Posted in Insurance, Training, Updates

UHC Commercial and Medicaid Plans- Adding 11 codes to Genetic Testing List (unproven)

Effective 12/01/2020- UHC Commercial and Medicaid Plans will add 11 more codes (Genetic Testing for Hereditary Cancer) to the list of UPROVEN/INVESTIGATIONAL codes.

“Genetic testing for BRCA1 and BRCA2, or multi-gene hereditary cancer panels with RNA testing, are unproven and not medically necessary for all indications.”

These eleven codes will be denied as unproven per medical policy. Codes will deny no matter the prior authorization status. Therefore, UHC is removing the prior authorization requirement.

Partial List of codes Below:

For complete list of these 11 codes and definitions, please visit: Genetic Testing for Hereditary Cancer CPT® Code Update Effective Date: Dec. 1, 2020 (uhcprovider.com)

#UHCgenetictesting, #hereditarycancer

Author:

My name is Kate Patskovska, CPB. I am an Independent Medical Biller CPB (AAPC) and an owner of KR2 Medical Billing. KR2 Medical Billing is a full service Consulting/Medical Billing Business that is dedicated to educating, consulting, and overall improving the "financial health" of your medical practice.

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