CommercialCoverageMedium impact
Genetic Testing for Cystic Fibrosis 2.02.17
Excellus BlueCross BlueShield·OB-GYN, Pediatrics, Family Medicine +1 more·Genetic Disease (Inherited Disease)
Effective date
Jul 17, 2025
We identified it
Jun 20, 2026
Summary
Excellus BlueCross BlueShield has updated their genetic testing policy for cystic fibrosis, effective July 17, 2025. The policy establishes specific medical necessity criteria for CF genetic testing including diagnostic, carrier, and prenatal testing scenarios, while explicitly stating that expanded panel testing (CPT 81223) is not medically necessary.
Action Required
By July 17, 2025: Billing team must update system to flag CPT 81223 (expanded CF panel testing) as not covered by Excellus BCBS. Update encounter forms and provider alerts to indicate this code will be denied. Ensure documentation supports medical necessity criteria for standard CF genetic testing before billing.