CommercialCoverageMedium impact
Molecular Testing in the Management of Pulmonary Nodules 2.02.58
Excellus BlueCross BlueShield·Pulmonology, Oncology, Radiology +1 more·Lab Tests (pathology), Lungs (Respiratory)
Effective date
Oct 16, 2025
We identified it
Jun 20, 2026
Summary
Excellus BlueCross BlueShield has classified all molecular testing for pulmonary nodule management as investigational and non-covered, including 10 specific tests like CyPath Lung, EarlyCDT Lung, and Nodify tests. All claims for these molecular diagnostic tests will be denied as experimental/investigational services.
Action Required
By October 16, 2025: Billing team must update system to deny/reject all molecular testing claims for pulmonary nodule management (codes 0406U, 83520, 0317U, 0360U, 0080U, 0395U, 0092U) for Excellus BCBS members. Update encounter forms to alert providers these tests are non-covered. Advise patients of non-coverage before ordering to avoid patient financial responsibility disputes.