All PlansCoverageMedium impact
Circulating Tumor-Tissue-Modified Viral DNA Testing for Cancer Management
Blue Cross & Blue Shield of Mississippi·MS · Oncology, ENT (Ear, Nose & Throat), General Surgery·Medical Policy
Effective date
Aug 15, 2024
We identified it
Jun 20, 2026
Summary
BCBS has classified circulating tumor-tissue-modified viral (TTMV) HPV DNA testing, including the NavDx test, as investigational and non-covered. This affects billing for HPV-related head and neck or anal cancer monitoring and recurrence testing.
Action Required
Immediately: Stop billing CPT code 0356U for TTMV-HPV DNA testing (NavDx) to BCBS plans as it is now classified as investigational and will be denied. Billing team must update system to flag this code for prior review or denial. Providers should inform patients this testing may not be covered and obtain ABNs if proceeding.