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CommercialCoverageMedium impact

Urinary Biomarkers for Cancer Screening, Diagnosis, and Surveillance

Blue Cross & Blue Shield of Mississippi·MS · Urology, Oncology, Gastroenterology +2 more·Medical Policy
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

This policy establishes that all urinary biomarker tests for cancer screening, diagnosis, and surveillance are considered investigational and not covered, despite FDA approval of several tests. The policy affects both bladder cancer monitoring and colonic polyp screening tests.

Action Required

Action needed
Immediately: Billing team must verify that urinary biomarker tests (BTA stat, BTA TRAK, NMP22, UroVysion, Bladder EpiCheck, and laboratory-developed tests) are not billed to this payer as they are considered investigational. Update billing system to flag these tests for denial prevention. Inform providers that alternative covered diagnostic methods should be used.

Affected Billing Codes

81000
81001
81002
81003
81005
81007
81015
81020
81099
86316
88271
88299
88367
88368
88120
88121
83365