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Excellus BlueCross BlueShieldAll Plans · Coverage · Lab Tests (pathology), Lungs (Respiratory) · Pulmonology, Pathology, OncologyMedium impact

Molecular Testing in the Management of Pulmonary Nodules 2.02.58

Effective date
Oct 22, 2026
Identified
Jun 20, 2026

Summary

Policy 2.02.58 considers molecular testing for undiagnosed pulmonary nodules investigational in all circumstances, including plasma-based proteomic screening, gene expression of bronchial brushings or nasal swabs, and flow cytometry of sputum. The policy names CyPath Lung, EarlyCDT Lung, LungLB, Nodify CDT, Nodify XL2, OncobiotaLUNG, ReVeal Lung Nodule Characterization, PAULA's Test, Percepta Genomic Sequencing Classifier and Percepta Nasal Swab as investigational tests. The current effective date is October 22, 2026, and the 10/22/26 annual review left the policy intent unchanged.

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What to do

Action · 3 steps
01Already effective 2026-10-22: Billing team: Confirm that the member holds a valid contract before billing these tests, because coverage only applies to members with a valid contract and is not provided for family members without one.
02Billing team: Confirm that the laboratory performing the genetic test is CLIA-certified, because genetic testing is appropriate only when performed by a qualified CLIA-certified laboratory.
03Billing team: The codes marked (E/I) in the policy include 0080U, 0092U, 0317U, 0360U, 0395U and 0406U.

Codes mentioned

835208147981599R91R91.1R91.8Z12.2

Original notice

Molecular Testing in the Management of Pulmonary Nodules 2.02.58
excellusbcbs.com · Always check the source before changing claims.
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Related policy hubs

Excellus BlueCross BlueShield policiesPulmonologyPathologyOncologyCode 83520Code 81479Code 81599Code R91Code R91.1Code R91.8Code Z12.2

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