Coding Updates – BCBS/Anthem

Effective September 1, 2019, we will be implementing coding updates in the claims system for the following policies listed below which may result in investigational/not medically necessary determinations for certain services.

• GENE.00001 – Genetic Testing for Cancer Susceptibility
• GENE.00007 – Cardiac Ion Channel Genetic Testing
• GENE.00003 – Genetic Testing and Biochemical Markers for the Diagnosis of Alzheimer’s Disease
• GENE.00017 – Genetic Testing for Diagnosis and Management of Hereditary Cardiomyopathies (including arrhythmogenic right ventricular dysplasia/cardiomyopathy)
• GENE.00023 – Gene Expression Profiling of Melanomas
• CG-GENE-07 – BCR-ABL Mutation Analysis
• CG-GENE-09 – Genetic Testing for CHARGE Syndrome

(The policies below were revised and might result in services that were previously covered but may now be found to be either not medically necessary and/or investigational.)

• GENE.00010 – Genotype Testing for Genetic Polymorphisms to Determine Drug-Metabolizer Status
• GENE.00012 – Preconception or Prenatal Genetic Testing of a Parent or Prospective Parent
• GENE.00043 – Genetic Testing of an Individual’s Genome for Inherited Diseases
• MED.00101 – Physiologic Recording of Tremor using Accelerometer(s) and Gyroscope(s)

Source: https://providernews.anthem.com/maine/article/coding-updates-1