Blue Cross & Blue Shield of MississippiCommercial · Coverage · Medical Policy · MS · Neurology, Rheumatology, OncologyMedium impact
Antibody Tests for Neurologic Diseases
Effective date
Not stated in the notice
Identified
Jun 20, 2026
Summary
Antibody tests may be considered medically necessary for the diagnosis and treatment of paraneoplastic neurologic disorders when ordered or performed by a Neurologist and all required criteria are met. Those criteria are that the patient displays clinical features of the disease in question, that the test result will directly impact the treatment being delivered, and that after history, physical examination and conventional diagnostic studies a definitive diagnosis remains uncertain and one of the listed antibodies is suspected. Antibody tests for screening of neurologic diseases are considered investigational and are only medically necessary when ordered selectively for evaluating persons with signs and symptoms of specific immune-mediated neuromuscular conditions.
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01Billing team: Bill antibody tests for paraneoplastic neurologic disorders only when they are ordered or performed by a Neurologist and all of the policy criteria are met: the patient displays clinical features of the disease, the result will directly impact treatment, and a definitive diagnosis remains uncertain after history, physical examination and conventional diagnostic studies with one of the listed antibodies suspected.
02Do not bill antibody tests for screening of neurologic diseases, which the policy describes as investigational and medically necessary only when ordered selectively for persons with signs and symptoms of specific immune-mediated neuromuscular conditions.
03Claims for these tests are not paid if they are not documented to be medically necessary, because BCBSMS makes no payment for services that are not documented to be Medically Necessary.
04The coverage guidelines in the Medical Policy Manual should not be used in place of the member's specific benefit plan language.
Codes mentioned
8351983520841828423886235Z13.858
Original notice
Antibody Tests for Neurologic Diseases
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