Serological Testing for Inflammatory Bowel Disease (IBD)

This policy addresses serological testing for inflammatory bowel disease (IBD) — including assays such as pANCA/ANCA, ASCA, anti‑OmpC, anti‑CBir1 and combined/proprietary panels (e.g., Prometheus IBD sgi/Crohn’s Prognostic) — used as adjunctive tests to aid diagnosis or classification of Crohn’s disease, ulcerative colitis, indeterminate colitis, and related autoimmune/vasculitic presentations. These tests are considered experimental/investigational and not covered, are not a substitute for endoscopy with histology, have variable sensitivity/specificity and limited ability to predict treatment or surgical response, must be performed in CLIA‑certified labs, and the policy itself is inactive for current claims adjudication.

"Inflammatory bowel disease (IBD), encompassing Crohn's disease (CD) and ulcerative colitis (UC)."

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