CommercialCoverageMedium impact
Serum Antibodies for the Diagnosis of Inflammatory Bowel Disease 2.02.19
Excellus BlueCross BlueShield·Gastroenterology·Lab Tests (pathology)
Effective date
Nov 20, 2025
We identified it
Jun 20, 2026
Summary
Excellus BlueCross BlueShield now considers ALL serum antibody testing for inflammatory bowel disease diagnosis and monitoring (including ANCA, ASCA, anti-OmpC, and Prometheus IBD testing) as not medically necessary for any indication. Claims for these tests will be denied.
Action Required
By November 20, 2025: Billing team must identify all serum antibody test codes for IBD diagnosis (ANCA, ASCA, anti-OmpC, anti-I2, anti-cBir1, ACCA, ALCA, AMCA, Prometheus IBD testing) and flag them for denial by Excellus BlueCross BlueShield. Update billing system to alert staff that these tests are not covered for IBD diagnosis or monitoring. Notify gastroenterology providers that alternative diagnostic methods must be used.