All PlansCoverageMedium impact
Measurement of Serum Antibodies to Selected Biologic Agents
Blue Cross & Blue Shield of Mississippi·MS · Rheumatology, Gastroenterology, Dermatology·Medical Policy
Effective date
Jan 30, 2025
We identified it
Jun 20, 2026
Summary
This policy continues to classify measurement of serum antibodies to biologic agents (infliximab, adalimumab, vedolizumab, ustekinumab) as investigational and not covered. The policy was reviewed with no changes on 01/30/2025, maintaining the same coverage restrictions for these diagnostic tests.
Action Required
Immediately: Billing team must ensure claims for antidrug antibody testing (CPT 80145, 80230, 80280, 80299, 0514U, 0515U) are flagged as investigational/non-covered services. Obtain patient financial responsibility acknowledgment before testing. Claims will be denied as investigational without proper patient notification.