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Genotype-Guided Warfarin Dosing

Blue Cross & Blue Shield of Mississippi·MS · Cardiology, Hematology, Internal Medicine +1 more·Medical Policy
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply
—

Summary

This policy clarifies that genotype-guided warfarin dosing (genetic testing to determine CYP2C9, CYP4F2, and VKORC1 variants) is considered investigational and not covered. The policy has remained unchanged since 2017 but is freshly republished.

Action Required

Action needed
Immediately: Billing team should verify that CPT codes 81227 and 81355 and HCPCS code G9413 for genetic testing related to warfarin dosing are flagged as non-covered/investigational in billing system. Ensure claims are not submitted for these services as they will be denied. Providers should be reminded that these genetic tests are not reimbursable.

Affected Billing Codes

81227
81355
G9413

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