Blue Cross & Blue Shield of MississippiAll Plans · Coverage · Medical Policy · Oncology, Genetics, OB-GYNMedium impact
Germline and Somatic Biomarker Testing (Including Liquid Biopsy) for Targeted Treatment in Ovarian Cancer (BRCA1, BRCA2, Homologous Recombination Deficiency, NTRK)
Effective date
Not stated in the notice
Identified
Jun 20, 2026
Summary
BRCA1 and BRCA2 variant analysis (germline, or somatic using tumor tissue) and homologous recombination deficiency analysis of tumor tissue may be considered medically necessary for individuals with advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer to select treatment with FDA-approved targeted therapies. NTRK1, NTRK2 and NTRK3 gene fusion analysis of tumor tissue was added in the 02/03/2025 policy update and may be considered medically necessary for the same population to select FDA-approved targeted therapies. BRCA1/2 variant analysis using circulating tumor DNA may be considered medically necessary when tissue-based analysis is not clinically feasible, while all other uses of these tests to guide targeted therapy, and simultaneous liquid and tumor biopsy testing outside paired or concurrent somatic-germline testing, are considered investigational.
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01Billing team: Bill BRCA1/2 variant analysis, HRD analysis of tumor tissue, and NTRK1, NTRK2 and NTRK3 gene fusion analysis of tumor tissue as medically necessary only when the testing is used to select FDA-approved targeted therapy for advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer.
02Use BRCA1/2 circulating tumor DNA (liquid biopsy) only when tissue-based analysis is not clinically feasible.
03Do not bill other uses of these tests to guide targeted therapy, or simultaneous liquid and tumor biopsy testing outside paired or concurrent somatic-germline testing, as medically necessary, since the policy considers them investigational.
Germline and Somatic Biomarker Testing (Including Liquid Biopsy) for Targeted Treatment in Ovarian Cancer (BRCA1, BRCA2, Homologous Recombination Deficiency, NTRK)
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