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Blue Cross & Blue Shield of MississippiAll Plans · Coverage · Medical Policy · Oncology, PathologyMedium impact

Analysis of MGMT Promoter Methylation in Malignant Gliomas

Effective date
Not stated in the notice
Identified
Jun 20, 2026

Summary

Methylation analysis of the MGMT gene promoter from glioma tumor tissue is medically necessary for individuals with a tumor type consistent with high-grade malignant glioma, such as glioblastoma multiforme or anaplastic astrocytoma, who are candidates for temozolomide therapy or radiotherapy and whose methylation results will be used to direct their therapy choices. MGMT promoter methylation analysis is investigational in situations that do not meet these criteria. CPT 81287 is listed in the medically necessary codes table, and the listed codes are only medically necessary if the procedure is performed according to the policy section.

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What to do

Action · 3 steps
01Billing team: Before billing CPT 81287 for MGMT promoter methylation analysis, confirm that the tumor type is consistent with high-grade malignant glioma (for example glioblastoma multiforme or anaplastic astrocytoma), that the individual is a candidate for temozolomide therapy or radiotherapy, and that the methylation results will be used to direct therapy choices.
02Testing in situations that do not meet these criteria is investigational.
03Diagnosis codes C71.0 through C71.9 (malignant neoplasm of brain) are listed with the medically necessary codes.

Codes mentioned

81287C71.0C71.9

Original notice

Analysis of MGMT Promoter Methylation in Malignant Gliomas
bcbsms.com · Always check the source before changing claims.
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Related changes

See all Blue Cross & Blue Shield of Mississippi changes →
Somatic Genetic Testing To Select Individuals with Melanoma or Glioma for Targeted Therapy (BRAF)MediumNo effective date · Medical PolicyIntensity-Modulated Radiotherapy (IMRT): Central Nervous System TumorsMediumNo effective date · Medical PolicyFunctional Magnetic Resonance Imaging of the Brain for Presurgical Mapping or Seizure Focus LocalizationMediumNo effective date · Medical PolicyMagnetoencephalography/Magnetic Source ImagingMediumNo effective date · Medical PolicyBrowse every Blue Cross & Blue Shield of Mississippi change in the policy list

Related policy hubs

Blue Cross & Blue Shield of Mississippi policiesOncologyPathologyCode 81287Code C71.0Code C71.9

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