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Molecular Genomic Profiling for Cancers of Unknown Primary
Effective date
Not stated in the notice
Identified
Jun 20, 2026
Summary
Gene expression and comprehensive genomic profiling are considered investigational to evaluate the site of origin of a tumor of unknown primary, to distinguish a primary from a metastatic tumor, or to guide treatment selection. The 2025-07-18 revision renamed the policy from Gene Expression-Based Assays for Cancers of Unknown Primary to Molecular Genomic Profiling for Cancers of Unknown Primary and added comprehensive genomic profiling to the investigational statement. The code reference lists CPT 81479, 81504, 81540, and 84999 as investigational codes.
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What to do
Action · 3 steps
01Check current applicability at the source link before billing.
02Billing team: Before billing gene expression or comprehensive genomic profiling for cancer of unknown primary, check the investigational code list in charge entry, including CPT 81479, 81504, 81540, and 84999.
03Billing team: Treat these services as investigational when they are used to evaluate the site of origin of a tumor of unknown primary, to distinguish a primary from a metastatic tumor, or to guide treatment selection.
Codes mentioned
81479815048154084999
Original notice
Molecular Genomic Profiling for Cancers of Unknown Primary
bcbsms.com · Always check the source before changing claims.
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