CommercialCoverageMedium impact
Urinary Tumor Markers for Bladder and Urothelial Cancers 2.02.12
Excellus BlueCross BlueShield·Urology, Oncology·Lab Tests (pathology)
Effective date
Jul 17, 2025
We identified it
Jun 20, 2026
Summary
Excellus BlueCross BlueShield has classified all urinary tumor markers for bladder and urothelial cancers as investigational and not covered for diagnosis, monitoring, or screening. This includes BTA tests, ImmunoCyt, NMP-22, FISH DNA probe technology, and multiplex protein-based immunoassays like Oncuria.
Action Required
Before July 17, 2025: Billing team must identify all CPT codes related to urinary tumor markers (BTA stat, BTA TRAK, ImmunoCyt, NMP-22, FISH DNA probe tests, Oncuria) and update billing system to flag these as non-covered/investigational for Excellus BlueCross BlueShield members. Update prior authorization system to automatically deny these tests. Notify urology providers that these tests will not be reimbursed and alternative diagnostic methods should be used.