Benefit Criteria to Change for Genetic Testing for Colorectal Cancer Effective May 1, 2013

Effective for dates of service on or after May 1, 2013, benefit criteria for genetic testing for colorectal cancer will change for Texas Medicaid.

The following genetic testing procedure codes will be a benefit when submitted with diagnosis code V16.0 (Family history of malignant neoplasm of gastrointestinal tract).

Diagnosis code V16.0 will be valid only with the procedure codes identified in the table. Prior authorization is still required and must be obtained for these services.