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Molecular Diagnostic Assays and Breath Testing for Transplant Rejection - MEDICAID - VIRGINIA (Revised)

Humana·VA · Transplant Surgery, Nephrology, Cardiology +2 more·Medicaid
Effective date
Jan 1, 2025
We identified it
Jun 24, 2026
Days to comply

Summary

Humana Medicaid in Virginia does not cover any molecular diagnostic assays or breath testing for transplant rejection, including specific tests like AlloSure, TruGraf, and Heartsbreath. All requests must be referred to Humana's Corporate Transplant Department for review.

Action Required

Action needed
By January 1, 2025: Billing team must update system to deny all molecular diagnostic assays and breath testing claims for transplant rejection for Humana Medicaid Virginia members. Route all requests to Humana Corporate Transplant Department at 1-866-421-5663 or transplant@humana.com before providing services. Claims for these services will be denied as non-covered.

Affected Billing Codes

81560
81479
81370
81371
81372
81373
81374
81375
81376
81377
81378
81379
81380
81381
81382
81383
81599