All PlansCoverageMedium impact
Serum Biomarker Human Epididymis Protein 4 (HE4)
Blue Cross & Blue Shield of Mississippi·OB-GYN, Oncology·Medical Policy
Effective date
Feb 10, 2025
We identified it
Jun 20, 2026
Summary
This policy confirms that Human Epididymis Protein 4 (HE4) testing remains investigational and non-covered for all indications, including ovarian cancer monitoring and evaluation of adnexal masses. The policy was updated with 2024 ovarian cancer statistics but the coverage determination remains unchanged.
Action Required
Immediately: Billing team must verify that CPT code 86305 (Human epididymis protein 4) is flagged as non-covered/investigational in billing system. Ensure claims for HE4 testing are not submitted as they will be denied. Inform providers that HE4 testing is considered investigational and not covered for any indication including ovarian cancer monitoring.