CommercialCoverageMedium impact
Multianalyte Assays with Algorithmic Analyses for Predicting Risk of Type 2 Diabetes
Blue Cross & Blue Shield of Mississippi·MS · Family Medicine, Internal Medicine, Endocrinology +1 more·Medical Policy
Effective date
Aug 4, 2025
We identified it
Jun 20, 2026
Summary
BCBS MS policy L.2.04.431 confirms that multianalyte assays with algorithmic analyses for predicting Type 2 diabetes risk (including Pre-Dx Diabetes Risk Score) remain investigational and are not covered. This policy was recently reviewed with no changes to coverage determination.
Action Required
Immediately: Billing team must ensure CPT code 81465 (multianalyte assays for diabetes risk prediction) is flagged as non-covered/investigational in billing system for BCBS MS patients. Inform providers that Pre-Dx Diabetes Risk Score and similar diabetes prediction panels are not reimbursable and patients must be notified of out-of-pocket responsibility before ordering.