Anthem Blue Cross and Blue Shield New Hampshire policy
LAB.00046 Testing for Biochemical Markers for Alzheimer’s Disease
LAB.00046 Testing for Biochemical Markers for Alzheimer’s Disease is a public Anthem Blue Cross and Blue Shield New Hampshire policy (policy LAB.00046). It lists 19 CPT or HCPCS codes, 14 of them on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage decision; the payer's own document governs.
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- Policy number
- LAB.00046
- Line of business
- Commercial
- Source
- www.anthem.com
Codes in this policy
The CPT and HCPCS codes the policy names. A policy can name a code it excludes. Prior authorization status is from the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list.
| Code | Prior authorization | Description on the prior authorization list | Other Anthem Blue Cross and Blue Shield New Hampshire policies |
|---|---|---|---|
| 0206U | On the list | Neurology (Alzheimer disease); cell aggregation using morphometric imaging and protein kinase C-epsilon (PKCe) concentration in response to amylospheroid treatment by ELISA, cultured skin fibroblasts, each reported as positive or negative for Alzheimer disease | Policies naming 0206U |
| 0207U | Not listed | Policies naming 0207U | |
| 0358U | On the list | Neurology (mild cognitive impairment), analysis of B-amyloid 1-42 and 1-40, chemiluminescence enzyme immunoassay, cerebral spinal fluid, reported as positive, likely positive, or negative | Policies naming 0358U |
| 0412U | On the list | Beta amyloid, AB42/40 ratio, immunoprecipitation with quantitation by liquid chromatography with tandem mass spectrometry (LC-MS/MS) and qualitative ApoE isoform-specific proteotyping, plasma combined with age, algorithm reported as presence or absence of brain amyloid pathology | Policies naming 0412U |
| 0445U | On the list | B-amyloid (Abeta42) and phospho tau (181P) (pTau181), electrochemiluminescent immunoassay (ECLIA), cerebral spinal fluid, ratio reported as positive or negative for amyloid pathology | Policies naming 0445U |
| 0459U | On the list | B-amyloid (Abeta42) and total tau (tTau), electrochemiluminescent immunoassay (ECLIA), cerebral spinal fluid, ratio reported as positive or negative for amyloid pathology | Policies naming 0459U |
| 0479U | On the list | Tau, phosphorylated, pTau217 | Policies naming 0479U |
| 0503U | On the list | Neurology (Alzheimer disease), beta amyloid (AB40, AB42, AB42/40 ratio) and tau-protein (ptau217, np-tau217, ptau217/np-tau217 ratio), blood, immunoprecipitation with quantita | Policies naming 0503U |
| 0547U | Not listed | Policies naming 0547U | |
| 0568U | Not listed | Policies naming 0568U | |
| 0596U | Not listed | Policies naming 0596U | |
| 81599 | On the list | Unlisted multianalyte assay with algorithmic analysis | Policies naming 81599 |
| 82233 | On the list | Beta-amyloid; 1-40 (Abeta 40) | Policies naming 82233 |
| 82234 | On the list | Beta-amyloid; 1-42 (Abeta 42) | Policies naming 82234 |
| 83520 | On the list | Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified | Policies naming 83520 |
| 83884 | On the list | Neurofilament light chain (NfL) | Policies naming 83884 |
| 84393 | On the list | Tau, phosphorylated (eg, pTau 181, pTau 217) | Policies naming 84393 |
| 84394 | On the list | Tau, total (tTau) | Policies naming 84394 |
| 84999 | Not listed | Policies naming 84999 |
All Anthem Blue Cross and Blue Shield New Hampshire policies · Anthem Blue Cross and Blue Shield New Hampshire prior authorization CPT list