YouÃll find the latest information about procedure codes and Blue Cross Blue Shield of Michigan billing guidelines in the following chart. Procedures for which BCBS MI is clarifying their guidelines will appear under Policy Clarifications. POLICY CLARIFICATION S3870 Experimental 81228, 81229 Basic Benefit Policy The safety and effectiveness of chromosomal microarray analysis have been established. It may be considered a useful diagnostic option when indicated for patients meeting specific patient selection criteria. The policy guidelines were updated, effective Sept. 1, 2012. Inclusionary Guidelines Chromosomal microarray analysis may be considered medically necessary for diagnosing a genetic abnormality in children with apparent nonsyndromic cognitive developmental delay or intellectual disability, or autism spectrum disorder according to accepted Diagnostic and Statistical Manual of Mental Disorders-IV criteria, when all of the following conditions are metÃ–.. _______________________________________________________________________________________________ 88399 Because there is no code for this service, the procedure should be reported with this not otherwise classified code. Other codes: 11100, 88305, 88314, 88342, 88356 Basic Benefit Policy The safety and effectiveness of epidermal or intraepidermal nerve fiber density testing have been established. It may be considered a useful diagnostic tool for patients meeting patient selection guidelines, effective Sept. 1, 2012. The measurement of sweat gland nerve fiber density for the diagnosis of small-fiber neuropathy and other indications is experimental. The clinical utility of this test has not been demonstrated. The peer-reviewed medical literature has not yet shown that sweat gland nerve fiber density testing has sufficient diagnostic accuracy to provide clinically relevant information.