CommercialPrior AuthHigh impact
Genetic Testing Update
Blue Cross Blue Shield of Nebraska·NE · Oncology, Genetics, Gastroenterology +3 more·Medical Policy
Effective date
Jul 1, 2024
We identified it
Jun 24, 2026
Summary
Blue Cross Blue Shield of Nebraska updated multiple genetic testing policies effective July 1, 2024, adding new preauthorization requirements and coverage criteria for hereditary cancer panels, circulating tumor DNA tests, and various genetic disorder screenings. All genetic testing now requires preauthorization with specific medical necessity criteria that must be met.
Action Required
By July 1, 2024: Billing team must update systems to require preauthorization for all genetic testing codes listed in the policy. Update encounter forms and EMR templates to include new medical necessity criteria documentation requirements. Staff must verify patients meet specific clinical criteria before ordering tests. Claims submitted without preauthorization will be denied.