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Genotype-Guided Warfarin Dosing
Effective date
Not stated in the notice
Identified
Jun 20, 2026
Summary
Genotyping to determine CYP2C9, CYP4F2 and VKORC1 genetic variants is considered investigational for managing the administration and dosing of warfarin, including guiding the initial dose to decrease time to stable INR and reduce the risk of serious bleeding. Suggested starting doses are also provided when genotyping information is unavailable, which indicates that genetic testing is not required.
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What to do
Action · 3 steps
01Billing team: Under this policy, genotyping for CYP2C9, CYP4F2 and VKORC1 variants to manage warfarin administration and dosing, including guiding the initial warfarin dose, is investigational, and investigative services are not considered medically necessary.
02The investigational codes listed in the policy are CPT 0030U, 81227, 81355 and HCPCS G9143.
03Federal Employee Program may dictate that all FDA-approved devices, drugs or biologics may not be considered investigational and may be assessed only on the basis of their medical necessity.
Codes mentioned
8122781355G9143
Original notice
Genotype-Guided Warfarin Dosing
bcbsms.com · Always check the source before changing claims.