Anthem – Gene Policy Updates

GENE.00010 Panel and other Multi-Gene Testing for Polymorphisms to Determine Drug-Metabolizer Status:
Added new CPT PLA code 0392U effective 07/01/2023 for panel test considered INV&NMN
GENE.00052 Whole Genome Sequencing, Whole Exome Sequencing, Gene Panels, and Molecular Profiling
Code 81455 for panel over 50 genes to be reviewed for MN criteria (was NMN); added existing code 0022U MN in vitro diagnostic (IVD) criteria.
Codes added from GENE.00049: 0326U molecular profiling MN criteria; 0239U IVD MN criteria; 0179U, 0242U ctDNA panels MN criteria (were INV&NMN); 0306U; 0307U; 0333U; 0356U; 0368U considered NMN (were INV&NMN);
Added new 07/01/2023 CPT PLA codes: 0391U molecular profiling MN criteria; 0388U, 0397U ctDNA panels MN criteria; 0400U inherited disease panel considered NMN; 0401U risk panel considered INV&NMN

Source: https://providernews.anthem.com/missouri/articles/medical-policies-and-clinical-guidelines-updates