Inflammatory Bowel Disease: Serologic Markers and Pharmacogenomic and Metabolic Assessment of Thiopurine Therapy

Covered: TPMT genotypic or phenotypic testing prior to starting azathioprine or 6‑mercaptopurine (one test per member lifetime), NUDT15 testing prior to initiation of any thiopurine to identify toxicity risk, 6‑TGN and 6‑MMPN measurements only to monitor compliance in non‑responders or assess suspected thiopurine toxicity, and fecal calprotectin and fecal lactoferrin for management of IBD and to distinguish IBD from IBS. Key limits: TPMT/NUDT15 tests, thiopurine metabolite assays, and fecal markers are considered experimental/investigational for other indications and are not covered beyond the specified uses.

"Fecal lactoferrin not established for diagnosing infectious diarrheas and should not be used to establish cause of acute infectious diarrhea (IDSA guideline statements): 'fecal leukocyte examinatio..."

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