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Blue Shield of CaliforniaAll Plans · Coverage · Genetic Testing · Genetics, OncologyMedium impact

Use of Common Genetic Variants (Single Nucleotide Variants) to Predict Risk of Nonfamilial Breast Cancer (2.04.63)

Effective date
Sep 1, 2026
Identified
Nov 1, 2025

Summary

Blue Shield of California considers testing for one or more common single nucleotide variants (SNVs) to predict an individual's risk of breast cancer investigational. The GeneType breast cancer risk test is considered investigational for all indications, including use as a method of estimating individual risk for developing breast cancer. This version is effective September 1, 2026, and its policy statement has no changes from the previous version.

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What to do

Action · 4 steps
01Already effective September 1, 2026: Billing team: Before billing for testing of one or more common SNVs to predict breast cancer risk, or for the GeneType breast cancer risk test, check this policy, because it considers that testing investigational for all indications.
02The coding table for this policy lists CPT 81599 (unlisted multianalyte assay with algorithmic analysis) and CPT 96041 (medical genetics and genetic counseling services, each 30 minutes).
03The policy's documentation for clinical review states that no records are required.
04The most recent policy history entry, dated 09/01/2026, covers updated policy guidelines, literature review and coding updates, so check that entry for current applicability.

Codes mentioned

8159996041

Original notice

Use of Common Genetic Variants (Single Nucleotide Variants) to Predict Risk of Nonfamilial Breast Cancer (2.04.63)
blueshieldca.com · Always check the source before changing claims.
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Related policy hubs

Blue Shield of California policiesGeneticsOncologyCode 81599Code 96041

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