CommercialCoverageMedium impact
Serum Biomarker Panel Testing for Systemic Lupus Erythematosus and Other Connective Tissue Diseases
Blue Cross & Blue Shield of Mississippi·MS · Rheumatology, Internal Medicine, Family Medicine·Medical Policy
We identified it
Jun 20, 2026
Summary
BCBS Mississippi considers serum biomarker panel testing with proprietary algorithms for diagnosing systemic lupus erythematosus and other connective tissue diseases as investigational and not covered. This affects specific laboratory tests including Avise tests and related CPT codes that will be denied if billed.
Action Required
Immediately: Billing team must flag CPT codes 0039U, 0312U, 0446U, 0447U, 81599, and 84999 as non-covered/investigational in billing system for BCBS Mississippi. Update encounter forms to alert providers these tests are not covered. Inform patients of potential out-of-pocket costs before ordering. Claims for these codes will be denied as investigational.