All PlansCoverageMedium impact
Fecal Calprotectin Testing
Blue Cross & Blue Shield of Mississippi·MS · Gastroenterology, Internal Medicine, Family Medicine +1 more·Medical Policy
We identified it
Jun 20, 2026
Summary
New policy establishes coverage for fecal calprotectin testing when used to differentiate between inflammatory bowel disease (IBD) and non-inflammatory conditions like irritable bowel syndrome, but only when endoscopy is being considered. Testing for IBD management, treatment monitoring, or relapse surveillance remains investigational and non-covered.
Action Required
Immediately: Billing team must verify that fecal calprotectin testing claims include documentation showing the test is being used to differentiate IBD from non-inflammatory bowel disease and that endoscopy with biopsy is being considered. Update prior authorization processes to deny coverage for fecal calprotectin testing used for IBD management, treatment monitoring, or surveillance of disease in remission as these are considered investigational.