ADAMTS13 Assay for Thrombotic Thrombocytopenic Purpura (TTP)

Aetna covers the ADAMTS13 assay (CPT 85397) as medically necessary for assessing prognosis in thrombotic thrombocytopenic purpura (TTP) when selection criteria are met (ICD-10: M31.10, M31.11, M31.19). It is considered experimental/investigational and not covered when used as a biomarker for delayed cerebral ischemia after subarachnoid hemorrhage, for COVID-19 severity/micro‑thrombosis, for early hepatocellular carcinoma detection, or for monitoring progression of acute myocardial infarction.

"Covered diagnoses (ICD-10) if selection criteria are met: M31."

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