Anthem Blue Cross Connecticut LAB.00019 Proprietary Algorithms for Liver Fibrosis Form

This document addresses proprietary algorithms utilizing serum markers to assist in the evaluation and monitoring of chronic liver disease, including, but not limited to hepatitis C, hepatitis B, and metabolic dysfunction-associated steatotic liver disease (MASLD). These markers are indirect and direct measures of liver fibrosis. This document does not address scoring systems that can be calculated bedside using common laboratory tests (for example, platelet count, or liver function tests).

Position Statement

Investigational and Not Medically Necessary:

Proprietary algorithms evaluating liver fibrosis are considered investigational and not medically necessary for all indications.