CommercialCoverageLow impact
Urinary Metabolite Tests for Adherence to Direct-Acting Antiviral Medications for Hepatitis C
Blue Cross & Blue Shield of Mississippi·Gastroenterology, Infectious Disease, Internal Medicine +1 more·Medical Policy
We identified it
Jun 20, 2026
Summary
Blue Cross Blue Shield has classified urinary metabolite tests for monitoring adherence to direct-acting antiviral medications for hepatitis C as investigational and not covered. This policy affects billing for urine drug level testing used to monitor patient compliance with expensive hepatitis C medications like sofosbuvir.
Action Required
Immediately: Billing team must not submit claims for CPT 80375 when used for monitoring adherence to hepatitis C direct-acting antiviral medications, as these are considered investigational and will be denied. Update billing system to flag these as non-covered when billed with hepatitis C diagnosis codes.