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)