CPT 88368, in plain terms, covers A lab technician uses a microscope and manual techniques to detect specific genetic material or viruses within tissue samples. CPT 88368 is referenced in 3 tracked payer policy changes from CareSource, Blue Shield of California, and 1 other payer. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 88368 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.
Official descriptor: CPT 88368 on AAPC
CareSource Georgia Medicaid is implementing new prior authorization requirements effective April 1, 2026, for 57 specific billing codes across multiple service categories including genetic testing, durable medical equipment, orthotic/prosthetic devices, and surgical procedures. All non-participating providers and inpatient services already require prior auth; this update expands requirements to include these specific codes for all providers.
Blue Shield of California's medical policy 2.04.151, Genetic Variant Testing (Including Liquid Biopsy) for Targeted Treatment in Advanced Cancer, lists the tumor tissue and liquid biopsy tests it may consider medically necessary to select FDA-approved targeted treatments. The policy states an effective date of November 1, 2026, and its policy history for that date says the policy statement, guidelines and literature were updated, the title changed from Genetic Biomarker Testing (Including Liquid Biopsy) for Targeted Treatment in Advanced Cancer, and a coding update was made. The policy refers to Appendix A for the policy statement changes from the previous version.
The policy considers urinary tumor markers investigational for screening, diagnosis, and monitoring of bladder cancer, and for screening for precancerous colonic polyps. The FDA approved or cleared urinary tumor marker tests named in the policy are indicated as adjuncts to standard procedures for initial diagnosis of bladder cancer, surveillance of bladder cancer patients, or identification of colonic polyps, and laboratory-developed tests are offered without FDA regulatory review. A 05/29/2026 update changed the description of laboratory-developed tests and left the policy statement unchanged.
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