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Molecular Testing of Tumor Tissue to Identify Targeted Therapies for Cancers 2.02.51
Excellus BlueCross BlueShield·Oncology, Hematology, Pathology·Genetic Disease (Inherited Disease)
Effective date
Feb 19, 2026
We identified it
Jun 20, 2026
Summary
Excellus BlueCross BlueShield updated their molecular testing policy for tumor tissue to identify targeted cancer therapies, effective February 19, 2026. The policy specifies covered genetic tests for 10 specific cancer types including colorectal, lung, melanoma, pancreatic, ovarian, prostate, breast, brain tumors, ependymomas, and medulloblastoma, with specific CPT codes listed for each condition.
Action Required
Before February 19, 2026: Billing team must update prior authorization and coverage verification processes for molecular tumor testing CPT codes. Ensure documentation includes all required criteria: testing must direct targeted therapy, results will guide patient management, and cancer type matches the 10 specific conditions listed in the policy. Update encounter forms and billing system edits to flag comprehensive genomic profiling tests as investigational and not covered.