Alzheimer’s biomarkers could soon receive their own ICD-10 code, allowing for earlier detection and treatment of the disease. Blood tests that signal the buildup of amyloid-beta plaques and other degeneration linked to Alzheimer’s can now identify the disease sooner, when treatment can be most effective. The decision to introduce a new code lies with the ICD-10 Coordination and Maintenance Committee.
How Codes Improve Quality of Care
ICD-10 codes are more than just administrative tools. By uniquely identifying a health condition, in this case the presence of Alzheimer’s biomarkers as distinct from Alzheimer’s disease itself, coding allows clinicians to classify patients accurately and early. Codes also impact how specific treatments are reimbursed and prioritized, so the ability to identify Alzheimer’s risk in a patient before symptoms fully emerge could notably improve care.
When scientists and researchers collect broad medical data for large-population studies, they often rely on ICD-10 codes to identify patients. Using these codes, clinicians worldwide can compare “apples to apples” when tracing disease progression, effective treatments and clinical outcomes.
The coding index includes more than 74,200 conditions, and is updated periodically to reflect improvements in clinical practice.
Biomarker Tests Still Face Coverage Gaps
Equally important for patients, a unique code makes it easier for insurers to cover the costs of testing or screening. The FDA-approved blood test for biomarkers is far cheaper than a PET scan (the previous diagnostic standard) and provides a more accessible tool to identify Alzheimer’s. But patients often pay for the testing out of pocket, creating systemic inequities in access to early detection and treatment
Some states have moved to require payers to cover biomarker blood tests, but this access is inconsistent. Assigning Alzheimer’s biomarkers an ICD-10 code would strengthen the case for broad coverage, reducing disparities and supporting widespread adoption of these tests, regardless of patient means.
In a September meeting, the committee heard from the public about the importance of this code. If the committee recommends pursuing an official code, it could open doors to earlier diagnosis, better access to emerging treatments and more years of healthy living.
