Notification of Policy Revisions Effective July 18, 2023 (Posted May 16, 2023)

Medical Policy	Revision
Biomarker Testing for Autoimmune Rheumatic Disease AHS – G2022 Policy Effective 07/18/2023 Replacing ANA/ENA Testing AHS – G2022	Reviewed by Avalon 1st Quarter 2023 CAB. Title changed to “Biomarker Testing for Autoimmune Rheumatic Disease”. Medical Director review 4/2023. Description, Policy Guidelines, and References updated Added once per lifetime limit related to testing for antinuclear antibodies (ANA) is allowed for individuals with a high clinical suspicion of autoimmune disease and repeat testing only if a significant change in symptoms occurs. Other coverage criteria updated for clarity. Billing/Coding section updated to add 81490. Notification given 5/16/2023 for effective date 7/18/2023.

Medical Policy

Revision

Biomarker Testing for Autoimmune Rheumatic Disease AHS – G2022

Policy Effective 07/18/2023

Replacing ANA/ENA Testing AHS – G2022

Reviewed by Avalon 1st Quarter 2023 CAB. Title changed to “Biomarker Testing for Autoimmune Rheumatic Disease”. Medical Director review 4/2023. Description, Policy Guidelines, and References updated Added once per lifetime limit related to testing for antinuclear antibodies (ANA) is allowed for individuals with a high clinical suspicion of autoimmune disease and repeat testing only if a significant change in symptoms occurs. Other coverage criteria updated for clarity. Billing/Coding section updated to add 81490. Notification given 5/16/2023 for effective date 7/18/2023.

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