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Blue Shield of CaliforniaAll Plans · Coverage · Genetic Testing · CA · Genetics, Internal MedicineMedium impact

Genetic Testing for Statin-Induced Myopathy (2.04.96)

Effective date
Feb 1, 2026
Identified
Nov 1, 2025

Summary

Blue Shield of California considers genetic testing for variants in the SLCO1B1 gene to identify individuals at risk of statin-induced myopathy investigational. This version is effective February 1, 2026, and the policy statement has no changes from the previous version. The evidence is insufficient to determine that the technology results in an improvement in the net health outcome.

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What to do

Action · 4 steps
01Billing team: Refer to the member's contract benefits in effect at the time of service to determine coverage or non-coverage of SLCO1B1 testing under CPT 81328, because benefit determinations are based on the member health services contract language.
02Genetic testing for SLCO1B1 variants to identify individuals at risk of statin-induced myopathy is considered investigational under this policy.
03No records are required for clinical review.
04Direct questions about the policy's applicability to the Prior Authorization Department at (800) 541-6652.

Codes mentioned

81328

Original notice

Genetic Testing for Statin-Induced Myopathy (2.04.96)
blueshieldca.com · Always check the source before changing claims.
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Related policy hubs

Blue Shield of California policiesCA policy changesGeneticsInternal MedicineCode 81328

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