BCBS – Genetic Cancer Susceptibility Panels Using Next Generation Sequencing

Effective 05-14-2021

In the Policy section: Genetic Cancer Susceptibility Panels Using Next Generation Sequencing

• Replaced previous statement “Genetic cancer susceptibility panel testing using next generation sequencing are considered experimental / investigational.” with the following policy statement: “General genetic cancer susceptibility panel testing is considered experimental / investigational; however, when the coverage criteria of other policies is met (see related policies), then limited genetic cancer susceptibility panels including only the gene variants for which a given member qualifies may be considered medically necessary.”
• Removed “Although genetic cancer susceptibility panels using next generation sequencing are considered experimental / investigational, there may be individual components of the panel that are medically necessary.” From the Policy Guidelines. Updated Rationale section.

In coding section: • Added CPT codes: 0049U, 0101U, 0129U, 0130U, 0131U, 0132U, 0133U, 0134U, 0135U, 0136U, 0137U, 0138U

• Removed CPT code: 0104U