CommercialCoverageLow impact
Genetic Testing for PTEN Hamartoma Tumor Syndrome
Blue Cross & Blue Shield of Mississippi·MS · Oncology, Endocrinology, OB-GYN +3 more·Medical Policy
We identified it
Jun 20, 2026
Summary
BCBS Mississippi has established a new medical policy for genetic testing for PTEN Hamartoma Tumor Syndrome, which includes coverage criteria for diagnosing conditions like Cowden syndrome and related disorders that increase cancer risk. This policy defines specific diagnostic criteria and clinical guidelines for when genetic testing is appropriate.
Action Required
Review policy A.2.04.88 for PTEN genetic testing requirements. Ensure providers document appropriate clinical criteria (macrocephaly, mucocutaneous lesions, cancer history, or family history) before ordering PTEN genetic testing. Update prior authorization processes if required by BCBS Mississippi for genetic testing services.