HumanaCommercial Clinical Policy

Humana Genetic and Biomarker Testing for Alzheimer Disease Form


CSF testing for Aβ and Tau proteins

Indications

(135785) Is the treatment with an FDA approved Aβ monoclonal antibody drug such as lecanemab [Leqembi] being considered for the patient? 

Contraindications

(135786) Is the CSF testing for biomarkers being requested for alpha-Synuclein (eg, SYNTap biomarker test) or other non-listed indications? 

DNA analysis for APOE epsilon 4 allele (APOE ε4)

Indications

(135787) Is the treatment with an FDA approved Aβ monoclonal antibody drug such as lecanemab [Leqembi] being considered for the patient? 

Contraindications

(135788) Is the DNA analysis being requested for genetic testing of APP, PSEN1, PSEN2 genes, mRNA GEP multi-gene, algorithmic testing, or other non-listed indications? 

Plasma testing for Aβ and/or Tau proteins and related assays

Notes: These tests are considered experimental/investigational and not covered.


Contraindications

(135789) Is plasma testing being requested for indications such as Aβ peptide testing, Aβ42/40 ratio, APOE proteotype assay, p-Tau181, or other related non-listed assays? 
YesNoN/A
YesNoN/A

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Effective Date

08/24/2023

Last Reviewed

NA

Original Document

  Reference



Genetic and Biomarker Testing for Alzheimer Disease

Medical Coverage Policy

Effective Date: 08/24/2023
Revision Date: 08/24/2023
Review Date: 08/24/2023
Policy Number: HUM-0527-016
Page: 1 of 9
Change Summary: Updated Description, Coverage Determination, Coverage Limitations, References

Humana's documents are updated regularly online. When printed, the version of this document becomes uncontrolled. Do not rely on printed copies for the most up-to-date version. Refer to Medical and Pharmacy Coverage Policies to verify that this is the current version before utilizing.

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