Billing Beat

BCBS M – Blue Cross highlights medical, benefit policy changes

December 12, 2023

Gene expression assay testing in tumor tissue for treatment guidance for breast cancer patients

81518, 81519, 81520, 81521, 81522, 81523

Experimental
81599,** 84999,** S3854,*** 0045U, 0153U

The safety and effectiveness of reverse-transcriptase polymerase chain reaction, or RT-PCR assays (i.e., Oncotype DX®, EndoPredict®, Breast Cancer Index®, MammaPrint® and Prosigna®) for determining whether to undergo adjuvant chemotherapy may be considered established. They are useful diagnostic tests for predicting the likelihood of early cancer recurrence (0 to 5 years) in individuals who meet the inclusionary guidelines.

Source: https://www.bcbsm.com/content/dam/microsites/corpcomm/provider/the_record/2023/dec/Record_01223i.html

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