All PlansCoverageMedium impact
Genetic and Protein Biomarkers for the Diagnosis and Cancer Risk Assessment of Prostate Cancer
Blue Cross & Blue Shield of Mississippi·Urology, Oncology·Medical Policy
Effective date
Jul 1, 2025
We identified it
Jun 20, 2026
Summary
This policy update adds new CPT codes (0534U, 0550U, 0572U) for investigational prostate cancer genetic and protein biomarker tests, with one code (0550U) subsequently deleted. All listed biomarker tests remain non-covered as investigational, meaning claims will be denied.
Action Required
By July 1, 2025: Billing team must update system to flag CPT codes 0005U, 0021U, 0047U, 0113U, 0228U, 0495U, 0497U, 0534U, 0572U, 81542, and 81551 as non-covered investigational services. Add alerts to prevent billing these codes as they will result in automatic claim denials. Remove deleted code 0550U from billing system if previously entered.