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New Clinical Guidelines - Coverage of Genetic Testing pdf

Connecticut Medicaid (HUSKY Health)·CT · Vascular Surgery, General Surgery·Provider Bulletin
Effective date
Nov 1, 2018
We identified it
Jun 20, 2026
Days to comply

Summary

Connecticut Medicaid (HUSKY Health) is implementing new prior authorization requirements and coverage guidelines for genetic testing, sclerotherapy procedures, and patient lift systems. New PA forms are required for genetic testing, and two sclerotherapy codes will require prior authorization starting January 1, 2019.

Action Required

Action needed
By November 1, 2018: Update billing system to reflect new genetic testing PA requirements and use new Genetic Testing Prior Authorization Request Form for Connecticut Medicaid patients. By January 1, 2019: Configure billing system to require prior authorization for CPT codes 36465 and 36466 (foam sclerotherapy procedures). Update encounter forms to alert providers of PA requirements. Train staff on new forms available at www.ct.gov/husky under Prior Authorization Forms.

Affected Billing Codes

36465
36466