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Excellus BlueCross BlueShieldCommercial · Coverage · Lab Tests (pathology) · Gastroenterology, Rheumatology, PathologyMedium impact

Testing for the Use of Biologic Therapeutics for the Treatment of Inflammatory Disorders 2.02.47

Effective date
Nov 20, 2025
Identified
Jun 20, 2026

Summary

Procise ADL, Procise IFX, PredictrPK IFX, ADALX, Anser ADA, Anser IFX, Anser UST and Anser VDZ are considered investigational when used to measure serum drug or antibody levels for biologic therapies. Tests that predict response or non-response to biologic therapies, such as PrismRA alone or as a combination test, are also considered investigational. Code 0456U was deleted in the 11/20/25 annual review.

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What to do

Action · 3 steps
01Already effective 2025-11-20: Billing team: Before billing the tests listed as investigational (Procise ADL, Procise IFX, PredictrPK IFX, ADALX, Anser ADA, Anser IFX, Anser UST, Anser VDZ and PrismRA), check the codes in charge entry.
02Codes 80145, 80230, 80280, 0514U and 0515U are marked experimental/investigational (E/I).
03Code 0456U was deleted.

Codes mentioned

80145802308028084999J0135J1745J3357J3358J3380

Original notice

Testing for the Use of Biologic Therapeutics for the Treatment of Inflammatory Disorders 2.02.47
excellusbcbs.com · Always check the source before changing claims.
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Related policy hubs

Excellus BlueCross BlueShield policiesGastroenterologyRheumatologyPathologyCode 80145Code 80230Code 80280Code 84999Code J0135Code J1745Code J3357Code J3358Code J3380

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