Medicare AdvantageCoverageMedium impact
MA06.013e, Serodiagnosis of Inflammatory Bowel Disease (IBD) and the Prometheus® IBD sgi Diagnostic™ Test
Independence Blue Cross·MA · Gastroenterology, Internal Medicine, Infectious Disease·Pharmacy
Effective date
Jul 9, 2025
We identified it
Jun 19, 2026
Summary
This policy (MA06.013e) addresses serodiagnosis testing for Inflammatory Bowel Disease (IBD), specifically the Prometheus® IBD sgi Diagnostic™ Test. The policy was reissued effective 07/09/2025 and subsequently removed from active posting on 09/09/2025, indicating this guidance may have been superseded or withdrawn. Billing teams should verify current coverage status with the plan before processing claims for IBD serodiagnostic testing.
Action Required
By 09/09/2025: Billing team must review current policy status for MA06.013e with the insurance carrier, as the policy was removed from active posting on this date. Confirm whether IBD serodiagnostic testing (including Prometheus® IBD sgi Diagnostic™ Test) remains covered under Medicare Advantage plans and obtain updated guidance. Do not process claims based on the reissued 07/09/2025 version without verification. Update billing system rules and provider communication to reflect current coverage status. Failure to verify may result in unexpected claim denials or payment delays for IBD diagnostic testing.