LCDActive
MolDX: Prometheus® IBD sgi Diagnostic® Policy
L37299
Effective: March 13, 2025
Updated: December 31, 2025
Policy Summary
The Prometheus® IBD sgi Diagnostic® multi-marker blood test (17 biomarkers, 4 SNPs, and a proprietary algorithm) is not covered. Specifically, use of this test to differentiate IBD vs non-IBD or Crohn's disease vs ulcerative colitis is excluded from coverage; no documentation or frequency allowances are provided.
Coverage Criteria Preview
Key requirements from the full policy
"The Prometheus® IBD sgi Diagnostic® test (multi-marker panel of 17 serologic/inflammatory markers, 4 genetic SNPs, and a proprietary algorithm producing an IBD score) is not covered."
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