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Blue Cross & Blue Shield of MississippiAll Plans · Coverage · Medical Policy · Orthopedics, GeneticsMedium impact

DNA-Based Testing for Adolescent Idiopathic Scoliosis

Effective date
Not stated in the notice
Identified
Jun 20, 2026

Summary

DNA-based prognostic testing for adolescent idiopathic scoliosis, including the ScoliScore AIS test, is considered investigational. The policy states that subsequent clinical studies were unable to replicate the association of the 53 genetic markers with progression of adolescent idiopathic scoliosis. It also states that the ScoliScore AIS Prognostic Test appears to be no longer commercially available, and that the FDA has chosen not to require any regulatory review of this test. The most recent policy review, dated 03/28/2025, reported no changes.

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What to do

Action · 4 steps
01Billing team: Under this policy, DNA-based prognostic testing for adolescent idiopathic scoliosis is considered investigational.
02Investigative services are not considered medically necessary under the policy definitions.
03The policy lists CPT 0004M and CPT 81479 under investigational codes.
04The policy exceptions section lists none.

Codes mentioned

81479

Original notice

DNA-Based Testing for Adolescent Idiopathic Scoliosis
bcbsms.com · Always check the source before changing claims.
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Related policy hubs

Blue Cross & Blue Shield of Mississippi policiesOrthopedicsGeneticsCode 81479

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