiency states (states occurring after prolonged consumption of a diet lacking the nutrient that is treated by adding the nutrient to the individual’s diet) have been reported for vitamins A, B1, B12, C and D, selenium, and other micronutrients. Classic nutritional deficiency diseases are uncommon in the United States as most individuals derive sufficient nutrition from diet alone or in combination with over-the-counter multivitamins.

Laboratory serum tests are available for individual micronutrients and are generally used to confirm suspected micronutrient deficiencies. This policy addresses laboratory tests that measure intracellular levels of micronutrients. This testing is also called micronutrient testing and functional intracellular analysis. Advocates claim that intracellular nutrient status is superior to serum testing because it reflects more stable micronutrient levels over longer time periods than serum levels; however, the relationship between serum and intracellular levels of micronutrients is complex. The balance of intra- and extracellular levels depend on a number of factors, including the physiology of cellular transport mechanisms and the individual cell type.

Proposed potential uses of this test include screening for nutritional deficiencies in healthy individuals or those with chronic disease and aiding in the diagnosis of disease in individuals with generalized symptoms. Examples of laboratories that perform intracellular micronutrient testing include SpectraCell, which offers a panel of tests that evaluates the intracellular status of micronutrients within lymphocytes in blood samples. The SpectraCell micronutrient panel also evaluates total antioxidant function. IntraCellular Diagnostics evaluates epithelial cells from buccal swabs and assesses levels of intracellular mineral electrolyte (i.e., magnesium, calcium, potassium, phosphorus, sodium, chloride).




No studies were identified that evaluate accuracy or clinical utility of intracellular micronutrient testing compared to serum testing for vitamin and mineral levels. There is limited data available in peer reviewed journals to evaluate the impact of this technology on health outcomes.


BlueCross BlueShield Association. Evidence Positioning System. (1:2020). Intracellular Micronutrient Analysis (2.04.73). Retrieved May 27, 2020 from  (1 article reviewed) Centers for Medicare & Medicaid Services. Palmetto GBA. (2019, October). Assays for vitamins and metabolic function (LCD ID L33418). Retrieved May 27, 2020 from

Houston, M. (2010). The role of cellular micronutrient analysis, nutraceuticals, vitamins, antioxidants and minerals in the prevention and treatment of hypertension and cardiovascular disease. Therapeutic Advances in Cardiac Disease, 4 (3) 165-183. (Level 4 evidence)




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