Medicare AdvantageCoverageMedium impact
MA06.013e, Serodiagnosis of Inflammatory Bowel Disease (IBD) and the Prometheus® IBD sgi Diagnostic™ Test
Independence Blue Cross·Gastroenterology, Internal Medicine, Family Medicine·Pharmacy
Effective date
Jul 9, 2025
We identified it
Jun 19, 2026
Summary
Medicare Advantage policy MA06.013e regarding serodiagnosis of inflammatory bowel disease and the Prometheus IBD sgi Diagnostic test has been reissued and will take effect July 9, 2025. This policy update affects billing and coverage criteria for IBD diagnostic testing under Medicare Advantage plans.
Action Required
By July 9, 2025: Review updated policy MA06.013e for serodiagnosis of IBD and Prometheus IBD sgi Diagnostic test requirements. Billing team should verify current coverage criteria and prior authorization requirements for IBD diagnostic testing under Medicare Advantage plans. Update billing procedures and staff training as needed based on the full policy content.