BCBS ArizonaCommercial · Coverage · Medical Policy · AZ · Neurology, PathologyMedium impact
Evaluation of Cerebrospinal Fluid, Urine, and Plasma Tests for Alzheimer Disease
Effective date
Jul 29, 2026
Identified
Aug 14, 2026
Summary
Cerebrospinal fluid testing of amyloid beta peptides and tau protein is medically necessary as part of an evaluation to start amyloid beta targeting therapy in individuals with mild cognitive impairment or mild dementia due to Alzheimer disease, when documented with an FDA approved or cleared test that confirms amyloid pathology. Plasma testing of amyloid beta and tau for that purpose, neural thread protein testing in CSF or plasma, CSF testing for continuation of amyloid beta targeting therapy, and urine analytes are considered experimental or investigational for these conditions. CSF, plasma and urine testing used as an adjunct to clinical diagnosis in these conditions is also considered experimental or investigational.
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01Already effective July 29, 2026: Billing team should confirm that documentation for CSF testing of amyloid beta and tau used before starting amyloid beta targeting therapy shows one of the listed FDA approved or cleared tests: Lumipulse G Amyloid Ratio 1-42/1-40 (Abeta42:Abeta40 ratio), Elecsys B-Amyloid 1-42 CSF II with Elecsys Phospho-Tau 181P CSF, or Elecsys B-Amyloid 1-42 CSF II with Elecsys Total-Tau CSF.
02Plasma testing of amyloid beta and tau for that purpose, neural thread protein testing, CSF testing for continuation of therapy, and urine analytes are experimental or investigational under this policy.
03Providers should provide complete medical rationale when requesting any exception to these guidelines.
Codes mentioned
8109982233822348352083884843938439486849
Original notice
Evaluation of Cerebrospinal Fluid, Urine, and Plasma Tests for Alzheimer Disease
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