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Excellus BlueCross BlueShieldCommercial · Coverage · Lab Tests (pathology) · NY · Pathology, Hematology, Oncology +1 moreMedium impact

JAK2, MPL, and CALR Testing for Myeloproliferative Neoplasms 2.02.53

Effective date
Mar 19, 2026
Identified
Jun 20, 2026

Summary

Molecular testing for suspected myelofibrosis (MF) or essential thrombocythemia (ET) is medically necessary when the test is completed on blood or bone marrow, the patient presents with clinical, laboratory, or pathologic findings suggesting MF or ET, secondary causes have been evaluated, and a JAK2, MPL, or CALR mutation is tested for. Molecular testing for suspected polycythemia vera (PV) is medically necessary when the test is completed on blood or bone marrow, the patient presents with findings suggesting PV, evaluation for secondary causes has been completed, and the test is for JAK2 mutations. JAK2, MPL, and CALR testing is investigational in all other circumstances, including diagnosis of nonclassic myeloproliferative neoplasms and molecular phenotyping of patients with MPNs. Broad molecular panel testing is considered investigational.

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What to do

Action · 7 steps
01Requirements for billing these services: Testing for suspected MF or ET is medically necessary only when all listed criteria are documented, including blood or bone marrow testing, findings suggesting MF or ET, evaluation for secondary causes, and a JAK2, MPL, or CALR mutation test.
02Testing for suspected PV is medically necessary only when blood or bone marrow testing, findings suggesting PV, completed evaluation for secondary causes, and a JAK2 test are documented.
03For suspected PV, JAK2 V617F should be tested first; if negative, further testing for other JAK2 variants (for example exon 12) is warranted.
04For suspected ET or primary myelofibrosis, JAK2 V617F should be tested first; if negative, MPL and CALR testing is warranted.
05Genetic testing is appropriate only when performed by a CLIA-certified laboratory.
06Coverage applies only to members with a valid contract, and not to family members without a valid contract.
07Testing outside these criteria is considered investigational.

Codes mentioned

812198127081279813388133981450814518145581456C96.2C92.10C92.12D45D47.3D47.4

Original notice

JAK2, MPL, and CALR Testing for Myeloproliferative Neoplasms 2.02.53
excellusbcbs.com · Always check the source before changing claims.
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Related policy hubs

Excellus BlueCross BlueShield policiesNY policy changesPathologyHematologyOncologyGeneticsCode 81219Code 81270Code 81279Code 81338Code 81339Code 81450Code 81451Code 81455Code 81456Code C96.2Code C92.10Code C92.12Code D45Code D47.3Code D47.4

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