Medi-Cal – Breast Cancer Gene Analysis TAR Override Update

Effective for dates of service on or after June 1, 2019, an approved Treatment Authorization Request (TAR) with the following documentation will no longer override the once-in-a-lifetime frequency limitation for CPT code 81162 (BRCA1, BRCA2 gene analysis; full sequence analysis and full duplication/deletion analysis):

• For patients with previous BRCA test other than the FoundationFocus CDxBRCA, repeat BRCA testing with FoundationFocus CDxBRCA may be necessary when treatment with Rubraca (rucaparib) is contingent on the test results.