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Regence BlueShieldAll Plans · Coverage · Coding · Genetics, Oncology, Neurology +4 moreMedium impact

Evaluating the Utility of Genetic Panels

Effective date
Oct 1, 2026
Identified
Jun 16, 2026

Summary

Effective October 1, 2026, a genetic panel test is considered investigational when there is not enough research to show that its genes or variants can be used to manage treatment decisions and improve net health outcomes, and the entire panel is then considered investigational, with or without optional add-on genes. Named panels from laboratories such as Blueprint Genetics, GeneDx, Invitae and Labcorp are listed as investigational, and some of them are reviewed under other cross-referenced policies.

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What to do

Action · 3 steps
01Already effective October 1, 2026: The following must be submitted for review: the name of the genetic test or panel, the name of the performing laboratory, the exact genes and variants being tested, the relevant billing codes, a brief description of how the genetic test results will guide clinical decisions that would not otherwise be made in the absence of testing, and medical records related to the test if available, including history and physical exam, conventional testing and outcomes, and conservative treatment provided.
02If a specific analyte has no listed CPT code, report unlisted code 81479 once to represent all unlisted analytes in the panel.
03Patients should receive pre- and post-test genetic counseling from a qualified professional when testing is performed to diagnose or predict susceptibility for inherited diseases.

Codes mentioned

81105811068110781108811098111081111811128117081175811768120081201812028120381205812068120781208812098121081218812198122081221812228122381224812258122681227812288122981235812408124181242812438124481245812468124781248812498125081251812528125381254812558125681257812608126181262812638126481270812728127381275812768128781288812908129181292812938129481295812968129781298812998130081302813038130481310813118131481315813168131781318813198132181322813238132481325813268133081331813328134081342813498135081355814008140181402814038140481405814068140781408814128141381432814348143781440814418144381450814518145581456814608146581470814718147981599

Original notice

Evaluating the Utility of Genetic Panels
beonbrand.getbynder.com · Always check the source before changing claims.
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Related changes

See all Regence BlueShield changes →
Lynch Syndrome and APC-associated and MUTYH-associated Polyposis SyndromesMediumEffective Feb 1, 2026 · Prior AuthorizationGenetic Testing for Hereditary Breast, Ovarian, Pancreatic and Prostate Cancer and Li-Fraumeni SyndromeMediumEffective Jun 1, 2026 · Prior AuthorizationMeasurement of Serum Antibodies to Selected Biologic AgentsMediumEffective Mar 1, 2026 · PharmacyInvestigational Gene Expression, Biomarker, and Multianalyte TestingMediumEffective Sep 1, 2026 · CodingBrowse every Regence BlueShield change in the policy list

Related policy hubs

Regence BlueShield policiesGeneticsOncologyNeurologyPsychiatryCardiologyNephrologyPharmacyCode 81105Code 81106Code 81107Code 81108Code 81109Code 81110Code 81111Code 81112Code 81170Code 81175Code 81176Code 81200Code 81201Code 81202Code 81203Code 81205Code 81206Code 81207Code 81208Code 81209Code 81210Code 81218Code 81219Code 81220Code 81221Code 81222Code 81223Code 81224Code 81225Code 81226Code 81227Code 81228Code 81229Code 81235Code 81240Code 81241Code 81242Code 81243Code 81244Code 81245Code 81246Code 81247Code 81248Code 81249Code 81250Code 81251Code 81252Code 81253Code 81254Code 81255Code 81256Code 81257Code 81260Code 81261Code 81262Code 81263Code 81264Code 81270Code 81272Code 81273Code 81275Code 81276Code 81287Code 81288Code 81290Code 81291Code 81292Code 81293Code 81294Code 81295Code 81296Code 81297Code 81298Code 81299Code 81300Code 81302Code 81303Code 81304Code 81310Code 81311Code 81314Code 81315Code 81316Code 81317Code 81318Code 81319Code 81321Code 81322Code 81323Code 81324Code 81325Code 81326Code 81330Code 81331Code 81332Code 81340Code 81342Code 81349Code 81350Code 81355Code 81400Code 81401Code 81402Code 81403Code 81404Code 81405Code 81406Code 81407Code 81408Code 81412Code 81413Code 81432Code 81434Code 81437Code 81440Code 81441Code 81443Code 81450Code 81451Code 81455Code 81456Code 81460Code 81465Code 81470Code 81471Code 81479Code 81599

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