CurrentBlue Cross Blue Shield - TennesseePolicy N/A

Serum Biomarker Testing for Multiple Sclerosis and Related Neurologic Diseases

Clinical coverage criteria for laboratory biomarker testing (serum and CSF) to aid diagnosis of MS, neuromyelitis optica spectrum disorders (NMOSD), and MOG-IgG-associated encephalomyelitis (MOG-EM); governs when tests meet coverage criteria versus do not, and lists applicable procedure codes. Applies to Blue Cross Blue Shield - Tennessee members subject to their benefit coverage.

Policy Summary

PayerBlue Cross Blue Shield - Tennessee

PolicySerum Biomarker Testing for Multiple Sclerosis and Related Neurologic Diseases

Policy CodePolicy N/A

Change TypeNo material changes

Effective Date

Next Review Date

Key ActionDocument clinical presentation and compatible radiologic/electrophysiologic findings plus at least one supporting feature for AQP4/MOG testing, and order paired CSF and serum OCB testing when diagnosis of MS is unclear or presentation is atypical.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

CoveredOCB/CSF oligoclonal band testing

ConditionalAQP4-IgG and MOG-IgG serum testing

Not coveredAll other serum biomarker tests for MS/NMOSD/MOG-EM

Codes listProcedure codes provided

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