Genetic and Molecular Prior Authorization Update

Beginning Oct. 1, 2020, for all commercial and UnitedHealthcare Community Plan plans included in the genetic and molecular testing program, we are suspending prior authorization and notification requirements for the following three genetic and molecular CPT codes performed in an outpatient setting:

  • 87480: Infectious agent detection by nucleic acid (DNA or RNA); candida species, direct probe technique
  • 87660: Infectious agent detection by nucleic acid (DNA OR RNA); Trichomonas vaginalis, direct probe technique
  • 87661: Infectious agent detection by nucleic acid (DNA OR RNA); Trichomonas vaginalis, amplified probe technique:

These codes were part of the expansion of the online prior authorization and notification program for genetic and molecular testing that took effect on July 1, 2020. We’re suspending the codes indefinitely to ease the administrative burden for care providers during the COVID-19 national public health emergency. Please note that we will be reviewing claims for these codes to ensure they are being billed appropriately.

Visit UHCprovider.com/genetics to learn more and view up-to-date code lists. For more information, use the Genetic and Molecular Lab Test tool on Link. Or, call 800-377-8809, Monday – Friday, 7 a.m. – 7 pm.