Serological and Fecal Testing for Inflammatory Bowel Disease - Medicare Advantage

Covers serological and fecal testing (e.g., fecal calprotectin, fecal lactoferrin, serologic/antiglycan/autoantibody assays and MolDX Prometheus IBD sgi panel) for evaluation and monitoring of inflammatory bowel disease, including Crohn disease and ulcerative colitis. Coverage is adjunctive (not a sole diagnostic) and is limited to services deemed reasonable and necessary and subject to CMS/NCD/LCD and contractor-specific MolDX/DEX requirements demonstrating analytical/clinical validity and clinical utility; tests outside FDA labeling, lacking medical necessity, or not ordered/used by the treating physician are not covered.

"Diagnosis or assessment of inflammatory bowel disease (IBD)."

Sign up to see full coverage criteria, indications, and limitations.