CommercialCoverageMedium impact
Genetic Testing for Inherited Thrombophilia
Blue Cross & Blue Shield of Mississippi·MS · Hematology, Cardiology, OB-GYN +2 more·Medical Policy
We identified it
Jun 20, 2026
Summary
BCBS Mississippi has classified all genetic testing for inherited thrombophilia (including Factor V Leiden, prothrombin gene variants, and MTHFR variants) as investigational and not covered. This affects genetic testing orders related to blood clotting disorders and thrombosis risk assessment.
Action Required
Immediately: Billing team must verify coverage before processing genetic thrombophilia testing claims for BCBS Mississippi members. Inform providers that Factor V Leiden, prothrombin gene, and MTHFR genetic testing is considered investigational by BCBS MS and will likely be denied. Obtain alternative coverage verification or discuss self-pay options with patients before testing.