Genetic testing for hereditary cancer unproven codes

Last modified: January 15, 2021

Effective Dec. 1, 2020, the Genetic Testing for Hereditary Cancer medical policy was updated to include eleven unproven codes for our commercial and Medicaid members.

“Genetic testing for BRCA1 and BRCA2, or multi-gene hereditary cancer panels with RNA testing, are unproven and not medically necessary for all indications.” (Policy Number CS049.N)

These eleven codes will deny as unproven per medical policy. Codes will deny no matter the prior authorization status. Therefore, we are removing the prior authorization requirement.

Questions? Call 1-952-202-2015.